Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, United States of America.
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States of America; Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.
Gynecol Oncol. 2019 Oct;155(1):105-111. doi: 10.1016/j.ygyno.2019.07.025. Epub 2019 Aug 2.
Ovarian cancer is the deadliest gynecologic malignancy, yet the effects on survival of modifiable pre-diagnosis lifestyle factors, such as obesity and physical activity, remain largely unexplored. Our objective was to evaluate the effect of pre-diagnosis BMI and physical activity on ovarian cancer mortality using prospectively collected data.
Data on women who developed ovarian cancer after enrollment into the NIH-AARP Diet and Health Study were analyzed. Cancer incidence was ascertained through linkage state cancer registries and consisted of 741 cases of epithelial ovarian cancer.
Higher pre-diagnosis BMI was associated with increased overall and ovarian cancer-specific mortality. Comparing women with BMI 25-29.9, 30-34.9 and ≥ 35 to normal weight women, the HRs of overall mortality were 1.18 (95%CI 0.96-1.45), 1.05 (0.82-1.36) and 1.59 (1.14-2.18, p-trend = 0.02). The findings were similar for ovarian cancer-specific mortality comparing women with BMI ≥ 35 to normal weight women (BMI <25) with a HR of 1.47 (95%CI 1.03-2.09, p-trend 0.08). Pre-diagnosis physical activity was not associated with mortality, with HRs for overall mortality of 1.06 (95%CI 0.79-1.43), 0.94 (0.72-1.23), 0.98 (0.76-1.25), and 0.98 (0.75-1.28, p-trend = 0.91), comparing women who engaged in vigorous physical activity 1-3 times/month, 1-2 times/week, 3-4 times/week and 5 times/week, respectively, with those who never/rarely engaged in such activity.
Women who were obese before developing ovarian cancer had increased mortality than those who were normal weight, but physical activity before diagnosis was not associated with mortality in this study population. These results suggest that maintaining a healthy weight is a powerful preventative tool.
卵巢癌是最致命的妇科恶性肿瘤，但可改变的诊断前生活方式因素（如肥胖和身体活动）对生存的影响在很大程度上仍未得到探索。我们的目的是使用前瞻性收集的数据评估诊断前 BMI 和身体活动对卵巢癌死亡率的影响。
分析了参加美国国立卫生研究院-美国退休人员协会饮食与健康研究后被诊断患有卵巢癌的女性的数据。癌症发病率通过州癌症登记处的联系确定，包括 741 例上皮性卵巢癌病例。
较高的诊断前 BMI 与总死亡率和卵巢癌特异性死亡率增加有关。与正常体重女性相比，BMI 为 25-29.9、30-34.9 和≥35 的女性的总死亡率 HR 分别为 1.18（95%CI 0.96-1.45）、1.05（0.82-1.36）和 1.59（1.14-2.18，p 趋势=0.02）。与 BMI<25 的正常体重女性相比，BMI≥35 的女性卵巢癌特异性死亡率也类似（BMI<25），HR 为 1.47（95%CI 1.03-2.09，p 趋势 0.08）。诊断前身体活动与死亡率无关，总死亡率的 HR 分别为 1.06（95%CI 0.79-1.43）、0.94（0.72-1.23）、0.98（0.76-1.25）和 0.98（0.75-1.28，p 趋势=0.91），分别比较每月 1-3 次、1-2 次/周、3-4 次/周和每周 5 次剧烈运动的女性与从不/很少进行此类活动的女性。
在诊断为卵巢癌之前肥胖的女性比体重正常的女性死亡率更高，但在本研究人群中，诊断前的身体活动与死亡率无关。这些结果表明，保持健康的体重是一种强大的预防工具。
