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

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

^* To whom correspondence should be addressed. E-mail: lj.schouten{at}epid.unimaas.nl.

	Abstract

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)

Key Words: height, BMI, ovarian cancer, etiology, prospective studies