Tworoger Shelley S, Gertig Dorota M, Gates Margaret A, Hecht Jonathan L, Hankinson Susan E
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Cancer. 2008 Mar 1;112(5):1169-77. doi: 10.1002/cncr.23275.
Smoking, caffeine, and alcohol intake are all potentially modifiable factors that have an unclear association with ovarian cancer risk. Therefore, the associations between these exposures and ovarian cancer risk were prospectively examined among 110,454 women in the Nurses' Health Study (NHS) for the smoking analyses and 80,253 women for the dietary analyses.
Women completed biennial questionnaires assessing ovarian cancer risk factors beginning in 1976, with food frequency questionnaires administered every 2 to 4 years starting in 1980. For the smoking analyses, 737 confirmed cases of epithelial ovarian cancer were identified and for the dietary aims, 507 cases were identified through June 1, 2004.
Compared with never-smokers, neither current nor past smoking was associated with ovarian cancer risk overall; however, both were associated with mucinous tumors (n = 69; rate ratio [RR], past = 2.02 [95% confidence interval (CI), 1.15-3.55]; RR, current = 2.22 [95% CI, 1.16-4.24]). A modest inverse association between caffeine intake and ovarian cancer risk was observed (RR, top vs bottom quintile = 0.80; 95% CI, 0.60-1.07 [P = .03]), which was strongest for women who had never used either oral contraceptives (RR = 0.65; 95% CI, 0.46-0.92 [P for heterogeneity = .02]) or postmenopausal hormones (RR = 0.57; 95% CI, 0.36-0.91 [P for heterogeneity = .13]). Alcohol was not associated with ovarian cancer risk.
The results of the current study suggest that cigarette smoking may only increase the risk for mucinous ovarian tumors, and alcohol intake was not associated with risk. However, an inverse association was observed between caffeine intake and ovarian cancer risk, particularly in women not using hormones; this finding merits further study.
吸烟、咖啡因和酒精摄入都是潜在的可改变因素，它们与卵巢癌风险之间的关联尚不清楚。因此，在护士健康研究（NHS）中，对110454名女性进行了吸烟分析，对80253名女性进行了饮食分析，前瞻性地研究了这些暴露因素与卵巢癌风险之间的关联。
女性从1976年开始每两年完成一次评估卵巢癌风险因素的问卷，从1980年开始每2至4年进行一次食物频率问卷调查。在吸烟分析中，确定了737例确诊的上皮性卵巢癌病例；在饮食分析中，截至2004年6月1日确定了507例病例。
与从不吸烟者相比，目前吸烟和既往吸烟总体上均与卵巢癌风险无关；然而，两者均与黏液性肿瘤相关（n = 69；率比[RR]，既往吸烟= 2.02 [95%置信区间（CI），1.15 - 3.55]；RR，目前吸烟= 2.22 [95% CI，1.16 - 4.24]）。观察到咖啡因摄入与卵巢癌风险之间存在适度的负相关（RR，最高五分位数与最低五分位数相比= 0.80；95% CI，0.60 - （此处原文有误，应为1.07）1.07 [P = .03]），这在从未使用过口服避孕药（RR = 0.65；95% CI，0.46 - 0.92 [异质性P = .02]）或绝经后激素（RR = 0.57；95% CI，0.36 - 0.91 [异质性P = .13]）的女性中最为明显。酒精与卵巢癌风险无关。
本研究结果表明，吸烟可能仅增加黏液性卵巢肿瘤的风险，而酒精摄入与风险无关。然而，观察到咖啡因摄入与卵巢癌风险之间存在负相关，尤其是在未使用激素的女性中；这一发现值得进一步研究。
