Joint exposure to smoking, excessive weight, and physical inactivity and survival of ovarian cancer patients, evidence from the Ovarian Cancer Association Consortium

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

doi:10.1007/s10552-019-01157-3

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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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Joint exposure to smoking, excessive weight, and physical inactivity and survival of ovarian cancer patients, evidence from the Ovarian Cancer Association Consortium

Albina N Minlikeeva, Rikki Cannioto, Allan Jensen, Susanne K Kjaer, Susan J Jordan, Brenda Diergaarde, J Brian Szender, Kunle Odunsi, Hani Almohanna, Paul Mayor, …

Cancer causes & control, Vol.30(5), pp.537-547

05/2019

DOI: https://doi.org/10.1007/s10552-019-01157-3

PMCID: PMC6614876

PMID: 30905014

Abstract

Carcinoma, Ovarian Epithelial - epidemiology

Female

Humans

Motor Activity

Obesity - complications

Ovarian Neoplasms - epidemiology

Ovarian Neoplasms - mortality

Overweight - complications

Proportional Hazards Models

Risk Factors

Sedentary Behavior

Smoking - adverse effects

Smoking - epidemiology

Weight Gain

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. 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. 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. 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.

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Title: Joint exposure to smoking, excessive weight, and physical inactivity and survival of ovarian cancer patients, evidence from the Ovarian Cancer Association Consortium
Creators: Albina N Minlikeeva - Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, A-352 Carlton House, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA
Rikki Cannioto - Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, A-352 Carlton House, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA
Allan Jensen - Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
Susanne K Kjaer - Deparment of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Susan J Jordan - The University of Queensland, School of Public Health, Herston, QLD, Australia
Brenda Diergaarde - Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, and UPMC Hillman Cancer Center, Pittsburgh, PA, USA
J Brian Szender - START Center for Cancer Care, San Antonio, TX, USA
Kunle Odunsi - Center of Immunotherapy, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Hani Almohanna - Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, A-352 Carlton House, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA
Paul Mayor - Department of Surgery, Division of Gynecologic Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Kirsten Starbuck - Department of Surgery, Division of Gynecologic Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Emese Zsiros - Center of Immunotherapy, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Elisa V Bandera - Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
Daniel W Cramer - Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
Jennifer A Doherty - Department of Epidemiology, The Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
Anna DeFazio - Department of Gynecological Oncology, Westmead Hospital and the Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
Robert Edwards - Ovarian Cancer Center of Excellence, Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
Ellen L Goode - Division of Epidemiology, Department of Health Science Research, Mayo Clinic, Rochester, MN, USA
Marc T Goodman - Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Estrid Høgdall - Department of Pathology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
Keitary Matsuo - Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
Mika Mizuno - Department of Gynecological Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
Christina M Nagle - The University of Queensland, School of Public Health, Herston, QLD, Australia
Roberta B Ness - School of Public Health, The University of Texas, Houston, TX, USA
Lisa E Paddock - Rutgers Cancer Institute, New Brunswick, NJ, USA
Celeste L Pearce - Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
Harvey A Risch - Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
Mary Anne Rossing - Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
Kathryn L Terry - Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
Anna H Wu - Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
Francesmary Modugno - Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
Penelope M Webb - The University of Queensland, School of Public Health, Herston, QLD, Australia
Kirsten B Moysich - Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA. kirsten.moysich@roswellpark.org
Australian Ovarian Cancer Study Group
Publication Details: Cancer causes & control, Vol.30(5), pp.537-547
Date published: 05/2019
Grant note: P50-CA105009 / National Institutes of Health Grant-in-Aid for the Third Term Comprehensive 10-Year Strategy for Cancer Control / Ministry of Health, Labour and Welfare K07-CA080668 / National Cancer Institute DAMD17-02-1-0669 / U.S. Department of Defense APP1120431 / National Health and Medical Research Council K22-CA138563 / National Cancer Institute N01CN025403 / National Institutes of Health P30-CA15083 / National Institutes of Health K07 CA095666 / National Cancer Institute R01-CA122443 / National Institutes of Health N01-CN-55424 / National Institutes of Health T32 CA108456 / NCI NIH HHS R01-CA87538 / National Institutes of Health 94 222 52 / Danish Cancer Society None / Cancer Foundation of Western Australia R01-CA61107 / National Cancer Institute P50CA159981 / National Cancer Institute N01PC67010 / National Institutes of Health 2R25CA113951 / National Cancer Institute R01-CA95023 / National Cancer Institute R03CA115195 / National Institutes of Health R01CA61132 / National Institutes of Health DAMD17-01-1-0729 / Medical Research and Materiel Command 199600 / National Health and Medical Research Council APP1073898 / National Health & Medical Research Council of Australia R01 CA188900 / NCI NIH HHS 2II0200 / California Cancer Research Program 00-01389V-20170 / California Cancer Research Program APP1043134 / National Health & Medical Research Council of Australia 4R25CA113951 / National Cancer Institute R03CA113148 / National Institutes of Health APP1061341 / National Health and Medical Research of Australia P30-CA072720 / National Cancer Institute P01CA17054 / National Institutes of Health P30-CA072720 / National Health and Medical Research Council R01-CA080742 / National Institutes of Health W81XWH-10-1-02802 / U.S. Department of Defense T32CA108456 / National Institutes of Health R01-CA074850 / National Institutes of Health R01-CA112523 / National Institutes of Health 400281 / National Health and Medical Research Council R01CA126841 / National Cancer Institute N01-PC-67001 / National Institutes of Health R01-CA54419 / National Institutes of Health P50-CA136393 / National Institutes of Health R01-CA58598 / National Institutes of Health R01CA095023 / National Cancer Institute P30CA14089 / National Institutes of Health
Academic Unit: Cancer Epidemiology and Health Outcomes
Language: English
Resource Type: Journal article
Identifiers: 991031665759104646