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Rigshospitalet - en del af Københavns Universitetshospital
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Joint exposure to smoking, excessive weight, and physical inactivity and survival of ovarian cancer patients, evidence from the Ovarian Cancer Association Consortium

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  • Albina N Minlikeeva
  • Rikki Cannioto
  • Allan Jensen
  • Susanne K Kjaer
  • Susan J Jordan
  • Brenda Diergaarde
  • J Brian Szender
  • Kunle Odunsi
  • Hani Almohanna
  • Paul Mayor
  • Kirsten Starbuck
  • Emese Zsiros
  • Elisa V Bandera
  • Daniel W Cramer
  • Jennifer A Doherty
  • Anna DeFazio
  • Robert Edwards
  • Ellen L Goode
  • Marc T Goodman
  • Estrid Høgdall
  • Keitary Matsuo
  • Mika Mizuno
  • Christina M Nagle
  • Roberta B Ness
  • Lisa E Paddock
  • Celeste L Pearce
  • Harvey A Risch
  • Mary Anne Rossing
  • Kathryn L Terry
  • Anna H Wu
  • Francesmary Modugno
  • Penelope M Webb
  • Kirsten B Moysich
  • Australian Ovarian Cancer Study Group
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PURPOSE: Previous epidemiologic studies have shown that smoking, obesity, and physical inactivity are associated with poor survival following a diagnosis of ovarian cancer. Yet, the combined relationship of these unfavorable lifestyle factors on ovarian cancer survival has not been sufficiently investigated.

METHODS: Using data pooled from 13 studies, we examined the associations between combined exposures to smoking, overweight/obesity weight, and physical inactivity and overall survival (OS) as well as progression-free survival (PFS) among women diagnosed with invasive epithelial ovarian carcinoma (n = 7,022). Using age- and stage-adjusted Cox proportional hazards regression models, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) associated with joint exposure to these factors.

RESULTS: Combined exposure to current smoking, overweight/obesity, and physical inactivity prior to diagnosis was associated with a significantly increased risk of mortality compared to women who never smoked, had normal body mass index (BMI), and were physically active (HR = 1.37; 95% CI 1.10-1.70). The association for a joint exposure to these factors exceeded that of each exposure individually. In fact, exposure to both current smoking and overweight/obesity, and current smoking and physical inactivity was also associated with increased risk of death (HR = 1.28; 95% CI 1.08-1.52, and HR = 1.26; 95% CI 1.04-1.54, respectively). The associations were of a similar magnitude when former smoking was assessed in combination with the other exposures and when excessive weight was limited to obesity only. No significant associations were observed between joint exposure to any of these factors and PFS.

CONCLUSIONS: Joint exposure to smoking, excessive weight, and physical inactivity may negatively impact survival of ovarian cancer patients. These results suggest the importance of examining the combined effect of lifestyle factors on ovarian cancer patients' survival.

OriginalsprogEngelsk
TidsskriftCancer causes & control : CCC
Vol/bind30
Udgave nummer5
Sider (fra-til)537-547
Antal sider11
ISSN0957-5243
DOI
StatusUdgivet - maj 2019

ID: 58439569