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Dairy Products and Ovarian Cancer: A Pooled Analysis of 12 Cohort Studies

Departments of ¹ Nutrition, ² Epidemiology, and ³ Biostatistics, Harvard School of Public Health; ⁴ Channing Laboratory and Department of Medicine, and ⁵ Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; ⁶ Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota; ⁷ Division of Epidemiology, Department of Environmental Medicine, New York University, New York, New York; ⁸ The Center for Health Research, Loma Linda University School of Medicine, Loma Linda, California; ⁹ Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo, New York; ¹⁰ Department of Food and Chemical Risk Analysis, the Netherlands Organization for Applied Scientific Research Quality of Life, Zeist, the Netherlands; ¹¹ Department of Nutrition, University of Oslo, Oslo, Norway; ¹² Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, Maryland; ¹³ Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; ¹⁴ Epidemiology and Surveillance Research, American Cancer Society, Atlanta, Georgia; ¹⁵ Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; ¹⁶ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and ¹⁷ Department of Epidemiology, Nutrition and Toxicology Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands

Requests for reprints: Jeanine Genkinger, Department of Nutrition, Harvard School of Public Health, Room 339, Building 2, 665 Huntington Avenue, Boston, MA 02115. Phone: 617-432-4976; Fax: 617-432-2435. E-mail: pooling{at}hsphsun2.harvard.edu

Background: Dairy foods and their constituents (lactose and calcium) have been hypothesized to promote ovarian carcinogenesis. Although case-control studies have reported conflicting results for dairy foods and lactose, several cohort studies have shown positive associations between skim milk, lactose, and ovarian cancer.

Methods: A pooled analysis of the primary data from 12 prospective cohort studies was conducted. The study population consisted of 553,217 women among whom 2,132 epithelial ovarian cases were identified. Study-specific relative risks and 95% confidence intervals were calculated by Cox proportional hazards models and then pooled by a random-effects model.

Results: No statistically significant associations were observed between intakes of milk, cheese, yogurt, ice cream, and dietary and total calcium intake and risk of ovarian cancer. Higher lactose intakes comparing 30 versus <10 g/d were associated with a statistically significant higher risk of ovarian cancer, although the trend was not statistically significant (pooled multivariate relative risk, 1.19; 95% confidence interval, 1.01-1.40; P_trend = 0.19). Associations for endometrioid, mucinous, and serous ovarian cancer were similar to the overall findings.

Discussion: Overall, no associations were observed for intakes of specific dairy foods or calcium and ovarian cancer risk. A modest elevation in the risk of ovarian cancer was seen for lactose intake at the level that was equivalent to three or more servings of milk per day. Because a new dietary guideline recommends two to three servings of dairy products per day, the relation between dairy product consumption and ovarian cancer risk at these consumption levels deserves further examination. (Cancer Epidemiol Biomarkers Prev 2006;15(2):364–72)

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