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Risk of ovarian cancer in the United States in relation to anthropometric measures: does the association depend on menopausal status?

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Abstract

Objective: To elucidate the association between anthropometric measures and ovarian cancer risk. Methods: From a population-based study of 563 cases of ovarian cancer and 523 controls we recorded weight, both at index age and age 18, and height using an in-person questionnaire, and used these to calculate body mass index (BMI). Multivariate logistic regression was used to calculate the exposure odds ratios, adjusted for established risk factors, stratified, in turn, by menopausal status and histologic type of ovarian cancer. Results: Height, weight, and BMI were unrelated to risk for ovarian cancer in the total group of cases and controls. After stratification by menopausal status, weight and BMI were associated positively with risk among premenopausal women, but did not affect risk postmenopausally. High BMI, weight, and height were most strongly related to risk of serous borderline cancer, particularly among premenopausal women. The association did not appear to be confined only to those overweight women with gynecologic problems such as irregular periods or ovarian cysts. Conclusions: Weight and BMI are positively related to premenopausal ovarian cancer risk in this population-based case–control study. This association is particularly noted for serous borderline tumors. This may suggest the importance of endocrine factors, which are altered in overweight women, such as insulin or androgens.

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References

  1. Bergstrom A, Pisani P, Tenet V, Wolk A, Adami HO (2001) Overweight as an avoidable cause of cancer in Europe. Int J Cancer 91: 421-430.

    Google Scholar 

  2. Chute CG, Willett WC, Colditz GA, et al. (1991) A prospective study of body mass, height, and smoking on the risk of colorectal cancer in women. Cancer Causes Control 2: 117-124.

    Google Scholar 

  3. Suadicani P, Hein HO, Gyntelberg F (1993) Height, weight, and risk of colorectal cancer. An 18-year follow-up in a cohort of 5249 men. Scand J Gastroenterol 28: 285-288.

    Google Scholar 

  4. Tretli S, Magnus K (1990) Height and weight in relation to uterine corpus cancer morbidity and mortality. A follow-up study of 570,000 women in Norway. Int J Cancer 46: 165-172.

    Google Scholar 

  5. Tretli S, Robsahm TE (1999) Height, weight and cancer of the oesophagus and stomach: a follow-up study in Norway. Eur J Cancer Prev 8: 115-122.

    Google Scholar 

  6. van den Brandt PA, Spiegelman D, Yaun SS, et al. (2000) Pooled analysis of prospective cohort studies on height, weight, and breast cancer risk. Am J Epidemiol 152: 514-527.

    Google Scholar 

  7. Madigan MP, Troisi R, Potischman N, Dorgan JF, Brinton LA, Hoover RN (1998) Serum hormone levels in relation to reproductive and lifestyle factors in postmenopausal women (United States). Cancer Causes Control 9: 199-207.

    Google Scholar 

  8. Signorello LB, Kuper H, Lagiou P, et al. (2000) Lifestyle factors and insulin-like growth factor 1 levels among elderly men. Eur J Cancer Prev 9: 173-178.

    Google Scholar 

  9. Arnesen E, Forsdahl A (1985) The Tromso heart study: coronary risk factors and their association with living conditions during childhood. J Epidemiol Commun Health 39: 210-214.

    Google Scholar 

  10. Frost C, Coleman MP (1997) Obesity and ovarian cancer. Eur J Cancer 33: 1529-1531.

    Google Scholar 

  11. Risch HA, Marrett LD, Jain M, Howe GR (1996) Differences in risk factors for epithelial ovarian cancer by histologic type. Results of a case-control study. Am J Epidemiol 144: 363-372.

    Google Scholar 

  12. Titus-Ernstoff L, Perez K, Cramer DW, Harlow BL, Baron JA, Greenberg ER(2001) Menstrual and reproductive factors in relation to ovarian cancer risk. Br J Cancer 84: 714-721.

    Google Scholar 

  13. Cramer DW, Harlow BL, Titus-Ernstoff L, Bohlke K, Welch WR, Greenberg ER(1998) Over-the-counter analgesics and risk of ovarian cancer. Lancet 351: 104-107.

    Google Scholar 

  14. Bohlke K, Harlow BL, Cramer DW, Spiegelman D, Mueller NE (1999) Evaluation of a population roster as a source of population controls: the Massachusetts Residents lists. Am J Epidemiol 150: 354-358.

