Cancer Causes & Control

, Volume 26, Issue 11, pp 1691–1697 | Cite as

Moderate-to-vigorous physical activity and leisure-time sitting in relation to ovarian cancer risk in a large prospective US cohort

  • Janet S. HildebrandEmail author
  • Susan M. Gapstur
  • Mia M. Gaudet
  • Peter T. Campbell
  • Alpa V. Patel
Brief report



Physical activity is hypothesized to lower the risk of ovarian cancer, but current evidence for an association is limited and inconclusive. The purpose of this study was to examine moderate-to-vigorous physical activity, walking, and leisure-time sitting in relation to incident ovarian cancer, overall and by histologic subtype.


Moderate–vigorous recreational physical activity (MET-hours/week), recreational walking, and leisure-time sitting were examined in relation to epithelial ovarian cancer in the American Cancer Society Cancer Prevention Study II Nutrition Cohort, a US cohort followed for cancer incidence from 1992 to 2011. Exposure information was collected via self-administered questionnaires. Cox proportional hazards regression was used to estimate multivariable-adjusted relative risks (RRs) and 95 % confidence intervals (CIs) of total, serous, and nonserous ovarian cancer according to MET-hours/week, hours/week of walking, and hours/day of sitting.


Among 63,972 postmenopausal women, 651 cases of ovarian cancer were identified during follow-up. Neither MET-hours/week nor walking was associated with risk. However, ≥6 h/day of sitting, compared to <3, was associated with higher risk of ovarian cancer (RR 1.44, 95 % CI 1.12–1.85), particularly for serous cancer (RR 1.52, 95 % CI 1.06–2.16), although statistical heterogeneity by histology was not detected (p = 0.36).


Results from this study do not support an association between physical activity and ovarian cancer, whereas prolonged sitting may be associated with higher risk. Additional large studies are needed to further assess possible etiologic differences by histologic subtype.


