Ovarian cancer and body size: Individual participant meta-analysis including 25,157 women with ovarian cancer from 47 epidemiological studies

Beral, V., Hermon, C., Peto, R., Reeves, G., Brinton, L., Marchbanks, P., Negri, E., Ness, R., Peeters, P.H.M., Vessey, M., Calle, E.E., Gapstur, S.M., Patel, A.V., Dal Maso, L., Talamini, R., Chetrit, A., Hirsh-Yechezkel, G., Lubin, F., Sadetzki, S., Allen, N., Bull, D., Callaghan, K., Crossley, B., Gaitskell, K., Goodill, A., Green, J., Key, T., Moser, K., Collins, R., Doll, R., Gonzalez, C.A., Lee, N., Ory, H.W., Peterson, H.B., Wingo, P.A., Martin, N., Pardthaisong, T., Silpisornkosol, S., Theetranont, C., Boosiri, B., Chutivongse, S., Jimakorn, P., Virutamasen, P., Wongsrichanalai, C., Tjonneland, A., Titus-Ernstoff, L., Byers, T., Rohan, T., Mosgaard, B.J., Yeates, D., Freudenheim, J.L., Chang-Claude, J., Kaaks, R., Anderson, K.E., Folsom, A., Robien, K., Rossing, M.A., Thomas, D.B., Weiss, N.S., Riboli, E., Clavel-Chapelon, F., Cramer, D., Hankinson, S.E., Tworoger, S.S., Franceschi, S., La Vecchia, C., Magnusson, C., Riman, T., Weiderpass, E., Wolk, A., Schouten, L.J., van den Brandt, P.A., Chantarakul, N., Koetsawang, S., Rachawat, D., Palli, D., Black, A., de Gonzalez, A.B., Freedman, D.M., Hartge, P., Hsing, A.W., Lacey, J.V., Hoover, R.N., Schairer, C., Graff-Iversen, S., Selmer, R., Bain, C.J., Green, A.C., Purdie, D.M., Siskind, V., Webb, P.M., McCann, S.E., Hannaford, P., Kay, C., Binns, C.W., Lee, A.H., Zhang, M., Ness, R.B., Nasca, P., Coogan, P.F., Palmer, J.R., Rosenberg, L., Kelsey, J., Paffenbarger, R., Whittemore, A., Katsouyanni, K., Trichopoulou, A., Trichopoulos, D., Tzonou, A., Dabancens, A., Martinez, L., Molina, R., Salas, O., Goodman, M.T., Lurie, G., Carney, M.E., Wilkens, L.R., Hartman, L., Manjer, J., Olsson, H., Grisso, J.A., Morgan, M., Wheeler, J.E., Casagrande, J., Pike, M.C., Ross, R.K., Wu, A.H., Miller, A.B., Kumle, M., Lund, E., McGowan, L., Shu, X.O., Zheng, W., Farley, T.M.M., Holck, S., Meirik, O., Risch, H.A. and Collaborative Grp Epidemiol Studie (2012) Ovarian cancer and body size: Individual participant meta-analysis including 25,157 women with ovarian cancer from 47 epidemiological studies. Plos Medicine, 9 4: e1001200-1-e1001200-12. doi:10.1371/journal.pmed.1001200

