Abstract
Few prospective studies have reported dietary risk factors for ovarian cancer. A total of 71 histologically confirmed epithelial ovarian cancers occurred among 13,281 non-Hispanic white California Seventh-day Adventist women during follow-up. Participants were part of the Adventist Health Study (AHS) and had no history of cancer or hysterectomy at baseline in 1976 when they completed a detailed lifestyle questionnaire including a dietary assessment. The association of dietary variables with either all ovarian cancer cases or postmenopausal cases was tested using proportional hazards regression with adjustment for age and other covariates. The strongest hazardous risk factor associations among the food variables were found for meat intake with a risk ratio (RR) of 2.42 for intake ≥1 time/week versus no meat (p for trend = 0.006), and cheese intake with a RR of 2.02 for intake of >2 time/week versus <1 per week (p for trend = 0.10), both of these being in postmenopausal cases. We found significantly reduced risk of all ovarian cancer with higher tomato consumption (RR = 0.32) comparing intakes ≥ five times/week versus never to <1 time/week (p for trend = 0.002), and also with higher fruit consumption (p < 0.01). A weak protective association was found with low fat, but not whole milk. Little confounding was observed between these foods.
Similar content being viewed by others
References
A Jemal RC Tiwari T Murray (2004) ArticleTitleCancer Statistics, 2004 CA Cancer J Clin 54 IssueID1 8–29 Occurrence Handle14974761
JE Dunn (1975) ArticleTitleCancer epidemiology in populations of the United States with emphasis on Hawaii and California and Japan Cancer Res 35 3240–3245 Occurrence Handle1:STN:280:CSmD28vhtVQ%3D Occurrence Handle1192400
DP Rose AP Boyar EL Wynder (1986) ArticleTitleInternational comparisons of mortality rates for cancer of the breast, ovary, prostate and colon and per capita food consumption Cancer 58 2363–2371 Occurrence Handle1:STN:280:BiiD38jptlw%3D Occurrence Handle3768832
LH Kushi PJ Mink AR Folsom (1999) ArticleTitleProspective study of diet and ovarian cancer Am J Epidemiol 149 IssueID1 21–31 Occurrence Handle1:STN:280:DyaK1M%2FpvVamuw%3D%3D Occurrence Handle9883790
DA Snowdon (1985) ArticleTitleDiet and ovarian cancer (Letter) JAMA 254 356–357 Occurrence Handle1:STN:280:BiqB3sjotVM%3D Occurrence Handle4009856
G Ursin E Bjelke I Heuch (1990) ArticleTitleMilk consumption and cancer incidence: a Norwegian prospective Br J Cancer 61 IssueID3 456–459 Occurrence Handle1:STN:280:By%2BB38npvFI%3D Occurrence Handle2328215
Hirayama T (1981) An analytical epidemiology of ovarian cancer and possible environmental carcinogenesis (in Japanese). Med Chugai 34:282–286 (Quoted by Kushi et al. see Ref. [4])
SC Larsson L Holmberg A Wolk (2004) ArticleTitleFruit and vegetable consumption in relation to ovarian cancer incidence: The Swedish Mammography Cohort Br J Cancer 90 2167–2170 Occurrence Handle1:STN:280:DC%2BD2c3msVOrtw%3D%3D Occurrence Handle15150575
DW Cramer WR Welch GB Hutchison W Willett RE Scully (1984) ArticleTitleDietary animal fat in relation to ovarian cancer risk Obstet Gynecol 63 833–838 Occurrence Handle1:STN:280:BiuB38%2Fmt1Y%3D Occurrence Handle6728366
HA Risch LD Marrett M Jain et al. (1996) ArticleTitleDifferences in risk factors for epithelial ovarian cancer by histologic type. Results of a case-control study Am J Epidemiol 144 IssueID4 363–372 Occurrence Handle1:STN:280:BymA3MnnvVU%3D Occurrence Handle8712193
XO Shu YT Gao JM Yuan et al. (1989) ArticleTitleDietary factors and epithelial ovarian cancer Br J Cancer 59 92–96 Occurrence Handle1:STN:280:BiaA3srltV0%3D Occurrence Handle2757927
