Nutrient intake and ovarian cancer: an Italian case-control study

Objective: The role of selected macronutrients, cholesterol, and fatty acids in the etiology of epithelial ovarian cancer was analyzed using data from a case-control study carried out in five Italian areas between January 1992 and December 1999. Methods: Cases comprised 1031 women with incident, histologically confirmed epithelial ovarian cancer, admitted to the major teaching and general hospitals of the study areas. Controls comprised 2411 women admitted for acute, non-neoplastic conditions to the same network of hospitals. Information on dietary habits was elicited using a validated food-frequency questionnaire including 78 food groups and recipes. Odds ratios (OR) and their corresponding 95% confidence intervals (CI) were computed by subsequent quintiles of nutrient intake. Results: Direct associations with ovarian cancer emerged for starch intake (OR = 1.4 in the highest vs the lowest quintile of intake; 95% CI 1.1-1.8), while inverse associations emerged for monounsaturated (OR = 0.7; 95% CI 0.5-0.9), and polyunsaturated (OR = 0.7; 95% CI 0.5-0.9) fatty acids. Among fatty acids, oleic (OR = 0.7; 95% CI 0.5-0.9), linoleic (OR = 0.7; 95% CI 0.5-0.9), and linolenic (OR = 0.8; 95% CI 0.6-1.0) acids were inversely related to ovarian cancer. When, however, six macronutrients were included in the same model, only the adverse effect of high starch intake remained significant. Results were consistent in separate strata of menopausal status, parity, and energy intake. Conclusions: Starch was directly associated, and unsaturated fatty acids were inversely associated, with ovarian cancer risk.