Author Beral, V.
Hermon, C.
Peto, R.
Reeves, G.
Brinton, L.
Marchbanks, P.
Negri, E.
Ness, R.
Peeters, P.H.M.
Vessey, M.
Calle, E.E.
Gapstur, S.M.
Patel, A.V.
Dal Maso, L.
Talamini, R.
Chetrit, A.
Hirsh-Yechezkel, G.
Lubin, F.
Sadetzki, S.
Allen, N.
Bull, D.
Callaghan, K.
Crossley, B.
Gaitskell, K.
Goodill, A.
Green, J.
Key, T.
Moser, K.
Collins, R.
Doll, R.
Gonzalez, C.A.
Lee, N.
Ory, H.W.
Peterson, H.B.
Wingo, P.A.
Martin, N.
Pardthaisong, T.
Silpisornkosol, S.
Theetranont, C.
Boosiri, B.
Chutivongse, S.
Jimakorn, P.
Virutamasen, P.
Wongsrichanalai, C.
Tjonneland, A.
Titus-Ernstoff, L.
Byers, T.
Rohan, T.
Mosgaard, B.J.
Yeates, D.
Freudenheim, J.L.
Chang-Claude, J.
Kaaks, R.
Anderson, K.E.
Folsom, A.
Robien, K.
Rossing, M.A.
Thomas, D.B.
Weiss, N.S.
Riboli, E.
Clavel-Chapelon, F.
Cramer, D.
Hankinson, S.E.
Tworoger, S.S.
Franceschi, S.
La Vecchia, C.
Magnusson, C.
Riman, T.
Weiderpass, E.
Wolk, A.
Schouten, L.J.
van den Brandt, P.A.
Chantarakul, N.
Koetsawang, S.
Rachawat, D.
Palli, D.
Black, A.
de Gonzalez, A.B.
Freedman, D.M.
Hartge, P.
Hsing, A.W.
Lacey, J.V.
Hoover, R.N.
Schairer, C.
Graff-Iversen, S.
Selmer, R.
Bain, C.J.
Green, A.C.
Purdie, D.M.
Siskind, V.
Webb, P.M.
McCann, S.E.
Hannaford, P.
Kay, C.
Binns, C.W.
Lee, A.H.
Zhang, M.
Ness, R.B.
Nasca, P.
Coogan, P.F.
Palmer, J.R.
Rosenberg, L.
Kelsey, J.
Paffenbarger, R.
Whittemore, A.
Katsouyanni, K.
Trichopoulou, A.
Trichopoulos, D.
Tzonou, A.
Dabancens, A.
Martinez, L.
Molina, R.
Salas, O.
Goodman, M.T.
Lurie, G.
Carney, M.E.
Wilkens, L.R.
Hartman, L.
Manjer, J.
Olsson, H.
Grisso, J.A.
Morgan, M.
Wheeler, J.E.
Casagrande, J.
Pike, M.C.
Ross, R.K.
Wu, A.H.
Miller, A.B.
Kumle, M.
Lund, E.
McGowan, L.
Shu, X.O.
Zheng, W.
Farley, T.M.M.
Holck, S.
Meirik, O.
Risch, H.A.
Collaborative Grp Epidemiol Studie
Title Ovarian cancer and body size: Individual participant meta-analysis including 25,157 women with ovarian cancer from 47 epidemiological studies
Journal name Plos Medicine   Check publisher's open access policy
ISSN 1549-1277
Publication date 2012-04-01
Sub-type Article (original research)
DOI 10.1371/journal.pmed.1001200
Open Access Status DOI
Volume 9
Issue 4
Start page e1001200-1
End page e1001200-12
Total pages 12
Place of publication San Francisco, CA, United States
Publisher Public Library of Science
Language eng
Formatted abstract
Only about half the studies that have collected information on the relevance of women's height and body mass index to their risk of developing ovarian cancer have published their results, and findings are inconsistent. Here, we bring together the worldwide evidence, published and unpublished, and describe these relationships.

Methods and Findings:

Individual data on 25,157 women with ovarian cancer and 81,311 women without ovarian cancer from 47 epidemiological studies were collected, checked, and analysed centrally. Adjusted relative risks of ovarian cancer were calculated, by height and by body mass index. Ovarian cancer risk increased significantly with height and with body mass index, except in studies using hospital controls. For other study designs, the relative risk of ovarian cancer per 5 cm increase in height was 1.07 (95% confidence interval [CI], 1.05-1.09; p<0.001); this relationship did not vary significantly by women's age, year of birth, education, age at menarche, parity, menopausal status, smoking, alcohol consumption, having had a hysterectomy, having first degree relatives with ovarian or breast cancer, use of oral contraceptives, or use of menopausal hormone therapy. For body mass index, there was significant heterogeneity (p<0.001) in the findings between ever-users and never-users of menopausal hormone therapy, but not by the 11 other factors listed above. The relative risk for ovarian cancer per 5 kg/m 2 increase in body mass index was 1.10 (95% CI, 1.07-1.13; p<0.001) in never-users and 0.95 (95% CI, 0.92-0.99; p = 0.02) in ever-users of hormone therapy.


Ovarian cancer is associated with height and, among never-users of hormone therapy, with body mass index. In high-income countries, both height and body mass index have been increasing in birth cohorts now developing the disease. If all other relevant factors had remained constant, then these increases in height and weight would be associated with a 3% increase in ovarian cancer incidence per decade.
Keyword Oral-Contraceptive Use
Requiring Prolonged Observation
Epithelial Ovarian
Mass Index
Anthropometric Measures
Prospective Cohort
Postmenopausal Women
Hormonal Factors
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article number e1001200

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
School of Medicine Publications
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