Cruciferous vegetables and ovarian cancer.

Ovarian cancer risk: Data about the relation with ovarian cancer risk was provided by a pooled analysis of 12 cohorts (9), and one additional cohort (11). No associations were found.

Ovarian cancer mortality: Data about the relation with ovarian cancer mortality was provided by one cohort (5). A significant protective effect was found.

Conclusion: Effects were restricted to findings from one cohort. No evidence was found for an association between cruciferous vegetables and ovarian cancer.

Author	Cohort name	Subjects	Years of follow-up	Cases	End point	Consumption of	Relative Risk (RR)	Adjustments
11) Chang ET (2007)	The California Teachers Study Cohort	97,275 women aged ≤ 84 without a history of bilateral oophorectomy.	1995-96 to 2003	280	Ovarian cancer risk	Cabbage/coleslaw	RR = 1.12 (0.79-1.59; P = 0.21) for the highest vs lowest quintile of consumption. Amount specific data (g): 0.0: RR = 1. > 0.0-1.1: RR = 0.78 (0.53-1.16). > 1.1-1.8: RR = 0.89 (0.62-1.29). > 1.8-3.6: RR = 1.05 (0.74-1.48). > 3.6: RR = 1.12 (0.79-1.59). There were no substantial differences when the analysis was restricted to peri-/postmenopausal women, nor when the cases were limited to invasive or serous ovarian cancer only (data not shown).	Race, total energy intake, parity, oral contraceptive use, strenuous exercise, wine consumption, and menopausal status/hormone therapy use; stratified by age at baseline.
11) Chang ET (2007)	The California Teachers Study Cohort	97,275 women aged ≤ 84 without a history of bilateral oophorectomy.	1995-96 to 2003	280	Ovarian cancer risk	Cauliflower/Brussels sprouts	RR = 0.80 (0.56-1.15; P = 0.33) for the highest vs lowest quintile of consumption. Amount specific data (g): 0.0: RR = 1. > 0.0-2.1: RR = 0.87 (0.61-1.25). > 2.1-4.1: RR = 0.77 (0.54-1.11). > 4.1-8.0: RR = 0.86 (0.61-1.22). > 8.0: RR = 0.80 (0.56-1.15). There were no substantial differences when the analysis was restricted to peri-/postmenopausal women, nor when the cases were limited to invasive or serous ovarian cancer only (data not shown).	Race, total energy intake, parity, oral contraceptive use, strenuous exercise, wine consumption, and menopausal status/hormone therapy use; stratified by age at baseline.
9) Koushik A (2005)	Pooled analysis of 12 cohort studies.	560,441 women.	7-22	2,130?	Invasive epithelial ovarian cancer risk	Cruciferae	INCLUSION CRITERIA: At least 50 incident invasive epithelial ovarian cancer cases. An assessment of usual diet. A validation study of the diet assessment method or a closely related instrument. INCLUDED STUDIES (Follow-up years/No. of ovarian cancer casses): The Adventist Health Study (1976-1988/53). Singh PN. Dietary risk factors for colon cancer in a low-risk population. Am J Epidemiol. 1998 Oct 15;148(8):761-74. Full text The Breast Cancer Detection Demonstration Project (1987-1999/142). Hannan LM. Physical activity and risk of ovarian cancer: a prospective cohort study in the United States. Cancer Epidemiol Biomarkers Prev. 2004 May;13(5):765-70. Full text The Canadian National Breast Screening Study (1980-2000/223). Terry PD. Cigarette smoking and the risk of invasive epithelial ovarian cancer in a prospective cohort study. Eur J Cancer. 2003 May;39(8):1157-64. Abstract The Cancer Prevention Study II Nutrition Cohort (1992-2001/278). Calle EE. The American Cancer Society Cancer Prevention Study II Nutrition Cohort: rationale, study design, and baseline characteristics. Cancer. 2002 Jan 15;94(2):500-11. Abstract The Iowa Women's Health Study (1986-2001/208). Kushi LH. Prospective study of diet and ovarian cancer. Am J Epidemiol. 