Recreational physical inactivity and mortality in women with invasive epithelial ovarian cancer: evidence from the Ovarian Cancer Association Consortium.
Little is known about modifiable behaviours that may be associated with epithelial ovarian cancer (EOC) survival. We conducted a pooled analysis of 12 studies from the Ovarian Cancer Association Consortium to investigate the association between pre-diagnostic physical inactivity and mortality.



Participants included 6806 women with a primary diagnosis of invasive EOC. In accordance with the Physical Activity Guidelines for Americans, women reporting no regular, weekly recreational physical activity were classified as inactive. We utilised Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) representing the associations of inactivity with mortality censored at 5 years.



In multivariate analysis, inactive women had significantly higher mortality risks, with (HR=1.34, 95% CI: 1.18-1.52) and without (HR=1.22, 95% CI: 1.12-1.33) further adjustment for residual disease, respectively.



In this large pooled analysis, lack of recreational physical activity was associated with increased mortality among women with invasive EOC.
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA.
Rikki A
RA
Cannioto
Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA.
Michael J
MJ
LaMonte
Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
Linda E
LE
Kelemen
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
Harvey A
HA
Risch
Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY, USA.
Kevin H
KH
Eng
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA.|Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA.
Albina N
AN
Minlikeeva
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA.
Chi-Chen
CC
Hong
Department of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA.
J Brian
JB
Szender
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA.
Lara
L
Sucheston-Campbell
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA.
Janine M
JM
Joseph
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
Andrew
A
Berchuck
Unit of Genetic Epidemiology, Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.|Germany and University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jenny
J
Chang-Claude
Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Daniel W
DW
Cramer
Department of Gynecological Oncology, Westmead Hospital and The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia.
Anna
A
DeFazio
Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA.
Brenda
B
Diergaarde
Gynecology Research Unit, Hannover Medical School, Hannover, Germany.
Thilo
T
Dörk
Department of Epidemiology, The Geisel School of Medicine at Dartmouth Medical, Hanover, NH, USA.
Jennifer A
JA
Doherty
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.|Ovarian Cancer Center of Excellence, Women's Cancer Research Program, Magee-Women's Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
Robert P
RP
Edwards
Biostatistics and Informatics Shared Resource, University of Kansas Medical Center, Kansas City, KS, USA.
Brooke L
BL
Fridley
Independent Health, Buffalo, NY, USA.
Grace
G
Friel
Department of Health Science Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA.
Ellen L
EL
Goode
Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Marc T
MT
Goodman
Hannover Medical School, Clinics of Gynaecology and Obstetrics, Hannover, Germany.
Peter
P
Hillemanns
Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.|Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Estrid
E
Hogdall
Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan.
Satoyo
S
Hosono
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Joseph L
JL
Kelley
Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.|Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Susanne K
SK
Kjaer
Hannover Medical School, Clinics of Gynaecology and Obstetrics, Hannover, Germany.
Rüdiger
R
Klapdor
Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan.
Keitaro
K
Matsuo
Department of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA.
Kunle
K
Odunsi
Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
Christina M
CM
Nagle
Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
Catherine M
CM
Olsen
New Jersey State Cancer Registry, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
Lisa E
LE
Paddock
Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA.
Celeste L
CL
Pearce
Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY, USA.
Malcolm C
MC
Pike
Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Mary A
MA
Rossing
Department of Gynecology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Barbara
B
Schmalfeldt
Departments of Immunology and Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA.
Brahm H
BH
Segal
Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
Elizabeth A
EA
Szamreta
Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Pamela J
PJ
Thompson
Department of Preventive Medicine, Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
Chiu-Chen
CC
Tseng
Department of Health Science Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
Robert
R
Vierkant
Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA.
Joellen M
JM
Schildkraut
Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch, National Cancer Institute, Bethesda, MD, USA.
Nicolas
N
Wentzensen
Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Kristine G
KG
Wicklund
Department of Health Science Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
Stacey J
SJ
Winham
Department of Preventive Medicine, Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
Anna H
AH
Wu
Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA.|Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.|Ovarian Cancer Center of Excellence, Women's Cancer Research Program, Magee-Women's Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
Francesmary
F
Modugno
The University of Texas School of Public Health, Houston, TX, USA.
Roberta B
RB
Ness
Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
Allan
A
Jensen
Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
Penelope M
PM
Webb
Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Kathryn
K
Terry
Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
Elisa V
EV
Bandera
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA.
Kirsten B
KB
Moysich
D000077216:Carcinoma, Ovarian Epithelial; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000401:mortality*; D010051:Ovarian Neoplasms / Q000401:mortality*; D016016:Proportional Hazards Models; D011998:Recreation / Q000502:physiology*; D012307:Risk Factors