C Vecchia ParticleLa A Decarli E Negri et al. (1987) ArticleTitleDietary factors and risk of epithelial ovarian cancer J Natl Cancer Inst 79 663–669 Occurrence Handle3116309
M Mori H Miyake (1988) ArticleTitleDietary and other risk factors of ovarian cancer among elderly women Jpn J Cancer Res 79 997–1004 Occurrence Handle1:STN:280:BiaD2MzotVU%3D Occurrence Handle3142839
M Mori I Harabuchi H Miyake (1988) ArticleTitleReproductive, genetic, and dietary risk factors for ovarian cancer AM J Epidemiol 128 771–777 Occurrence Handle1:STN:280:BieA3sflvFM%3D Occurrence Handle3421242
M Slattery KL Schuman DW West (1989) ArticleTitleNutrient intake and ovarian cancer Am J Epidemiol 130 497–502 Occurrence Handle1:STN:280:BiaA2cbhsFw%3D Occurrence Handle2763995
ER Bertone SE Hankinson PA Newcomb (2001) ArticleTitleA population-based case-control study of carotenoid and vitamin A intake and ovarian cancer (United States) Cancer Causes Control 12 83–90 Occurrence Handle10.1023/A:1008985015927 Occurrence Handle1:STN:280:DC%2BD3M3ksVyktA%3D%3D Occurrence Handle11227928
CJ Mettlin MS Piver (1990) ArticleTitleA case-control study of milk-drinking and ovarian cancer risk Am J Epidemiol 132 871–876 Occurrence Handle1:STN:280:By6D2M7kvFU%3D Occurrence Handle2239901
PM Webb CJ Bain DM Purdie PWJ Harvey A Green (1998) ArticleTitleMilk consumption, galactose metabolism and ovarian cancer (Australia) Cancer Causes Control 9 637–644 Occurrence Handle10.1023/A:1008891714412 Occurrence Handle1:STN:280:DyaK1M3gt12gsQ%3D%3D Occurrence Handle10189050
HA Risch M Jain LD Marrett (1994) ArticleTitleDietary fat intake and risk of epithelial ovarian cancer J Natl Cancer Inst 86 1409–1415 Occurrence Handle1:STN:280:ByuA2M7ns1U%3D Occurrence Handle8072035
DW Cramer BL Harlow WC Willett (1989) ArticleTitleGalactose consumption and metabolism in relation to the risk of ovarian cancer Lancet 2 66–71 Occurrence Handle1:CAS:528:DyaL1MXlslaru7s%3D Occurrence Handle2567871
SE McCann JL Freudenheim JR Marshall S Graham (2004) ArticleTitleRisk of ovarian cancer is related to dietary intake of selected nutrients, phytochemicals and food groups J Nutr 133 1937–1942
SY Pan AM Ugnat Y Mao SW Wen KC Johnson (2004) ArticleTitleCanadian Cancer Registries Epidemiology Research Group. A case-control study of diet and risk of ovarian cancer Cancer Epidemiol Biomarkers 13 1521–1527
R Harris AS Whittemore J Itnyre (1992) ArticleTitleCharacteristics relating to ovarian cancer risk: collaborative analysis of 12 case-control studies. III. Epithelial tumors of low malignant potential in white women Am J Epidemiol 136 1204–1211 Occurrence Handle1:STN:280:ByyC3MfmtlA%3D Occurrence Handle1476142
WL Beeson PK Mills RL Phillips (1989) ArticleTitleChronic disease among Seventh-day Adventist, A low risk group Cancer 64 557–581
RL Phillips (1975) ArticleTitleRole of lifestyle and dietary habits in risk of cancer among Seventh-day Adventists Cancer Res 35 IssueIDSuppl 3513–3522 Occurrence Handle1:STN:280:CSmD28vhsVU%3D Occurrence Handle1192416
GE Fraser (2003) Diet, Life Expectancy and Chronic Disease. Studies of Seventh-day Adventists and other Vegetarians Oxford University Press New York
GE Fraser PW Dysinger C Best (1987) ArticleTitleIHD risk factors in middle-aged Seventh-day Adventist men and their neighbors Am J Epidemiol 126 638–646 Occurrence Handle1:STN:280:BiiA38zhvVw%3D Occurrence Handle3631054
