Obesity and Ovarian Cancer
Ovarian cancer is the most fatal gynecologic cancer and is an important source of cancer-related mortality, particularly in developed countries. Despite substantial research examining adiposity (primarily adult body mass index [BMI]), the overall evidence
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Abstract
Ovarian cancer is the most fatal gynecologic cancer and is an important source of cancer-related mortality, particularly in developed countries. Despite substantial research examining adiposity (primarily adult body mass index [BMI]), the overall evidence suggests only a weak positive association between adiposity and risk of ovarian cancer, with stronger associations observed for populationbased case–control studies compared to prospective studies. Ovarian cancer is not one disease and emerging data suggest that higher BMI may only be associated with risk of certain histologic subtypes, including low-grade serous and invasive mucinous tumors. Interestingly, some larger studies and metaanalyses have reported a stronger relationship with premenopausal ovarian cancers, which are more likely to be of these subtypes. Relatively few studies have conducted detailed examinations of other adiposity-related factors such as measures of abdominal adiposity, early-life body size and weight change. While the underlying mechanisms that may relate adiposity to risk are unclear, increased inflammatory biomarkers have been associated with risk and hormonal factors, including androgen levels, may be important for the development of
S.S. Tworoger (&) Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA e-mail: [email protected] S.S. Tworoger T. Huang Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA T. Huang Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA © Springer International Publishing Switzerland 2016 T. Pischon and K. Nimptsch (eds.), Obesity and Cancer, Recent Results in Cancer Research 208, DOI 10.1007/978-3-319-42542-9_9
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mucinous tumors. Future research should leverage the large sample sizes of consortia to evaluate associations by key tumor characteristics as well as consider patterns of weight change over the life course with both ovarian cancer risk and survival. Keywords
Ovarian cancer
1
Body mass index Inflammation Histologic subtypes
Introduction
In 2014, body fatness was listed as a probable risk factor for ovarian cancer by World Cancer Research Fund/American Institute for Cancer Research, although the link of overweight and obesity with other cancer sites, such as postmenopausal breast, colorectal and endometrial cancer, has been well established for many years [1, 2]. Conversely, according to the US National Cancer Institute, ovarian cancer is not considered an obesity-related cancer; however, a potential relationship between obesity and ovarian cancer cannot be ruled out: ‘Some studies have shown a weak association between increasing body mass index (BMI) and risk of ovarian cancer, especially in premenopausal women, although other studies have not found an association’ [3]. Similarly, the American Cancer Society lists ovarian cancer as only possibly being linked to overweight or obesity
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