Ovarian cancer and body size: individual participant meta-analysis including 25,157 women with ovarian cancer from 47 epidemiological studies

Only about half the studies that have collected information on the relevance of women's height and body mass index to their risk of developing ovarian cancer have published their results, and findings are inconsistent. Here, we bring together the worldwide evidence, published and unpublished, a...

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Published inPLoS medicine Vol. 9; no. 4; p. e1001200
Main Author Cancer, Studies ofOvarian
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 2012
Public Library of Science (PLoS)
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Summary:Only about half the studies that have collected information on the relevance of women's height and body mass index to their risk of developing ovarian cancer have published their results, and findings are inconsistent. Here, we bring together the worldwide evidence, published and unpublished, and describe these relationships. Individual data on 25,157 women with ovarian cancer and 81,311 women without ovarian cancer from 47 epidemiological studies were collected, checked, and analysed centrally. Adjusted relative risks of ovarian cancer were calculated, by height and by body mass index. Ovarian cancer risk increased significantly with height and with body mass index, except in studies using hospital controls. For other study designs, the relative risk of ovarian cancer per 5 cm increase in height was 1.07 (95% confidence interval [CI], 1.05-1.09; p<0.001); this relationship did not vary significantly by women's age, year of birth, education, age at menarche, parity, menopausal status, smoking, alcohol consumption, having had a hysterectomy, having first degree relatives with ovarian or breast cancer, use of oral contraceptives, or use of menopausal hormone therapy. For body mass index, there was significant heterogeneity (p<0.001) in the findings between ever-users and never-users of menopausal hormone therapy, but not by the 11 other factors listed above. The relative risk for ovarian cancer per 5 kg/m(2) increase in body mass index was 1.10 (95% CI, 1.07-1.13; p<0.001) in never-users and 0.95 (95% CI, 0.92-0.99; p=0.02) in ever-users of hormone therapy. Ovarian cancer is associated with height and, among never-users of hormone therapy, with body mass index. In high-income countries, both height and body mass index have been increasing in birth cohorts now developing the disease. If all other relevant factors had remained constant, then these increases in height and weight would be associated with a 3% increase in ovarian cancer incidence per decade. Please see later in the article for the Editors' Summary.
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This manuscript is one of a series of papers by a group author, ‘The Collaborative Group on Epidemiological Studies of Ovarian Cancer’. Individual data from 47 separate studies have been submitted centrally by all collaborators listed in the Acknowledgments section. Each collaborator was responsible for the design of one or more of the 47 contributing epidemiological studies. All collaborators have seen this manuscript and a previous version, and their comments are incorporated here. Analyzed the data: VB CH RP GR. Wrote the first draft of the manuscript: VB CH RP GR. Contributed to the writing of the manuscript: Collaborators. ICMJE criteria for authorship read and met: VB CH RP GR. Agree with manuscript results and conclusions: Collaborators.
ISSN:1549-1676
1549-1277
1549-1676
DOI:10.1371/journal.pmed.1001200