Abstract
Dietary energy restriction may protect against cancer. In parts of the Netherlands, mostly in larger cities, periods of chronically impaired nutrition and even severe famine (Hunger Winter 1944–1945) existed during the 1930s and World War II (1940–1945). We studied the association between energy restriction during childhood and early adulthood on the risk of ovarian cancer later in life. In 1986, the Netherlands Cohort Study was initiated. A self-administered questionnaire on dietary habits and other cancer risk factors was completed by 62,573 women aged 55–69 years at baseline. Follow-up for cancer was established by record linkage to the Netherlands Cancer Registry. After 16.3 years of follow-up, 364 invasive epithelial ovarian cancer cases and 2220 subcohort members (sampled from the total cohort directly after baseline) with complete information confounders were available for case-cohort analyses. In multivariable analysis, ovarian cancer risk was lower for participants with an unemployed father during the 1930s (Hazard Ratio (HR), 0.70; 95% Confidence Interval (CI), 0.47–1.06) compared to participants with an employed father as well as for participants living in a city during World War II (HR, 0.69; 95% CI, 0.54–0.90) compared to participants living in the country-side. Residence in a Western City during the famine (Hunger Winter) was not associated with a decreased risk. Our results show a relation between proxy variables for modest energy restriction over a longer period of time during childhood or early adulthood and a reduced ovarian cancer risk.
Highlights
IntroductionOvarian cancer is the seventh most common malignancy among women living in the world, with approximately 225,000 newly diagnosed ovarian cancer cases and almost 140,000 deaths due to ovarian cancer in 2008. [1]Oral contraceptive use, parity and tubal ligation have been associated with a reduced ovarian cancer risk. [2,3] Height has been associated with an increased risk of ovarian cancer. [4] Increased risks have been reported for postmenopausal hormone use, intake of lactose/galactose, overweight and smoking, but these factors are inconsistently associated with ovarian cancer. [2]In animal studies an inverse association between energy restriction and cancer has been found for mice [5], while such an association was less consistent for breast cancer [6,7,8] and colorectal cancer [9,10,11,12] in humans
In animal studies an inverse association between energy restriction and cancer has been found for mice [5], while such an association was less consistent for breast cancer [6,7,8] and colorectal cancer [9,10,11,12] in humans
The most frequent subtypes of ovarian cancer observed in this population were serous carcinoma (49%), mucinous carcinoma (9%), endometrioid carcinoma (9%) and adenocarcinoma – not otherwise specified (24%)
Summary
Ovarian cancer is the seventh most common malignancy among women living in the world, with approximately 225,000 newly diagnosed ovarian cancer cases and almost 140,000 deaths due to ovarian cancer in 2008. [1]Oral contraceptive use, parity and tubal ligation have been associated with a reduced ovarian cancer risk. [2,3] Height has been associated with an increased risk of ovarian cancer. [4] Increased risks have been reported for postmenopausal hormone use, intake of lactose/galactose, overweight and smoking, but these factors are inconsistently associated with ovarian cancer. [2]In animal studies an inverse association between energy restriction and cancer has been found for mice [5], while such an association was less consistent for breast cancer [6,7,8] and colorectal cancer [9,10,11,12] in humans. A substantial part of the population experienced a severe famine during World War II, the so-called Hunger winter (1944– 1945), especially in the Western Cities of the country. This unique setting provided the opportunity to study the association between energy restriction during childhood and early adulthood on the risk of ovarian cancer later in life. We evaluated this within the Netherlands cohort study on diet and cancer
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