1999 Jan 1;149(1):21-31 Full text The Netherlands Cohort Study (1986-1995/208). Mommers M. Consumption of vegetables and fruits and risk of ovarian carcinoma. Cancer. 2005 Oct 1;104(7):1512-9. Full text The New York State Cohort (1980-1987/77). Bandera EV. Diet and alcohol consumption and lung cancer risk in the New York State Cohort (United States). Cancer Causes Control. 1997 Nov;8(6):828-40. Abstract The New York University Women's Health Study (1985-1998/65). Kato I. Prospective study of diet and female colorectal cancer: the New York University Women's Health Study. Nutr Cancer. 1997;28(3):276-81. Abstract The Nurses' Health Study A + B (A = 1980-1986/120. B = 1986-2002/315). Fairfield KM. Risk of ovarian carcinoma and consumption of vitamins A, C, and E and specific carotenoids: a prospective analysis. Cancer. 2001 Nov 1;92(9):2318-26. Full text The Nurses' Health Study II (1991-2000/52). Cho E. Premenopausal fat intake and risk of breast cancer. J Natl Cancer Inst. 2003 Jul 16;95(14):1079-85. Full text The Swedish Mammography Cohort (1987-2004/285). Larsson SC. Fruit and vegetable consumption in relation to ovarian cancer incidence: the Swedish Mammography Cohort. Br J Cancer. 2004 Jun 1;90(11):2167-70. Full text The Women's Health Study (1993-2004/104). Higginbotham S. Dietary glycemic load and breast cancer risk in the Women's Health Study. Cancer Epidemiol Biomarkers Prev. 2004 Jan;13(1):65-70. Full text RELATIVE RISK: RR = 0.95 (0.82-1.11) for a 100 g/day increment.	Parity, oral contraceptive use, menopausal status and postmenopausal hormone use, age at menarche, BMI, physical activity, smoking status, and total energy intake. Age in years and year of questionnaire return were included as stratification variables.
7) Mommers M (2005)	The Netherlands Cohort Study	62,573 postmenopausal women aged 55-69.	11,3 (1986-1997)	240	Invasive epithelial ovarian cancer incidence	Brassicas (not defined)	RR = 1.42 (0.88-2.29; P = 0.54) for the highest vs lowest quintile of consumption. Amount specific data (grams/day): 11: RR = 1. 20: RR = 1.33 (0.82-2.16). 27: RR = 1.49 (0.93-2.38). 37: RR = 1.38 (0.85-2.25). 57: RR = 1.42 (0.88-2.29).	Age, height, current cigarette smoking, duration of cigarette smoking, number of cigarettes smoked daily, duration of oral contraceptive use, parity, and total fruit. Test for other possible confounders included hormone therapy, weight, BMI, family history of ovarian or breast carcinoma, hysterectomy, age at menarche, age ate menopause, tubal ligation, and socioeconomic status.
5) Nagle CM (2003)	No cohort name defined	609 women aged 18-79 with invasive epithelial ovarian cancer from a population-based case-control study. (Australia)	7.3 (1990-93 to 1999)	372?	Ovarian cancer mortality	Cruciferous vegetables (broccoli, cauliflower, cabbage, coleslaw, Brussels sprouts)	HR = 0.75 (0.57-0.98; P = 0.03) for the highest vs lowest tertile of consumption. Amount specific data (servings/day): < 0.41: HR = 1. 0.41-0.83: HR = 0.87 (0.67-1.13). > 0.83: HR = 0.75 (0.57-0.98).	FIGO stage, age, grade, total energy, BMI.
4) Fairfield KM (2001)	The Nurses' Health Study	80,326 women aged 38-63. Excluding women with a history of bilateral oophorectomy, hysterectomy with unknown number of ovaries removed, or history of pelvic irradiation. (USA)	1984-1996	204	Invasive epithelial ovarian cancer incidence	Cruciferous vegetables (broccoli, cabbage, cauliflower, brussels sprouts, and kale)	RR = 1.04 (0.69-1.57; P = 0.58) for the highest vs lowest tertile of consumption. Amount specific data (servings/week): ≤ 1: RR = 1. 2-3: RR = 1.06 (0.72-1.57). 3+: RR = 1.04 (0.69-1.57).	Age, BMI, duration of oral contraceptive use, smoking history, parity, history of tubal ligation, total energy, and dietary fiber.

