Height, body mass index, and ovarian cancer: a pooled analysis of 12 cohort studies

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 > or =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 > or =30 kg/m(2) was 1.03 (95% CI, 0.86-1.22) compared with women with a BMI from 18.5 to 23 kg/m(2). 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.

Figure 1

Study-specific and pooled multivariate RRs and 95% CIs of ovarian cancer and height, category ≥1.70 versus ≤1.60 m. Black squares and horizontal lines, study-specific multivariate RRs and 95% CIs for the comparison of the highest versus the lowest category of height. The area of the black square reflects the study-specific weight (inverse of the variance). Diamond, pooled multivariate RR and 95% CI.

Figure 2

Study-specific and pooled multivariate RRs and 95% CIs of ovarian cancer and BMI, category ≥30 versus ≤23 kg/m². Black squares and horizontal lines, study-specific multivariate RRs and 95% CIs for the comparison of the highest versus the lowest category of BMI. The area of the black square reflects the study-specific weight (inverse of the variance). Diamond, pooled multivariate RR and 95% CI.