Dietary Risk Factors for Ovarian Cancer: The Adventist Health Study (United States)

Abstract

Few prospective studies have reported dietary risk factors for ovarian cancer. A total of 71 histologically confirmed epithelial ovarian cancers occurred among 13,281 non-Hispanic white California Seventh-day Adventist women during follow-up. Participants were part of the Adventist Health Study (AHS) and had no history of cancer or hysterectomy at baseline in 1976 when they completed a detailed lifestyle questionnaire including a dietary assessment. The association of dietary variables with either all ovarian cancer cases or postmenopausal cases was tested using proportional hazards regression with adjustment for age and other covariates. The strongest hazardous risk factor associations among the food variables were found for meat intake with a risk ratio (RR) of 2.42 for intake > or = 1 time/week versus no meat (p for trend = 0.006), and cheese intake with a RR of 2.02 for intake of > 2 time/week versus < 1 per week (p for trend = 0.10), both of these being in postmenopausal cases. We found significantly reduced risk of all ovarian cancer with higher tomato consumption (RR = 0.32) comparing intakes > or = five times/week versus never to < 1 time/week (p for trend = 0.002), and also with higher fruit consumption (p < 0.01). A weak protective association was found with low fat, but not whole milk. Little confounding was observed between these foods.

A prospective study of dietary flavonoid intake and incidence of epithelial ovarian cancer

“…Additional studies have evaluated the association between flavonoid-rich foods and beverages and ovarian cancer risk. 10, Although some studies have found inverse associations with consumption of certain vegetables and fruits, tea and other dietary sources of flavonoids, 22,[26][27][28]31,33,39,42,45 overall the data are equivocal. The same flavonoid can be present in multiple foods and beverages, which suggests that an association between flavonoid intake and ovarian cancer risk could exist despite the absence of a clear association with consumption of certain flavonoid-rich foods.…”

Height, Body Mass Index, and Ovarian Cancer: A Pooled Analysis of 12 Cohort Studies

“…A pooled analysis of the primary data from 12 prospective cohort studies (13,19,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) based in North America and western Europe was conducted in the Pooling Project of Prospective Studies of Diet and Cancer. The methods have been described in detail elsewhere (41).…”

“…In the analysis regarding BMI during early adulthood, individuals whose BMI at that time was <14 or >50 kg/m 2 were excluded. The Adventist Health Study (37) and New York State Cohort (29) did not obtain information on oophorectomy at baseline; thus, we were not able to exclude individuals who had a bilateral oophorectomy before baseline in these studies.…”

“…Participants were followed from the date of the baseline questionnaire until date of diagnosis of ovarian cancer, date of death, date the participant moved out of the study area (if applicable), or end of follow-up, whichever came first. Invasive epithelial ovarian cancer was ascertained by self-report with subsequent medical record review (30,36,45), cancer registry linkage (13,19,29,34,35), or both (32,33,37,38). Some studies also obtained incident outcome and mortality information from death registries (13, 29-34, 36, 38 Relative risks (RR) and 95% confidence intervals (95% CI) were calculated by Cox proportional hazards models for each individual study.…”

“…Given the observed heterogeneity in results across studies, we investigated the association between height and body mass index (BMI) and risk of ovarian cancer in 12 cohort studies (13,19,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38), meeting the inclusion criteria for participation in the analyses of dietary factors and ovarian cancer risk as part of the Pooling Project of Prospective Studies of Diet and Cancer. We also investigated whether the associations with height and BMI varied by several risk factors for ovarian cancer.…”