E White LH Kushi MS Pepe (1994) ArticleTitleThe effect of exposure variance and exposure measurement error on study sample size: implications for the design of epidemiologic studies J Clin Epidemiol 47 873–880 Occurrence Handle1:STN:280:ByqB2cfjslE%3D Occurrence Handle7730890
Beeson WL, Fraser GE, Mills PK (1990) Validation of record linkage to 2 California population-based tumor registries in a cohort study. Proceedings of the 1989 Public Health Conference on Records and Statistics. DHHS publication No. (PHS) 90-1214, 1990, pp. 196–201
DE Abbey N Nishino WF McDonnell (1999) ArticleTitleLong-term inhalable particles and other air pollutants related to mortality in non-smokers Am J Respir Crit Care Med 159 373–382 Occurrence Handle1:STN:280:DyaK1M7is1KmsQ%3D%3D Occurrence Handle9927346
PN Singh GE Fraser (1998) ArticleTitleDietary risk factors for Colon cancer in a low-risk population Am J Epidemiol 148 761–774 Occurrence Handle1:STN:280:DyaK1M%2FgtVWksg%3D%3D Occurrence Handle9786231
SF Serov RE Scully LH Sobin (1973) International Histological Classification of Tumors. No. 9. Histological Typing of Ovarian Tumors World Health Organization Geneva, Switzerland
JM Piper DL Kennedy (1987) ArticleTitleOral contraceptives in the United States: trends in content and potency Int J Epidemiol 16 215–221 Occurrence Handle1:STN:280:BiiB2sfnvFY%3D Occurrence Handle3301706
NE Breslow NE Day (1987) ArticleTitleStatistical methods in cancer research. Volume II-The design and analysis of cohort studies LARC Sci Publ 82 1–406
SAS/STAT Users Guide, Version 6, SAS Institute, Cary, 1998
HT Lynch WA Albano JF Lynch (1982) ArticleTitleSurveillance and management of patients at high genetic risk for ovarian carcinoma Obstet Gynecol 59 589–596 Occurrence Handle1:STN:280:Bi2C2sznt1w%3D Occurrence Handle7070730
S Franceschi E Bidoli C La Vecchia (1994) ArticleTitleTomatoes and risk of digestive-tract cancers Int J Cancer 59 IssueID2 181–184 Occurrence Handle1:STN:280:ByqD3M3os1E%3D Occurrence Handle7927916
E DeStafani P Boffetta F Oreggia et al. (2000) ArticleTitlePlant foods and risk of laryngeal cancer: a case-control study in Uruguay Int J Cancer 87 IssueID1 129–132
PH Gann J Ma E Giovannucci (1999) ArticleTitleLower prostate cancer risk in men with elevated plasma lycopene levels: results of a prospective analysis Cancer Res 59 IssueID60 1225–1230 Occurrence Handle1:CAS:528:DyaK1MXhvFehtLo%3D Occurrence Handle10096552
PK Mills WL Beeson RL Phillips GE Fraser (1989) ArticleTitleCohort study of diet, lifestyle, and prostate cancer in Adventist men Cancer 64 598–604 Occurrence Handle1:STN:280:BiaA3czntFY%3D Occurrence Handle2743254
KA Steinmetz JD Potter (1991) ArticleTitleVegetables, fruit, and cancer. II. Mechanisms Cancer Causes control 2 427–442 Occurrence Handle1:STN:280:By2C3M%2FkvFw%3D Occurrence Handle1764568
Potter JD (ed.) (1997) Food, Nutrition, the Prevention of Cancer: A Global Perspective. Washington DC: World Cancer Research Fund and American Institute for Cancer Research, 445 pp
KM Fairfield SE Hankinson BA Rosner DJ Hunter GA Colditz WC Willet (2001) ArticleTitleRisk of ovarian cancer and consumption of vitamins A, C and E and specific carotenoids Cancer 92 2318–2326 Occurrence Handle10.1002/1097-0142(20011101)92:9<2318::AID-CNCR1578>3.0.CO;2-7 Occurrence Handle1:CAS:528:DC%2BD3MXotl2itLk%3D Occurrence Handle11745286
B Armstrong R Doll (1975) ArticleTitleEnvironmental factors and cancer incidence in different countries, with special reference to dietary factors Int J Cancer 15 617–631 Occurrence Handle1:STN:280:CSqC1cfmsVw%3D Occurrence Handle1140864
ER Bertone BA Rosner DJ Hunter (2002) ArticleTitleDietary fat intake and ovarian cancer in a cohort of U.S. women Am J Epidemiol 156 22–31 Occurrence Handle12076885
