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Nutrient-wide association study of 57 foods/nutrients and epithelial ovarian cancer in the European Prospective Investigation into Cancer and Nutrition study and the Netherlands Cohort Study.

Abstract

BACKGROUND

Studies of the role of dietary factors in epithelial ovarian cancer (EOC) development have been limited, and no specific dietary factors have been consistently associated with EOC risk.

OBJECTIVE

We used a nutrient-wide association study approach to systematically test the association between dietary factors and invasive EOC risk while accounting for multiple hypothesis testing by using the false discovery rate and evaluated the findings in an independent cohort.

DESIGN

We assessed dietary intake amounts of 28 foods/food groups and 29 nutrients estimated by using dietary questionnaires in the EPIC (European Prospective Investigation into Cancer and Nutrition) study (n = 1095 cases). We selected 4 foods/nutrients that were statistically significantly associated with EOC risk when comparing the extreme quartiles of intake in the EPIC study (false discovery rate = 0.43) and evaluated these factors in the NLCS (Netherlands Cohort Study; n = 383 cases). Cox regression models were used to estimate HRs and 95% CIs.

RESULTS

None of the 4 dietary factors that were associated with EOC risk in the EPIC study (cholesterol, polyunsaturated and saturated fat, and bananas) were statistically significantly associated with EOC risk in the NLCS; however, in meta-analysis of the EPIC study and the NLCS, we observed a higher risk of EOC with a high than with a low intake of saturated fat (quartile 4 compared with quartile 1; overall HR: 1.21; 95% CI: 1.04, 1.41).

CONCLUSION

In the meta-analysis of both studies, there was a higher risk of EOC with a high than with a low intake of saturated fat.

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  • Authors+Show Affiliations

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    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; m.merritt@imperial.ac.uk.

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    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom;

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    Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands;

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    Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands;

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    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece;

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    Department of Community Medicine, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland;

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    Department of Biomedical Informatics, Harvard Medical School, Boston, MA;

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    Danish Cancer Society Research Center, Copenhagen, Denmark;

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    Danish Cancer Society Research Center, Copenhagen, Denmark;

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    Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark;

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    Centre for Research in Epidemiology and Population Health, Inserm (Institut National de la Santé et de la Recherche Médicale), Villejuif Cedex, France; Univ Paris Sud, Villejuif, France; Gustave Roussy, Villejuif, France;

    ,

    Centre for Research in Epidemiology and Population Health, Inserm (Institut National de la Santé et de la Recherche Médicale), Villejuif Cedex, France; Univ Paris Sud, Villejuif, France; Gustave Roussy, Villejuif, France;

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    Centre for Research in Epidemiology and Population Health, Inserm (Institut National de la Santé et de la Recherche Médicale), Villejuif Cedex, France; Univ Paris Sud, Villejuif, France; Gustave Roussy, Villejuif, France;

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    Division of Cancer Epidemiology, German Cancer Research Center [Deutsches Krebsforschungszentrum (DKFZ)], Heidelberg, Germany;

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    Division of Cancer Epidemiology, German Cancer Research Center [Deutsches Krebsforschungszentrum (DKFZ)], Heidelberg, Germany;

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    Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany;

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    Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany;

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    Hellenic Health Foundation, Athens, Greece; Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece;

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    Department of Epidemiology, Harvard School of Public Health, Boston, MA; Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece;

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    Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece;

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    Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy;

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    Epidemiology and Prevention Unit, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori, Milano, Italy;

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    Cancer Registry and Histopathology Unit, "Civic-M.P. Arezzo" Hospital, Azienda Sanitaria Provinciale, Ragusa, Italy;

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    Unit of Epidemiology, Regional Health Service, Azienda Sanitaria Locale (ASL) TO3, Grugliasco, Italy; Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy;

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    Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy;

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    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment [Rijksinstituut voor Volksgezondheid en Milieu (RIVM)], Bilthoven, Netherlands; Department of Gastroenterology and Hepatology and Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;

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    Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands;

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    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands;

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    Department of Community Medicine, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway;

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    Department of Community Medicine, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway;

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    Public Health Directorate, Asturias, Oviedo, Spain;

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    Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain;

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    Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública, Madrid, Spain;

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    Public Health Division of Gipuzkoa, BioDonostia Research Institute, Health Department of Basque Region, San Sebastian, Spain;

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    CIBER de Epidemiología y Salud Pública, Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain;

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    CIBER de Epidemiología y Salud Pública, Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA) Pamplona, Spain;

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    Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden;

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    Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden;

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    Department of Clinical Sciences, Obstetrics and Gynecology, Department of Public Health and Clinical Medicine, Nutritional Research and.

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    Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden;

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    Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom;

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    Cambridge Institute of Public Health, University of Cambridge, Cambridge, United Kingdom;

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    Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; and.

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    Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.

