Nutrient intake and ovarian cancer: an Italian case–control study Article DOI:
Cite this article as: Bidoli, E., La Vecchia, C., Montella, M. et al. Cancer Causes Control (2002) 13: 255. doi:10.1023/A:1015047625060 Abstract Objective: The role of selected macronutrients, cholesterol, and fatty acids in the etiology of epithelial ovarian cancer was analyzed using data from a case–control study carried out in five Italian areas between January 1992 and December 1999. Methods: Cases comprised 1031 women with incident, histologically confirmed epithelial ovarian cancer, admitted to the major teaching and general hospitals of the study areas. Controls comprised 2411 women admitted for acute, non-neoplastic conditions to the same network of hospitals. Information on dietary habits was elicited using a validated food-frequency questionnaire including 78 food groups and recipes. Odds ratios (OR) and their corresponding 95% confidence intervals (CI) were computed by subsequent quintiles of nutrient intake. Results: Direct associations with ovarian cancer emerged for starch intake (OR = 1.4 in the highest vs the lowest quintile of intake; 95% CI 1.1–1.8), while inverse associations emerged for monounsaturated (OR = 0.7; 95% CI 0.5–0.9), and polyunsaturated (OR = 0.7; 95% CI 0.5–0.9) fatty acids. Among fatty acids, oleic (OR = 0.7; 95% CI 0.5–0.9), linoleic (OR = 0.7; 95% CI 0.5–0.9), and linolenic (OR = 0.8; 95% CI 0.6–1.0) acids were inversely related to ovarian cancer. When, however, six macronutrients were included in the same model, only the adverse effect of high starch intake remained significant. Results were consistent in separate strata of menopausal status, parity, and energy intake. Conclusions: Starch was directly associated, and unsaturated fatty acids were inversely associated, with ovarian cancer risk. case–control study macronutrients ovarian cancer References
Armstrong B, Doll R (1975) Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practice. Int J Cancer 15: 617-631.
Decarli A, La Vecchia C (1986) Environmental factors and cancer mortality in Italy: correlational exercise. Oncology 43: 116-126.
Serra-Majem L, La Vecchia C, Ribas-Barba L, Lucchini F, Ramon JM, Salleras L (1993) Changes in diet and mortality from selected cancers in southern Mediterranean countries, 1960-1989. Eur J Clin Nutr 47: S25-S34.
La Vecchia C, Decarli A, Negri E, et al. (1987) Dietary factors and the risk of epithelial ovarian cancer. J Natl Cancer Inst 79: 663-669.
Shu XO, Gao YT, Yuan JM, Ziegler RG, Brinton LA (1989) Dietary factors and epithelial ovarian cancer. Br J Cancer 59: 92-96.
Bosetti C, Negri E, Franceschi S, et al. (2001) Diet and ovarian cancer risk: a case-control study in Italy. Int J Cancer 93: 911-915.
Risch HA, Jain M, Marrett LD, Howe GR (1994) Dietary fat intake and risk of epithelial ovarian cancer. J Natl Cancer Inst 86: 1409-1415.
Cramer DW, Welch WR, Hutchison GB, Willett W, Scully RE (1984) Dietary animal fat in relation to ovarian cancer risk. Obstet Gynecol 63: 833-838.
Slattery ML, Schuman KL, West DW, French TK, Robison LM (1989) Nutrient intake and ovarian cancer. Am J Epidemiol 130: 497-502.
Kushi LH, Mink PM, Folsom AR, et al. (1999) Prospective study of diet and ovarian cancer. Am J Epidemiol 149: 21-31.
Tzonou A, Hsieh C-C, Polychronopoulou A, et al. (1993) Diet and ovarian cancer: a case-control study in Greece. Int J cancer 55: 411-414.
Byers T, Marshall J, Graham S, Mettlin C, Swanson M (1983) A case-control study of dietary and nondietary factors in ovarian cancer. J Natl Cancer Inst 71: 681-686. 260 E. Bidoli et al.
Salvini S, Parpinel M, Gnagnarella P, Maisonneuve P, Turrini A (1998) Banca dati di composizione degli alimenti per studi epidemiologici in Italia. Milan: Istituto Europeo di Oncologia.