WC Willett MJ Stampfer GA Colditz (1990) ArticleTitleRelation of meat, fat and fiber intake to the risk of colon cancer among women N Engl J Med 323 1664–1672 Occurrence Handle1:STN:280:By6D2c3pt1Q%3D Occurrence Handle2172820
C Meester Particlede GB Gerber (1995) ArticleTitleThe role of cooked food mutagens as possible etiological agents in human cancer. A critical appraisal of recent epidemiological investigations Rev Epidemiol Sante Publique 43 IssueID2 147–161 Occurrence Handle7732201
K Augustsson K Skag M Jagerstad (1999) ArticleTitleDietary heterocyclic amines and cancer of the colon, rectum, bladder and kidney: a population-based study Lancet 353 703–707 Occurrence Handle10.1016/S0140-6736(98)06099-1 Occurrence Handle1:STN:280:DyaK1M7ntFGhsg%3D%3D Occurrence Handle10073512
M Jagerstad K Skog S Grivas (1991) ArticleTitleFormation of heterocyclic amines using model systems Mutat Res 259 219–233 Occurrence Handle1:STN:280:By6B3czpvFc%3D Occurrence Handle2017209
H Ushiyama K Wakabayashi M Hirose (1991) ArticleTitlePresence of carcinogenic heterocyclic amines in urine of healthy volunteers eating normal diet, but not of inpatients receiving parenteral alimentation Carcinogenesis 12 1417–1422 Occurrence Handle1:CAS:528:DyaK3MXlsFOgur0%3D Occurrence Handle1907222
S Bingham (1997) ArticleTitleMeat, starch and non-starch polysaccharides. Are epidemiologic and experimental findings consistent with acquired genetic alterations in sporadic colorectal cancer? Cancer Lett 114 25–34 Occurrence Handle10.1016/S0304-3835(97)04618-1 Occurrence Handle1:CAS:528:DyaK2sXit1ehsbs%3D Occurrence Handle9103247
DW Cramer (1989) ArticleTitleLactase persistence and milk consumption as determinants of ovarian cancer risk Am J Epidemiol 130 904–910 Occurrence Handle1:STN:280:By%2BD2MzltFU%3D Occurrence Handle2510499
KM Fairfield DJ Hunter GA Colditz (2004) ArticleTitleA prospective study of dietary lactose and ovarian cancer Int J Cancer 110 271–277 Occurrence Handle10.1002/ijc.20086 Occurrence Handle1:CAS:528:DC%2BD2cXjvVeiur8%3D Occurrence Handle15069693
MT Goodman AH Wu K-H Tung (2002) ArticleTitleAssociation of dairy products, lactose and calcium with the risk of ovarian cancer Am J Epidemiol 156 148–157 Occurrence Handle12117706
AS Whittemore R Harris J Itnyre (1992) ArticleTitleCharacteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white women Am J Epidemiol 136 1204–1211 Occurrence Handle1476142
Y Chen PC Wu JH Lang (1992) ArticleTitleRisk factors for epithelial ovarian cancer in Beijing, China Int J Epidemiol 21 23–29 Occurrence Handle1:CAS:528:DyaK3sXitlOjsr8%3D Occurrence Handle1544753
ML Wu AS Whittemore RS Paffenbarger SuffixJr (1988) ArticleTitlePersonal and environmental characteristics related to epithelial ovarian cancer. I. Reproductive and menstrual events and oral contraceptive use Am J Epidemiol 128 1216–1227 Occurrence Handle1:STN:280:BiaD28%2FisVQ%3D Occurrence Handle3195563
L Titus-Ernstoff K Perez DW Cramer (2001) ArticleTitleMenstrual and reproductive factors in relation to ovarian cancer risk Br J Cancer 84 IssueID5 714–721 Occurrence Handle10.1054/bjoc.2000.1596 Occurrence Handle1:STN:280:DC%2BD3M3hslSrsQ%3D%3D Occurrence Handle11237375
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kiani, F., Knutsen, S., Singh, P. et al. Dietary Risk Factors for Ovarian Cancer: The Adventist Health Study (United States). Cancer Causes Control 17, 137–146 (2006). https://doi.org/10.1007/s10552-005-5383-z
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s10552-005-5383-z