Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
Int J Cancer. 2010 May 15;126(10):2404-15. doi: 10.1002/ijc.24952.
We examined the associations of measured anthropometric factors, including general and central adiposity and height, with ovarian cancer risk. We also investigated these associations by menopausal status and for specific histological subtypes. Among 226,798 women in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, there were 611 incident cases of primary, malignant, epithelial ovarian cancer diagnosed during a mean 8.9 years of follow-up. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for potential confounders. Compared to women with body mass index (BMI) < 25 kg/m2, obesity (BMI > or = 30 kg/m2) was associated with excess ovarian cancer risk for all women combined (HR = 1.33, 95% CI = 1.05-1.68; p(trend) = 0.02) and postmenopausal women (HR = 1.59, 95% CI = 1.20-2.10; p(trend) = 0.001), but the association was weaker for premenopausal women (HR = 1.16, 95% CI = 0.65-2.06; p(trend) = 0.65). Neither height or weight gain, nor BMI-adjusted measures of fat distribution assessed by waist circumference, waist-hip ratio (WHR) or hip circumference were associated with overall risk. WHR was related to increased risk of mucinous tumors (BMI-adjusted HR per 0.05 unit increment = 1.17, 95% CI = 1.00-1.38). For all women combined, no other significant associations with risk were observed for specific histological subtypes. This large, prospective study provides evidence that obesity is an important modifiable risk factor for epithelial ovarian cancer, particularly among postmenopausal women.
我们研究了包括一般和中心性肥胖以及身高在内的测量人体测量学因素与卵巢癌风险之间的关联。我们还根据绝经状态和特定的组织学亚型研究了这些关联。在欧洲癌症与营养前瞻性调查（EPIC）队列中，有 226798 名女性，平均随访 8.9 年后，诊断出 611 例原发性、恶性、上皮性卵巢癌。使用 Cox 比例风险模型估计风险比（HR）和 95%置信区间（CI），并调整了潜在混杂因素。与 BMI<25kg/m2 的女性相比，所有女性的肥胖症（BMI≥30kg/m2）与卵巢癌风险增加相关（HR=1.33，95%CI=1.05-1.68；p(trend)=0.02），绝经后女性（HR=1.59，95%CI=1.20-2.10；p(trend)=0.001），但对于绝经前女性，这种相关性较弱（HR=1.16，95%CI=0.65-2.06；p(trend)=0.65）。身高或体重增加，或通过腰围、腰臀比（WHR）或臀围评估的 BMI 调整后脂肪分布的测量值均与总体风险无关。WHR 与黏液性肿瘤的风险增加相关（每增加 0.05 个单位的 BMI 调整 HR=1.17，95%CI=1.00-1.38）。对于所有女性，未观察到与特定组织学亚型相关的其他显著风险关联。这项大型前瞻性研究提供了证据表明肥胖是上皮性卵巢癌的一个重要可改变风险因素，特别是在绝经后女性中。