Physical activity Sedentary behavior Sitting Ovarian cancer Serous carcinoma 



The authors thank the Cancer Prevention Study II participants and the Study Management Group of the American Cancer Society Epidemiology Research Program for their invaluable contributions to this research. We also acknowledge the contribution of central cancer registries supported through the Centers for Disease Control and Prevention (CDC) National Program of Cancer Registries and cancer registries supported by the National Cancer Institute’s Surveillance Epidemiology and End Results Program. The American Cancer Society funds the creation, maintenance, and updating of the Cancer Prevention Study II cohort.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Berns EM, Bowtell DD (2012) The changing view of high-grade serous ovarian cancer. Cancer Res 72:2701–2704CrossRefPubMedGoogle Scholar
  2. 2.
    Soslow RA (2008) Histologic subtypes of ovarian carcinoma: an overview. Int J Gynecol Pathol 27:161–174PubMedGoogle Scholar
  3. 3.
    Gates MA, Rosner BA, Hecht JL, Tworoger SS (2010) Risk factors for epithelial ovarian cancer by histologic subtype. Am J Epidemiol 171:45–53PubMedCentralCrossRefPubMedGoogle Scholar
  4. 4.
    McCluggage WG (2011) Morphological subtypes of ovarian carcinoma: a review with emphasis on new developments and pathogenesis. Pathology 43:420–432CrossRefPubMedGoogle Scholar
  5. 5.
    Friedenreich CM, Neilson HK, Lynch BM (2010) State of the epidemiological evidence on physical activity and cancer prevention. Eur J Cancer 46:2593–2604CrossRefPubMedGoogle Scholar
  6. 6.
    Chionh F, Baglietto L, Krishnan K et al (2010) Physical activity, body size and composition, and risk of ovarian cancer. Cancer Causes Control 21:2183–2194CrossRefPubMedGoogle Scholar
  7. 7.
    Leitzmann MF, Koebnick C, Moore SC et al (2009) Prospective study of physical activity and the risk of ovarian cancer. Cancer Causes Control 20:765–773PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    Olsen CM, Bain CJ, Jordan SJ et al (2007) Recreational physical activity and epithelial ovarian cancer: a case-control study, systematic review, and meta-analysis. Cancer Epidemiol Biomark Prev 16:2321–2330CrossRefGoogle Scholar
  9. 9.
    Weiderpass E, Sandin S, Inoue M et al (2012) Risk factors for epithelial ovarian cancer in Japan—results from the Japan Public Health Center-based Prospective Study cohort. Int J Oncol 40:21–30PubMedGoogle Scholar
  10. 10.
    Yang HP, Trabert B, Murphy MA et al (2012) Ovarian cancer risk factors by histologic subtypes in the NIH-AARP Diet and Health Study. Int J Cancer 131:938–948PubMedCentralCrossRefPubMedGoogle Scholar
  11. 11.
    World Cancer Research Fund/American Institute for Cancer Research (2014) Continuous update project report. Food, nutrition, physical activity, and the prevention of ovarian cancer 2014.  Available at
  12. 12.
    Patel AV, Rodriguez C, Pavluck AL, Thun MJ, Calle EE (2006) Recreational physical activity and sedentary behavior in relation to ovarian cancer risk in a large cohort of US women. Am J Epidemiol 163:709–716CrossRefPubMedGoogle Scholar
  13. 13.
    Dosemeci M, Hayes RB, Vetter R et al (1993) Occupational physical activity, socioeconomic status, and risks of 15 cancer sites in Turkey. Cancer Causes Control 4:313–321CrossRefPubMedGoogle Scholar
  14. 14.
    Zhang M, Xie X, Lee AH, Binns CW (2004) Sedentary behaviours and epithelial ovarian cancer risk. Cancer Causes Control 15:83–89CrossRefPubMedGoogle Scholar
  15. 15.
    Centers for Disease Control and Prevention (CDC) (2012) Vital signs: walking among adults—United States, 2005 and 2010. MMWR. Morb Mortal Wkly Rep 61:595–601Google Scholar
  16. 16.
    Hildebrand JS, Gapstur SM, Campbell PT, Gaudet MM, Patel AV (2013) Recreational physical activity and leisure-time sitting in relation to postmenopausal breast cancer risk. Cancer Epidemiol Biomark Prev 22:1906–1912CrossRefGoogle Scholar
  17. 17.
    Calle EE, Rodriguez C, Jacobs EJ et al (2002) The American Cancer Society Cancer Prevention Study II Nutrition Cohort: rationale, study design, and baseline characteristics. Cancer 94:2490–2501CrossRefPubMedGoogle Scholar
  18. 18.
    Garfinkel L (1985) Selection, follow-up, and analysis in the American Cancer Society prospective studies. Natl Cancer Inst Monogr 67:49–52PubMedGoogle Scholar
  19. 19.
    Bergmann MM, Calle EE, Mervis CA, Miracle-McMahill HL, Thun MJ, Heath CW (1998) Validity of self-reported cancers in a prospective cohort study in comparison with data from state cancer registries. Am J Epidemiol 147:556–562CrossRefPubMedGoogle Scholar
  20. 20.
    Kleinbaum DG (2005) Survival analysis: a self-learning text, 2nd edn. Springer, New YorkGoogle Scholar
  21. 21.
    Cochran WG (1954) The combination of estimates from different experiments. Biometrics 10:101–129CrossRefGoogle Scholar
  22. 22.
    Chiaffarino F, Parazzini F, Bosetti C et al (2007) Risk factors for ovarian cancer histotypes. Eur J Cancer 43:1208–1213CrossRefPubMedGoogle Scholar
  23. 23.
    Lee AH, Su D, Pasalich M, Wong YL, Binns CW (2013) Habitual physical activity reduces risk of ovarian cancer: a case-control study in southern China. Prev Med 57(Suppl):S31–S33CrossRefPubMedGoogle Scholar
  24. 24.
    Moorman PG, Jones LW, Akushevich L, Schildkraut JM (2011) Recreational physical activity and ovarian cancer risk and survival. Ann Epidemiol 21:178–187PubMedCentralCrossRefPubMedGoogle Scholar
  25. 25.
    Rossing MA, Cushing-Haugen KL, Wicklund KG, Doherty JA, Weiss NS (2010) Recreational physical activity and risk of epithelial ovarian cancer. Cancer Causes Control 21:485–491PubMedCentralCrossRefPubMedGoogle Scholar
  26. 26.
    Furberg AS, Thune I (2003) Metabolic abnormalities (hypertension, hyperglycemia and overweight), lifestyle (high energy intake and physical inactivity) and endometrial cancer risk in a Norwegian cohort. Int J Cancer 104:669–676CrossRefPubMedGoogle Scholar
  27. 27.
    Le Marchand L, Wilkens LR, Kolonel LN, Hankin JH, Lyu LC (1997) Associations of sedentary lifestyle, obesity, smoking, alcohol use, and diabetes with the risk of colorectal cancer. Cancer Res 57:4787–4794PubMedGoogle Scholar
  28. 28.
    Lynch BM (2010) Sedentary behavior and cancer: a systematic review of the literature and proposed biological mechanisms. Cancer Epidemiol Biomark Prev 19:2691–2709CrossRefGoogle Scholar
  29. 29.
    McTiernan A (2000) Associations between energy balance and body mass index and risk of breast carcinoma in women from diverse racial and ethnic backgrounds in the US. Cancer 88:1248–1255CrossRefPubMedGoogle Scholar
  30. 30.
    Xiao Q, Yang HP, Wentzensen N, Hollenbeck A, Matthews CE (2013) Physical activity in different periods of life, sedentary behavior, and the risk of ovarian cancer in the NIH-AARP diet and health study. Cancer Epidemiol Biomark Prev 22:2000–2008CrossRefGoogle Scholar
  31. 31.
    Wolf AM, Hunter DJ, Colditz GA et al (1994) Reproducibility and validity of a self-administered physical activity questionnaire. Int J Epidemiol 23:991–999CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Janet S. Hildebrand
    • 1
    Email author
  • Susan M. Gapstur
    • 1
  • Mia M. Gaudet
    • 1
  • Peter T. Campbell
    • 1
  • Alpa V. Patel
    • 1
  1. 1.Epidemiology Research ProgramAmerican Cancer SocietyAtlantaUSA

Personalised recommendations