Franceschi S, Barbone F, Negri E, et al. (1995) Reproducibility of an Italian food frequency questionnaire for cancer studies. Results for specific nutrients. Ann Epidemiol 5: 69-75.
Decarli A, Franceschi S, Ferraroni M, et al. (1996) Validation of a food-frequency questionnaire to assess dietary intakes in cancer studies in Italy. Results for specific nutrients. Ann Epidemiol 6: 110-118.
Breslow NE, Day NE (1980) Statistical Methods in Cancer Research, vol. 1: The Analysis of Case-Control Studies. IARC Scientific Publications No. 32. Lyon: International Agency for Research on Cancer.
Willett WC, Stampfer MJ (1986) Total energy intake: implications for epidemiologic analysis. Am J Epidemiol 124: 17-27.
Decarli A, Favero A, La Vecchia C, et al. (1997) Macronutrients, energy intake, and breast cancer risk: implications from different models. Epidemiology 8: 425-428.
Potischman N, Swanson CA, Coates RJ, et al. (1997) Dietary relationship with early onset (under age 45) breast cancer case-control study in the United States: influence of chemotherapy treatment. Cancer Causes Control 8: 713-721.
Franceschi S, Bidoli E, Montella M, Amadori D, La Vecchia C (1999) Influence of chemotherapy on the evaluation of breast cancer-diet link. Cancer Causes Control 10: 319-321.
Favero A, Salvini S, Russo A, et al. (1997) Sources of macro-and micronutrients in Italian women: results from a food frequency questionnaire for cancer studies. Eur J Cancer Prev 6: 277-287.
Bidoli E, La Vecchia C, Talamini R, et al. (2001) Micronutrients and ovarian cancer: a case-control study in Italy. Ann Oncol 12: 1589-1593.
Franceschi S, Dal Maso L, Augustin L, et al. (2001) Dietary glycaemic load and colorectal cancer risk. Ann Oncol 12: 173-178.
Ron E, Gridley G, Hrubec Z, Page W, Arora S, Fraumeni JF Jr (1991) Acromegaly and gastrointestinal cancer (Published erratum appears in Cancer 1992; 69: 549). Cancer 68: 1673-1677.
Yu H, Rohan T (2000) Role of the insulin-like growth factor family in cancer development and progression. J Natl Cancer Inst 92: 1472-1489.
Lipworth L, Martinez ME, Angell J, Hsieh CC, Trichopoulos D (1997) Olive oil and human cancer: an assessment of the evidence. Prev Med 26: 181-190.
Franceschi S, La Vecchia C, Russo A, et al. (1998) Macronutrient intake and risk of colorectal cancer in Italy. Int J Cancer 76: 321-324.
Giovannucci E (1995) Insulin and colon cancer Cancer Causes Control 6: 164-179.
Goldin BR, Alercreutz H, Gorbach SL, et al. (1982) Estrogen excretion patterns and plasma levels in vegetarian and omnivorous women. N Engl J Med 307: 1542-1547.
Shultz LT, Leklem JE (1983) Nutrient intake and hormonal status of premenopausal vegetarian Seventh-day Adventists and premenopausal nonvegetarians. Nutr Cancer 4: 247-259.
Rish HA (1998) Hormonal etiology of epithelial ovarian cancer with a hypothesis concerning the role of androgens and progesterone. J Natl Cancer Inst 90: 1774-1786.
D'Avanzo B, La Vecchia C, Katsouyanni K, Negri E, Trichopoulos D (1997) An assessment, and reproducibility of food frequency data provided by hospital controls. Eur J Cancer Prev 6: 288-293.
Franceschi S, Favero A, Decarli A, et al. (1996) Intake of macronutrients and the risk of breast cancer. Lancet 347: 1351-1356.
Franceschi S, Russo A, La Vecchia C (1998) Carbohydrates, fat and cancer of the breast and colon-rectum. J Epidemiol Biostat 3: 217-218.
Google Scholar Copyright information
© Kluwer Academic Publishers 2002