    Google Scholar 

  15. Hsieh CC, Maisonneuve P, Boyle P, Macfarlane GJ, Roberston C (1991) Analysis of quantitative data by quantiles in epidemiologic studies: classification according to cases, noncases, or all subjects? Epidemiology 2: 137-140.

    Google Scholar 

  16. Breslow NE, Day NE (1980) Statistical Methods in Cancer Research, Vol. I: The Analysis of Case-Control Studies. Lyon: IARC Scientific Publication no. 32, pp. 5-338.

    Google Scholar 

  17. Wertheim I, Tangir J, Muto MG, et al. (1996) Loss of heterozygosity of chromosome 17 in human borderline and invasive epithelial ovarian tumors. Oncogene 12: 2147-2153.

    Google Scholar 

  18. Scully RS (1979) Tumors of the Ovary and Maldeveloped Gonads. Atlas of Tumor Pathology. Washington, DC: Armed Forces Institute of Pathology.

    Google Scholar 

  19. Kahn JA, Gordon CM (1999) Polycystic ovary syndrome. Adolesc Med 10: 321-336.

    Google Scholar 

  20. Shu XO, Gao YT, Yuan JM, Ziegler RG, Brinton LA (1989) Dietary factors and epithelial ovarian cancer. Br J Cancer 59: 92-96.

    Google Scholar 

  21. Cramer DW, Welch WR, Hutchison GB, Willett W, Scully RE (1984) Dietary animal fat in relation to ovarian cancer risk. Obstet Gynecol 63: 833-838.

    Google Scholar 

  22. Wolk A, Gridley G, Svensson M, et al. (2001) A prospective study of obesity and cancer risk (Sweden). Cancer Causes Control 12: 13-21.

    Google Scholar 

  23. Hildreth NG, Kelsey JL, LiVolsi VA, et al. (1981) An epidemiologic study of epithelial carcinoma of the ovary. Am J Epidemiol 114: 398-405.

    Google Scholar 

  24. Mink PJ, Folsom AR, Sellers TA, Kushi LH (1996) Physical activity, waist-to-hip ratio, and other risk factors for ovarian cancer: a follow-up study of older women. Epidemiology 7: 38-45.

    Google Scholar 

  25. Beard CM, Hartmann LC, Atkinson EJ, et al. (2000) The epidemiology of ovarian cancer: a population-based study in Olmsted County, Minnesota, 1935-1991. Ann Epidemiol 10: 14-23.

    Google Scholar 

  26. Folsom AR, Kushi LH, Anderson KE, et al. (2000) Associations of general and abdominal obesity with multiple health outcomes in older women. Arch Intern Med 160: 2117-2128.

    Google Scholar 

  27. Byers T, Marshall J, Graham S, Mettlin C, Swanson M (1983) A case-control study of dietary and nondietary factors in ovarian cancer. J Natl Cancer Inst 71: 681-686. 462 H. Kuper et al.

    Google Scholar 

  28. Tornberg SA, Carstensen JM (1994) Relationship between Quetelet's index and cancer of breast and female genital tract in 47,000 women followed for 25 years. Br J Cancer 69: 358-361.

    Google Scholar 

  29. Polychronopoulou A, Tzonou A, Hsieh CC, et al. (1993) Reproductive variables, tobacco, ethanol, coffee and somatometry as risk factors for ovarian cancer. Int J Cancer 55: 402-407.

    Google Scholar 

  30. Mori M, Kiyosawa H, Miyake H (1984) Case-control study of ovarian cancer in Japan. Cancer 53: 2746-2752.

    Google Scholar 

  31. Key TJ, Allen NE, Verkaslo PK, Banks E (2001) Energy balance and cancer: the role of sex hormones. Proc Nutr Soc 60: 81-89.

    Google Scholar 

  32. Dale PO, Tanbo T, Vaaler S, Abyholm T (1992) Body weight, hyperinsulinemia, and gonadotropin levels in the polycystic ovarian syndrome: evidence of two distinct populations. Fertil Steril 58: 487-491.

    Google Scholar 

  33. Wajchenberg BL, Marcondes JA, Mathor MB, Achando SS, Germak OA, Kirschner MA (1989) Free testosterone levels during the menstrual cycle in obese versus normal women. Fertil Steril 51: 535-537.

    Google Scholar 

  34. Wu S, Donigan A, Platsoucas CD, et al. (1997) All trans-retinoic acids blocks cell cycle progression of human ovarian adenocarcinoma cells at late G1. Exp Cell Res 232: 277-286.

