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Epidemiology

Racial differences in the association of body mass index and ovarian cancer risk in the OCWAA Consortium

British Journal of Cancer volume 127, pages 1983–1990 (2022)Cite this article

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Abstract

Background

Obesity disproportionately affects African American (AA) women and has been shown to increase ovarian cancer risk, with some suggestions that the association may differ by race.

Methods

We evaluated body mass index (BMI) and invasive epithelial ovarian cancer (EOC) risk in a pooled study of case–control and nested case–control studies including AA and White women. We evaluated both young adult and recent BMI (within the last 5 years). Associations were estimated using multi-level and multinomial logistic regression models.

Results

The sample included 1078 AA cases, 2582 AA controls, 3240 White cases and 9851 White controls. We observed a higher risk for the non-high-grade serous (NHGS) histotypes for AA women with obesity (ORBMI 30+= 1.62, 95% CI: 1.16, 2.26) and White women with obesity (ORBMI 30+= 1.20, 95% CI: 1.02, 2.42) compared to non-obese. Obesity was associated with higher NHGS risk in White women who never used HT (ORBMI 30+= 1.40, 95% CI: 1.08, 1.82). Higher NHGS ovarian cancer risk was observed for AA women who ever used HT (ORBMI 30+= 2.66, 95% CI: 1.15, 6.13), while in White women, there was an inverse association between recent BMI and risk of EOC and HGS in ever-HT users (EOC ORBMI 30+= 0.81, 95% CI: 0.69, 0.95, HGS ORBMI 30+= 0.73, 95% CI: 0.61, 0.88).

Conclusion

Obesity contributes to NHGS EOC risk in AA and White women, but risk across racial groups studied differs by HT use and histotype.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank the WHI investigators and staff for their dedication, and the study participants for making the study possible. A full listing of WHI investigators can be found at https://www.whi.org/doc/WHI-Investigator-Long-List.pdf. Pathology data were obtained from the following state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, VA), and results reported do not necessarily represent their views. The IRBs of participating institutions and cancer registries have approved these studies, as required. Opinions expressed by the authors are their own, and this material should not be interpreted as representing the official viewpoint of the U.S. Department of Health and Human Services, the National Institutes of Health, or the National Cancer Institute.

Funding

This study is supported by the National Institutes of Health (R01-CA207260 to Schildkraut and Rosenberg and K01-CA212056 to Bethea). AACES was funded by NCI (R01-CA142081 to Schildkraut); BWHS is funded by NIH (R01-CA058420,UM1-CA164974, and U01-CA164974 to Rosenberg); CCCCS was funded by NIH/NCI (R01-CA61093 to Rosenblatt); LACOCS was funded by NCI (R01-CA17054 to Pike, R01-CA58598 to Goodman and Wu, and Cancer Center Core Grant P30-CA014089 to Henderson and Wu) and by the California Cancer Research Program (2II0200 to A Wu); and NCOCS was funded by NCI (R01-CA076016 to Schildkraut). The WHI program is funded by the National Heart, Lung, and Blood Institute through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C and HHSN268201600004C. Additional grants to support WHI inclusion in OCWAA include UM1-CA173642-05 (to Anderson) and NIH/NHLBI-CSB-WH-2016-01-CM.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA

    Heather M. Ochs-Balcom

  2. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Courtney Johnson, Lauren F. Dempsey & Joellen M. Schildkraut

  3. Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA

    Kristin A. Guertin

  4. Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA

    Bo Qin & Elisa V. Bandera

  5. Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA

    Alicia Beeghly-Fadiel

  6. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA

    Fabian Camacho & Will Rosenow

  7. Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Campus, Washington DC, USA

    Traci N. Bethea

  8. Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago School of Medicine and Division of Epidemiology and Biostatistics, School of Public Health, Chicago, IL, USA

    Charlotte E. Joslin

  9. Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA

    Evan Myers

  10. Department of Family Medicine and Community Health, Duke University Medical Center, Durham, NC, USA

    Patricia G. Moorman

  11. Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Holly R. Harris

  12. Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Lauren C. Peres

  13. University of Southern California Norris Comprehensive Cancer Center, and Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA

    V. Wendy Setiawan & Anna H. Wu

  14. Slone Epidemiology Center at Boston University, Boston, MA, USA

    Lynn Rosenberg

Authors
  1. Heather M. Ochs-Balcom
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  2. Courtney Johnson
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  4. Bo Qin
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  10. Charlotte E. Joslin
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  12. Patricia G. Moorman
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  16. Anna H. Wu
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  17. Lynn Rosenberg
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  18. Joellen M. Schildkraut
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  19. Elisa V. Bandera
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Contributions

Conceptualisation: EVB, HMO, JMS and LR. Data curation: TNB, HRH, CEJ, PGM, WR, EM, HMO, VWS, AHW, LR, JMS and EVB. Formal analysis: CEJ. Funding acquisition: JMS and LR. Methodology: HMO, EVB, CEJ, BQ, JMS and LR. Writing—original draft: HMO, EVB and JMS. Writing—review and editing: all authors.

Corresponding author

Correspondence to Heather M. Ochs-Balcom.

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Competing interests

PGM has received compensation for work related to litigation in regard to talc and ovarian cancer. The remaining authors declare no competing interests.

Ethics approval and consent to participate

Each study obtained informed consent from its participants; the individual studies and the OCWAA Consortium were approved by the relevant Institutional Review Boards.

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Ochs-Balcom, H.M., Johnson, C., Guertin, K.A. et al. Racial differences in the association of body mass index and ovarian cancer risk in the OCWAA Consortium. Br J Cancer 127, 1983–1990 (2022). https://doi.org/10.1038/s41416-022-01981-6

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