Advertisement

Cancer Causes & Control

, Volume 17, Issue 2, pp 137–146 | Cite as

Dietary Risk Factors for Ovarian Cancer: The Adventist Health Study (United States)

  • Fatemeh Kiani
  • Synnove Knutsen
  • Pramil Singh
  • Giske Ursin
  • Gary Fraser
Original Paper

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.

Keywords

Ovarian cancer Seventh-day adventist Cohort study Meat Tomatoes Fruit  

References

  1. 1.
    Jemal, A, Tiwari, RC, Murray, T 2004Cancer Statistics, 2004CA Cancer J Clin54829PubMedGoogle Scholar
  2. 2.
    Dunn, JE 1975Cancer epidemiology in populations of the United States with emphasis on Hawaii and California and JapanCancer Res3532403245PubMedGoogle Scholar
  3. 3.
    Rose, DP, Boyar, AP, Wynder, EL 1986International comparisons of mortality rates for cancer of the breast, ovary, prostate and colon and per capita food consumptionCancer5823632371PubMedGoogle Scholar
  4. 4.
    Kushi, LH, Mink, PJ, Folsom, AR 1999Prospective study of diet and ovarian cancerAm J Epidemiol1492131PubMedGoogle Scholar
  5. 5.
    Snowdon, DA 1985Diet and ovarian cancer(Letter) JAMA254356357PubMedGoogle Scholar
  6. 6.
    Ursin, G, Bjelke, E, Heuch, I 1990Milk consumption and cancer incidence: a Norwegian prospectiveBr J Cancer61456459PubMedGoogle Scholar
  7. 7.
    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])Google Scholar
  8. 8.
    Larsson, SC, Holmberg, L, Wolk, A 2004Fruit and vegetable consumption in relation to ovarian cancer incidence: The Swedish Mammography CohortBr J Cancer9021672170PubMedGoogle Scholar
  9. 9.
    Cramer, DW, Welch, WR, Hutchison, GB, Willett, W, Scully, RE 1984Dietary animal fat in relation to ovarian cancer riskObstet Gynecol63833838PubMedGoogle Scholar
  10. 10.
    Risch, HA, Marrett, LD, Jain, M,  et al. 1996Differences in risk factors for epithelial ovarian cancer by histologic type. Results of a case-control studyAm J Epidemiol144363372PubMedGoogle Scholar
  11. 11.
    Shu, XO, Gao, YT, Yuan, JM,  et al. 1989Dietary factors and epithelial ovarian cancerBr J Cancer599296PubMedGoogle Scholar
  12. 12.
    Vecchia, C, Decarli, A, Negri, E,  et al. 1987Dietary factors and risk of epithelial ovarian cancerJ Natl Cancer Inst79663669PubMedGoogle Scholar
  13. 13.
    Mori, M, Miyake, H 1988Dietary and other risk factors of ovarian cancer among elderly womenJpn J Cancer Res799971004PubMedGoogle Scholar
  14. 14.
    Mori, M, Harabuchi, I, Miyake, H 1988Reproductive, genetic, and dietary risk factors for ovarian cancerAM J Epidemiol128771777PubMedGoogle Scholar
  15. 15.
    Slattery, M, Schuman, KL, West, DW 1989Nutrient intake and ovarian cancerAm J Epidemiol130497502PubMedGoogle Scholar
  16. 16.
    Bertone, ER, Hankinson, SE, Newcomb, PA 2001A population-based case-control study of carotenoid and vitamin A intake and ovarian cancer (United States)Cancer Causes Control128390CrossRefPubMedGoogle Scholar
  17. 17.
    Mettlin, CJ, Piver, MS 1990A case-control study of milk-drinking and ovarian cancer riskAm J Epidemiol132871876PubMedGoogle Scholar
  18. 18.
    Webb, PM, Bain, CJ, Purdie, DM, Harvey, PWJ, Green, A 1998Milk consumption, galactose metabolism and ovarian cancer (Australia)Cancer Causes Control9637644CrossRefPubMedGoogle Scholar
  19. 19.
    Risch, HA, Jain, M, Marrett, LD 1994Dietary fat intake and risk of epithelial ovarian cancerJ Natl Cancer Inst8614091415PubMedGoogle Scholar
  20. 20.
    Cramer, DW, Harlow, BL, Willett, WC 1989Galactose consumption and metabolism in relation to the risk of ovarian cancerLancet26671PubMedGoogle Scholar
