Diet quality and survival after ovarian cancer

Results from the Women's Health Initiative

Cynthia Thomson, Tracy E. Crane, Betsy C. Wertheim, Marian L. Neuhouser, Wenjun Li, Linda G. Snetselaar, Karen M. Basen-Engquist, Yang Zhou, Melinda L. Irwin

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Survival after an ovarian cancer diagnosis is poor. Given the high mortality in these patients, efforts to identify modifiable lifestyle behaviors that could influence survival are needed. Earlier evidence suggests a protective role for vegetables, but no prior studies have evaluated overall dietary quality and ovarian cancer survival. The purpose of this analysis was to evaluate the role of prediagnosis diet quality in ovarian cancer survival. Methods: We identified 636 centrally adjudicated cases of ovarian cancer within the Women's Health Initiative Observational Study or Clinical Trials of 161 808 postmenopausal women followed from 1995 to 2012. Dietary quality was assessed for the Healthy Eating Index (2005) using a food frequency questionnaire, covariables were obtained from standardized questionnaires, and adiposity was measured by clinic-based measurements of height, weight, and waist circumference. The association between diet quality and mortality was analyzed using Cox proportional hazards regression, adjusted for potential confounders, and stratified by waist circumference, physical activity level, and diabetes status. Tests of statistical significance were two-sided. Results: Overall, higher diet quality was associated with lower all-cause mortality after ovarian cancer (hazard ratio [HR] for highest vs lowest tertile = 0.73; 95% confidence interval [CI] = 0.55 to 0.97, Ptrend =.03). The effect was strongest among women with waist circumference of 88 cm or less and with no history of diabetes (HR = 0.73, 95% CI = 0.54 to 0.98). Physical activity level did not modify the association between diet quality and survival. Conclusion: Our results suggest that overall higher prediagnosis diet quality may protect against mortality after ovarian cancer.

Original languageEnglish (US)
Article numberdju314
JournalJournal of the National Cancer Institute
Volume106
Issue number11
DOIs
StatePublished - Nov 1 2014

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Women's Health
Ovarian Neoplasms
Diet
Survival
Waist Circumference
Mortality
Confidence Intervals
Exercise
Adiposity
Vegetables
Observational Studies
Life Style
Clinical Trials
Weights and Measures
Food

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Thomson, C., Crane, T. E., Wertheim, B. C., Neuhouser, M. L., Li, W., Snetselaar, L. G., ... Irwin, M. L. (2014). Diet quality and survival after ovarian cancer: Results from the Women's Health Initiative. Journal of the National Cancer Institute, 106(11), [dju314]. https://doi.org/10.1093/jnci/dju314

Diet quality and survival after ovarian cancer : Results from the Women's Health Initiative. / Thomson, Cynthia; Crane, Tracy E.; Wertheim, Betsy C.; Neuhouser, Marian L.; Li, Wenjun; Snetselaar, Linda G.; Basen-Engquist, Karen M.; Zhou, Yang; Irwin, Melinda L.

In: Journal of the National Cancer Institute, Vol. 106, No. 11, dju314, 01.11.2014.

Research output: Contribution to journalArticle

Thomson, C, Crane, TE, Wertheim, BC, Neuhouser, ML, Li, W, Snetselaar, LG, Basen-Engquist, KM, Zhou, Y & Irwin, ML 2014, 'Diet quality and survival after ovarian cancer: Results from the Women's Health Initiative', Journal of the National Cancer Institute, vol. 106, no. 11, dju314. https://doi.org/10.1093/jnci/dju314
Thomson, Cynthia ; Crane, Tracy E. ; Wertheim, Betsy C. ; Neuhouser, Marian L. ; Li, Wenjun ; Snetselaar, Linda G. ; Basen-Engquist, Karen M. ; Zhou, Yang ; Irwin, Melinda L. / Diet quality and survival after ovarian cancer : Results from the Women's Health Initiative. In: Journal of the National Cancer Institute. 2014 ; Vol. 106, No. 11.
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abstract = "Background: Survival after an ovarian cancer diagnosis is poor. Given the high mortality in these patients, efforts to identify modifiable lifestyle behaviors that could influence survival are needed. Earlier evidence suggests a protective role for vegetables, but no prior studies have evaluated overall dietary quality and ovarian cancer survival. The purpose of this analysis was to evaluate the role of prediagnosis diet quality in ovarian cancer survival. Methods: We identified 636 centrally adjudicated cases of ovarian cancer within the Women's Health Initiative Observational Study or Clinical Trials of 161 808 postmenopausal women followed from 1995 to 2012. Dietary quality was assessed for the Healthy Eating Index (2005) using a food frequency questionnaire, covariables were obtained from standardized questionnaires, and adiposity was measured by clinic-based measurements of height, weight, and waist circumference. The association between diet quality and mortality was analyzed using Cox proportional hazards regression, adjusted for potential confounders, and stratified by waist circumference, physical activity level, and diabetes status. Tests of statistical significance were two-sided. Results: Overall, higher diet quality was associated with lower all-cause mortality after ovarian cancer (hazard ratio [HR] for highest vs lowest tertile = 0.73; 95{\%} confidence interval [CI] = 0.55 to 0.97, Ptrend =.03). The effect was strongest among women with waist circumference of 88 cm or less and with no history of diabetes (HR = 0.73, 95{\%} CI = 0.54 to 0.98). Physical activity level did not modify the association between diet quality and survival. Conclusion: Our results suggest that overall higher prediagnosis diet quality may protect against mortality after ovarian cancer.",
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