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    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom;

    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom;

    Source

    MeSH

    Adult
    Aged
    Carcinoma, Ovarian Epithelial
    Cohort Studies
    Diet
    Dietary Fats
    Fatty Acids
    Feeding Behavior
    Female
    Humans
    Male
    Middle Aged
    Neoplasms, Glandular and Epithelial
    Netherlands
    Ovarian Neoplasms
    Risk Factors

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    26607939

    Citation

    Merritt, Melissa A., et al. "Nutrient-wide Association Study of 57 Foods/nutrients and Epithelial Ovarian Cancer in the European Prospective Investigation Into Cancer and Nutrition Study and the Netherlands Cohort Study." The American Journal of Clinical Nutrition, vol. 103, no. 1, 2016, pp. 161-7.
    Merritt MA, Tzoulaki I, van den Brandt PA, et al. Nutrient-wide association study of 57 foods/nutrients and epithelial ovarian cancer in the European Prospective Investigation into Cancer and Nutrition study and the Netherlands Cohort Study. Am J Clin Nutr. 2016;103(1):161-7.
    Merritt, M. A., Tzoulaki, I., van den Brandt, P. A., Schouten, L. J., Tsilidis, K. K., Weiderpass, E., ... Gunter, M. J. (2016). Nutrient-wide association study of 57 foods/nutrients and epithelial ovarian cancer in the European Prospective Investigation into Cancer and Nutrition study and the Netherlands Cohort Study. The American Journal of Clinical Nutrition, 103(1), pp. 161-7. doi:10.3945/ajcn.115.118588.
    Merritt MA, et al. Nutrient-wide Association Study of 57 Foods/nutrients and Epithelial Ovarian Cancer in the European Prospective Investigation Into Cancer and Nutrition Study and the Netherlands Cohort Study. Am J Clin Nutr. 2016;103(1):161-7. PubMed PMID: 26607939.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Nutrient-wide association study of 57 foods/nutrients and epithelial ovarian cancer in the European Prospective Investigation into Cancer and Nutrition study and the Netherlands Cohort Study. AU - Merritt,Melissa A, AU - Tzoulaki,Ioanna, AU - van den Brandt,Piet A, AU - Schouten,Leo J, AU - Tsilidis,Konstantinos K, AU - Weiderpass,Elisabete, AU - Patel,Chirag J, AU - Tjønneland,Anne, AU - Hansen,Louise, AU - Overvad,Kim, AU - His,Mathilde, AU - Dartois,Laureen, AU - Boutron-Ruault,Marie-Christine, AU - Fortner,Renée T, AU - Kaaks,Rudolf, AU - Aleksandrova,Krasimira, AU - Boeing,Heiner, AU - Trichopoulou,Antonia, AU - Lagiou,Pagona, AU - Bamia,Christina, AU - Palli,Domenico, AU - Krogh,Vittorio, AU - Tumino,Rosario, AU - Ricceri,Fulvio, AU - Mattiello,Amalia, AU - Bueno-de-Mesquita,H Bas, AU - Onland-Moret,N Charlotte, AU - Peeters,Petra H, AU - Skeie,Guri, AU - Jareid,Mie, AU - Quirós,J Ramón, AU - Obón-Santacana,Mireia, AU - Sánchez,María-José, AU - Chamosa,Saioa, AU - Huerta,José M, AU - Barricarte,Aurelio, AU - Dias,Joana A, AU - Sonestedt,Emily, AU - Idahl,Annika, AU - Lundin,Eva, AU - Wareham,Nicholas J, AU - Khaw,Kay-Tee, AU - Travis,Ruth C, AU - Ferrari,Pietro, AU - Riboli,Elio, AU - Gunter,Marc J, Y1 - 2015/11/25/ PY - 2015/07/06/received PY - 2015/10/05/accepted PY - 2015/11/27/entrez PY - 2015/11/27/pubmed PY - 2016/5/3/medline KW - diet KW - nutrition KW - ovarian cancer KW - prospective cohort KW - saturated fat KW - serous SP - 161 EP - 7 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 103 IS - 1 N2 - BACKGROUND: Studies of the role of dietary factors in epithelial ovarian cancer (EOC) development have been limited, and no specific dietary factors have been consistently associated with EOC risk. OBJECTIVE: We used a nutrient-wide association study approach to systematically test the association between dietary factors and invasive EOC risk while accounting for multiple hypothesis testing by using the false discovery rate and evaluated the findings in an independent cohort. DESIGN: We assessed dietary intake amounts of 28 foods/food groups and 29 nutrients estimated by using dietary questionnaires in the EPIC (European Prospective Investigation into Cancer and Nutrition) study (n = 1095 cases). We selected 4 foods/nutrients that were statistically significantly associated with EOC risk when comparing the extreme quartiles of intake in the EPIC study (false discovery rate = 0.43) and evaluated these factors in the NLCS (Netherlands Cohort Study; n = 383 cases). Cox regression models were used to estimate HRs and 95% CIs. RESULTS: None of the 4 dietary factors that were associated with EOC risk in the EPIC study (cholesterol, polyunsaturated and saturated fat, and bananas) were statistically significantly associated with EOC risk in the NLCS; however, in meta-analysis of the EPIC study and the NLCS, we observed a higher risk of EOC with a high than with a low intake of saturated fat (quartile 4 compared with quartile 1; overall HR: 1.21; 95% CI: 1.04, 1.41). CONCLUSION: In the meta-analysis of both studies, there was a higher risk of EOC with a high than with a low intake of saturated fat. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/26607939/full_citation L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.115.118588 DB - PRIME DP - Unbound Medicine ER -