  21. 21.
    McCann, SE, Freudenheim, JL, Marshall, JR, Graham, S 2004Risk of ovarian cancer is related to dietary intake of selected nutrients, phytochemicals and food groupsJ Nutr13319371942Google Scholar
  22. 22.
    Pan, SY, Ugnat, AM, Mao, Y, Wen, SW, Johnson, KC 2004Canadian Cancer Registries Epidemiology Research Group. A case-control study of diet and risk of ovarian cancerCancer Epidemiol Biomarkers1315211527Google Scholar
  23. 23.
    Harris, R, Whittemore, AS, Itnyre, J 1992Characteristics relating to ovarian cancer risk: collaborative analysis of 12 case-control studies. III. Epithelial tumors of low malignant potential in white womenAm J Epidemiol13612041211PubMedGoogle Scholar
  24. 24.
    Beeson, WL, Mills, PK, Phillips, RL 1989Chronic disease among Seventh-day Adventist, A low risk groupCancer64557581Google Scholar
  25. 25.
    Phillips, RL 1975Role of lifestyle and dietary habits in risk of cancer among Seventh-day AdventistsCancer Res3535133522PubMedGoogle Scholar
  26. 26.
    Fraser, GE 2003Diet, Life Expectancy and Chronic Disease. Studies of Seventh-day Adventists and other VegetariansOxford University PressNew YorkGoogle Scholar
  27. 27.
    Fraser, GE, Dysinger, PW, Best, C 1987IHD risk factors in middle-aged Seventh-day Adventist men and their neighborsAm J Epidemiol126638646PubMedGoogle Scholar
  28. 28.
    White, E, Kushi, LH, Pepe, MS 1994The effect of exposure variance and exposure measurement error on study sample size: implications for the design of epidemiologic studiesJ Clin Epidemiol47873880PubMedGoogle Scholar
  29. 29.
    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. 196–201Google Scholar
  30. 30.
    Abbey, DE, Nishino, N, McDonnell, WF 1999Long-term inhalable particles and other air pollutants related to mortality in non-smokersAm J Respir Crit Care Med159373382PubMedGoogle Scholar
  31. 31.
    Singh, PN, Fraser, GE 1998Dietary risk factors for Colon cancer in a low-risk populationAm J Epidemiol148761774PubMedGoogle Scholar
  32. 32.
    Serov, SF, Scully, RE, Sobin, LH 1973 International Histological Classification of Tumors. No. 9. Histological Typing of Ovarian TumorsWorld Health OrganizationGeneva, SwitzerlandGoogle Scholar
  33. 33.
    Piper, JM, Kennedy, DL 1987Oral contraceptives in the United States: trends in content and potencyInt J Epidemiol16215221PubMedGoogle Scholar
  34. 34.
    Breslow, NE, Day, NE 1987Statistical methods in cancer research. Volume II-The design and analysis of cohort studiesLARC Sci Publ821406Google Scholar
  35. 35.
    SAS/STAT Users Guide, Version 6, SAS Institute, Cary, 1998Google Scholar
  36. 36.
    Lynch, HT, Albano, WA, Lynch, JF 1982Surveillance and management of patients at high genetic risk for ovarian carcinomaObstet Gynecol59589596PubMedGoogle Scholar
  37. 37.
    Franceschi, S, Bidoli, E, La Vecchia, C 1994Tomatoes and risk of digestive-tract cancersInt J Cancer59181184PubMedGoogle Scholar
  38. 38.
    DeStafani, E, Boffetta, P, Oreggia, F,  et al. 2000Plant foods and risk of laryngeal cancer: a case-control study in UruguayInt J Cancer87129132Google Scholar
  39. 39.
    Gann, PH, Ma, J, Giovannucci, E 1999Lower prostate cancer risk in men with elevated plasma lycopene levels: results of a prospective analysisCancer Res5912251230PubMedGoogle Scholar
  40. 40.
    Mills, PK, Beeson, WL, Phillips, RL, Fraser, GE 1989Cohort study of diet, lifestyle, and prostate cancer in Adventist menCancer64598604PubMedGoogle Scholar
  41. 41.
