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open access
Abstract
Observational
studies assessing the association of dietary fat and risk of ovarian
cancer yield discrepant results. Pertinent prospective cohort studies
were identified by a PubMed search from inception to December 2015.
Sixteen independent case-control and nine cohort studies on dietary fat
intake were included, with approximately 900,000 subjects in total.
Relative risks (RRs) with 95% confidence intervals were pooled using a
random effects model. Heterogeneity, sensitivity analysis and
publication bias were assessed; subgroup analysis and analysis
stratified by EOC histology were conducted. The reported studies showed a
significant increase of ovarian cancer risk with high consumption of
total-, saturated-, and trans-fats, while serous ovarian cancer was more
susceptible to dietary fat consumption than other pathological
subtypes. No evidence of positive association between dietary fat intake
and ovarian cancer risk was provided by cohort studies. Menopausal
status, hormone replacement therapy, body mass index (BMI), and
pregnancy times, modified the objective associations. In conclusion, the
meta-analysis findings indicate that high consumption of total,
saturated and trans-fats increase ovarian cancer risk, and different
histological subtypes have different susceptibility to dietary fat.
Introduction
Ovarian cancer is considered the sixth most
commonly diagnosed cancer among women and the second cause of
gynecologic cancer mortality worldwide [1, 2]. The prognosis of ovarian cancer is poor, with the initial diagnosis in most patients made at an advanced stage [3, 4].
The noticeable relationship between ovarian cancer incidence and
geographical regions suggested that dietary habits and ethnic variations
are potentially modifiable factors [5], whose etiologic role in ovarian cancer risk, however, remains undefined [6].
Dietary fat, as one of the most controversial
dietary factors in nutritional epidemiology, has been reported with
positive correlations with breast [7] and gastric [8] cancers in two recent meta-analyses, and elevated ovarian cancer risk in early ecologic studies [5, 9].
Although multiple epidemiologic studies have explored the associations
between dietary fat consumption and risk of ovarian cancer, no definite
conclusion have been drawn, and the dietary fat varieties as well as
pathological types of ovarian cancer increase the complexity of this
research topic. The results of two meta-analyses [10, 11] and a pooled analysis [12]
that included data from 12 cohort studies also reached inconsistent
conclusions. Therefore, we conducted a meta-analysis of case-control and
cohort studies with more-detailed analyses of 1) the epidemiologic
evidence regarding the association of dietary fat consumption with risk
of ovarian cancer, 2) the association between dietary fat intake and the
risk of ovarian cancer and pathological subtypes. This analysis was
based on dietary fat types, and we extended the previous analyses [10, 11] with more included studies and dietary fat types, and an assessment stratified by EOC histology.
Materials and Methods
Search strategy
We obtained the literature published in any
language to December 2015 by fully searching the PubMed database. The
search terms used were “diet”, ‘‘dietary fat’’ in combination with
“ovarian cancer,” “ovarian neoplasm” or “ovarian carcinoma”, without
restrictions. In addition, we reviewed the reference lists of retrieved
studies and recent reviews to supplement electronic database searches......
An important highlight of our meta-analysis is that we analyzed the association between dietary fat intake and the risk of ovarian cancer subtypes. We found that serous ovarian cancer incidence was more susceptible to dietary fat intake. However, these results should be interpreted with caution. The insufficient number of included cases and potential misclassification of pathological subtypes may contribute to the statistical difference observed.
Future studies should focus more on specific pathological subtypes of ovarian cancer as well as the influence of molecular mechanisms and genetic factors on the association of dietary fat and ovarian cancer.
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