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Height, Body Mass Index, and Ovarian Cancer: A Pooled Analysis of 12 Cohort Studies

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

Requests for reprints: Leo J. Schouten, Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Phone: 31-43-3254059; Fax: 31-43-3884128. E-mail: lj.schouten{at}epid.unimaas.nl

Background: Although many studies have investigated the association between anthropometry and ovarian cancer risk, results have been inconsistent.

Methods: The associations of height, body mass index (BMI), and ovarian cancer risk were examined in a pooled analysis of primary data from 12 prospective cohort studies from North America and Europe. The study population consisted of 531,583 women among whom 2,036 epithelial ovarian cancer cases were identified. To summarize associations, study-specific relative risks (RR) were estimated using the Cox proportional hazards model and then combined using a random-effects model.

Results: Women with height 1.70 m had a pooled multivariate RR of 1.38 [95% confidence interval (95% CI), 1.16-1.65] compared with those with height <1.60 m. For the same comparison, multivariate RRs were 1.79 (95% CI, 1.07-3.00) for premenopausal and 1.25 (95% CI, 1.04-1.49) for postmenopausal ovarian cancer (P_interaction = 0.14). The multivariate RR for women with a BMI 30 kg/m² was 1.03 (95% CI, 0.86-1.22) compared with women with a BMI from 18.5 to 23 kg/m². For the same comparison, multivariate RRs were 1.72 (95% CI, 1.02-2.89) for premenopausal and 1.07 (95% CI, 0.87-1.33) for postmenopausal women (P_interaction = 0.07). There was no statistically significant heterogeneity between studies with respect to height or BMI. BMI in early adulthood was not associated with ovarian cancer risk.

Conclusion: Height was associated with an increased ovarian cancer risk, especially in premenopausal women. BMI was not associated with ovarian cancer risk in postmenopausal women but was positively associated with risk in premenopausal women. (Cancer Epidemiol Biomarkers Prev 2008;17(4):902–12)