    Google Scholar 

  35. Yam D, Ben-Hur H, Fink A, et al. (1994) Insulin and glucose tolerance status, tissue and plasma lipids in patients with tumours of the ovary or endometrium; possible dietary implications. Br J Cancer 70: 1186-1187.

    Google Scholar 

  36. Nestler JE (2000) Obesity, insulin, sex steroids and ovulation. Int J Obes Relat Metab Disord 24: S71-73.

    Google Scholar 

  37. Risch HA (1998) Hormonal etiology of epithelial ovarian cancer, with a hypothesis concerning the role of androgens and progesterone. J Natl Cancer Inst 90: 150-155.

    Google Scholar 

  38. Silva EG, Tornos C, Fritsche HA Jr, et al. (1997) The induction of benign epithelial neoplasms of the ovaries of guinea pigs by testosterone stimulation: a potential animal model. Mod Pathol 10: 879-883.

    Google Scholar 

  39. Slotman BJ, Rao BR (1989) Response to inhibition of androgen action of human ovarian cancer cells in vitro. Cancer Lett 45: 213-220.

    Google Scholar 

  40. Helzlsouer KJ, Alberg AJ, Gordon GB, et al. (1995) Serum gonadotropins and steroid hormones and the development of ovarian cancer. JAMA 274: 1926-1930.

    Google Scholar 

  41. Cardillo MR, Petrangeli E, Aliotta N, et al. (1998) Androgen receptors in ovarian tumors: correlation with oestrogen and progesterone receptors in an immunohistochemical and semiquantitative image analysis study. J Exp Clin Cancer Res 17: 231-237.

    Google Scholar 

  42. Chamberlain NL, Driver ED, Miesfeld RL (1994) The length and location of CAG trinucleotide repeats in the androgen receptor Nterminal domain affect transactivation function. Nucl Acids Res 22: 3181-3186.

    Google Scholar 

  43. Choong CS, Kemppainen JA, Zhou ZX, Wilson EM (1996) Reduced androgen receptor gene expression with first exon CAG repeat expansion. Mol Endocrinol 10: 1527-1535.

    Google Scholar 

  44. Levine DA, Boyd J (2001) The androgen receptor and genetic susceptibility to ovarian cancer: results from a case series. Cancer Res 61: 908-911.

    Google Scholar 

  45. Schildkraut JM, Schwingl PJ, Bastos E, Evanoff A, Hughes C (1996) Epithelial ovarian cancer risk among women with polycystic ovary syndrome. Obstet Gynecol 88: 554-559.

    Google Scholar 

  46. Rodriguez GC, Walmer DK, Cline M, et al. (1998) Effect of progestin on the ovarian epithelium of macaques: cancer prevention through apoptosis? J Soc Gynecol Investig 5: 271-276.

    Google Scholar 

  47. Mantzoros CS, Moschos SJ (1998) Leptin: in search of roles in human physiology and pathophysiology. Clin Endocrinol 49: 551-567.

    Google Scholar 

  48. Kuper H, Titus-Ernstoff L, Harlow BL, Cramer DW (2000) Population based study of coffee, alcohol and tobacco use and risk of ovarian cancer. Int J Cancer 88: 313-318.

    Google Scholar 

  49. Purdie DM, Siskind V, Bain CJ, Webb PM, Green AC (2001) Reproduction-related risk factors for mucinous and nonmucinous epithelial ovarian cancer. Am J Epidemiol 153: 860-864.

    Google Scholar 

  50. Adler AI, Weiss NS, Kamb ML, Lyon JL (1996) Is diabetes mellitus a risk factor for ovarian cancer? A case-control study in Utah and Washington (United States). Cancer Causes Control 7: 475-478.

    Google Scholar 

  51. Bertone ER, Willett WC, Rosner BA, et al. (2001) Prospective study of recreational physical activity and ovarian cancer. J Natl Cancer Inst 93: 942-948.

    Google Scholar 

  52. Harlow BL, Cramer DW, Baron JA, Titus-Ernstoff L, Greenberg ER(1998) Psychotropic medication use and risk of epithelial ovarian cancer. Cancer Epidemiol Biomarkers Prev 7: 697-702.

    Google Scholar 

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Kuper, H., Cramer, D.W. & Titus-Ernstoff, L. Risk of ovarian cancer in the United States in relation to anthropometric measures: does the association depend on menopausal status?. Cancer Causes Control 13, 455–463 (2002). https://doi.org/10.1023/A:1015751105039

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