    Steinmetz, KA, Potter, JD 1991Vegetables, fruit, and cancer. II. MechanismsCancer Causes control2427442PubMedGoogle Scholar
  42. 42.
    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 ppGoogle Scholar
  43. 43.
    Fairfield, KM, Hankinson, SE, Rosner, BA, Hunter, DJ, Colditz, GA, Willet, WC 2001Risk of ovarian cancer and consumption of vitamins A, C and E and specific carotenoidsCancer9223182326CrossRefPubMedGoogle Scholar
  44. 44.
    Armstrong, B, Doll, R 1975Environmental factors and cancer incidence in different countries, with special reference to dietary factorsInt J Cancer15617631PubMedGoogle Scholar
  45. 45.
    Bertone, ER, Rosner, BA, Hunter, DJ 2002Dietary fat intake and ovarian cancer in a cohort of U.S. womenAm J Epidemiol1562231PubMedGoogle Scholar
  46. 46.
    Willett, WC, Stampfer, MJ, Colditz, GA 1990Relation of meat, fat and fiber intake to the risk of colon cancer among womenN Engl J Med32316641672PubMedGoogle Scholar
  47. 47.
    Meester, C, Gerber, GB 1995The role of cooked food mutagens as possible etiological agents in human cancer. A critical appraisal of recent epidemiological investigationsRev Epidemiol Sante Publique43147161PubMedGoogle Scholar
  48. 48.
    Augustsson, K, Skag, K, Jagerstad, M 1999Dietary heterocyclic amines and cancer of the colon, rectum, bladder and kidney: a population-based studyLancet353703707CrossRefPubMedGoogle Scholar
  49. 49.
    Jagerstad, M, Skog, K, Grivas, S 1991Formation of heterocyclic amines using model systemsMutat Res259219233PubMedGoogle Scholar
  50. 50.
    Ushiyama, H, Wakabayashi, K, Hirose, M 1991Presence of carcinogenic heterocyclic amines in urine of healthy volunteers eating normal diet, but not of inpatients receiving parenteral alimentationCarcinogenesis1214171422PubMedGoogle Scholar
  51. 51.
    Bingham, S 1997Meat, starch and non-starch polysaccharides. Are epidemiologic and experimental findings consistent with acquired genetic alterations in sporadic colorectal cancer?Cancer Lett1142534CrossRefPubMedGoogle Scholar
  52. 52.
    Cramer, DW 1989Lactase persistence and milk consumption as determinants of ovarian cancer riskAm J Epidemiol130904910PubMedGoogle Scholar
  53. 53.
    Fairfield, KM, Hunter, DJ, Colditz, GA 2004A prospective study of dietary lactose and ovarian cancerInt J Cancer110271277CrossRefPubMedGoogle Scholar
  54. 54.
    Goodman, MT, Wu, AH, Tung, K-H 2002Association of dairy products, lactose and calcium with the risk of ovarian cancerAm J Epidemiol156148157PubMedGoogle Scholar
  55. 55.
    Whittemore, AS, Harris, R, Itnyre, J 1992Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white womenAm J Epidemiol13612041211PubMedGoogle Scholar
  56. 56.
    Chen, Y, Wu, PC, Lang, JH 1992Risk factors for epithelial ovarian cancer in Beijing, ChinaInt J Epidemiol212329PubMedGoogle Scholar
  57. 57.
    Wu, ML, Whittemore, AS, Paffenbarger, RS,Jr 1988Personal and environmental characteristics related to epithelial ovarian cancer. I. Reproductive and menstrual events and oral contraceptive useAm J Epidemiol12812161227PubMedGoogle Scholar
  58. 58.
    Titus-Ernstoff, L, Perez, K, Cramer, DW 2001Menstrual and reproductive factors in relation to ovarian cancer riskBr J Cancer84714721CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Fatemeh Kiani
    • 1
  • Synnove Knutsen
    • 1
  • Pramil Singh
    • 1
  • Giske Ursin
    • 2
  • Gary Fraser
    • 1
  1. 1.Department of Epidemiology and BiostatisticsLoma Linda UniversityLoma LindaUSA
  2. 2.Department of Preventive MedicineUniversity of Sourthern CaliforniaLos AngelesUSA

Personalised recommendations