Author

Cohort name

Subjects

Years of follow-up

Cases

End point

Consumption of

Relative Risk (RR)

Adjustments

11) Chang ET (2007)

The California Teachers Study Cohort

97,275 women aged ≤ 84 without a history of bilateral oophorectomy.

1995-96 to 2003

280

Ovarian cancer risk

Cabbage/coleslaw

RR = 1.12 (0.79-1.59; P = 0.21) for the highest vs lowest quintile of consumption.

Amount specific data (g):
0.0: RR = 1.
> 0.0-1.1: RR = 0.78 (0.53-1.16).
> 1.1-1.8: RR = 0.89 (0.62-1.29).
> 1.8-3.6: RR = 1.05 (0.74-1.48).
> 3.6: RR = 1.12 (0.79-1.59).

There were no substantial differences when the analysis was restricted to peri-/postmenopausal women, nor when the cases were limited to invasive or serous ovarian cancer only (data not shown).

Race, total energy intake, parity, oral contraceptive use, strenuous exercise, wine consumption, and menopausal status/hormone therapy use; stratified by age at baseline.

11) Chang ET (2007)

The California Teachers Study Cohort

97,275 women aged ≤ 84 without a history of bilateral oophorectomy.

1995-96 to 2003

280

Ovarian cancer risk

Cauliflower/Brussels sprouts

RR = 0.80 (0.56-1.15; P = 0.33) for the highest vs lowest quintile of consumption.

Amount specific data (g):
0.0: RR = 1.
> 0.0-2.1: RR = 0.87 (0.61-1.25).
> 2.1-4.1: RR = 0.77 (0.54-1.11).
> 4.1-8.0: RR = 0.86 (0.61-1.22).
> 8.0: RR = 0.80 (0.56-1.15).

There were no substantial differences when the analysis was restricted to peri-/postmenopausal women, nor when the cases were limited to invasive or serous ovarian cancer only (data not shown).

Race, total energy intake, parity, oral contraceptive use, strenuous exercise, wine consumption, and menopausal status/hormone therapy use; stratified by age at baseline.

9) Koushik A (2005)

Pooled analysis of 12 cohort studies.

560,441 women.

7-22

2,130?

Invasive epithelial ovarian cancer risk

Cruciferae

INCLUSION CRITERIA:

At least 50 incident invasive epithelial ovarian cancer cases.
An assessment of usual diet.
A validation study of the diet assessment method or a closely related instrument.

INCLUDED STUDIES (Follow-up years/No. of ovarian cancer casses):

The Adventist Health Study (1976-1988/53).
Singh PN. Dietary risk factors for colon cancer in a low-risk population. Am J Epidemiol. 1998 Oct 15;148(8):761-74. Full text
The Breast Cancer Detection Demonstration Project (1987-1999/142).
Hannan LM. Physical activity and risk of ovarian cancer: a prospective cohort study in the United States. Cancer Epidemiol Biomarkers Prev. 2004 May;13(5):765-70. Full text
The Canadian National Breast Screening Study (1980-2000/223).
Terry PD. Cigarette smoking and the risk of invasive epithelial ovarian cancer in a prospective cohort study. Eur J Cancer. 2003 May;39(8):1157-64. Abstract
The Cancer Prevention Study II Nutrition Cohort (1992-2001/278).
Calle EE. The American Cancer Society Cancer Prevention Study II Nutrition Cohort: rationale, study design, and baseline characteristics. Cancer. 2002 Jan 15;94(2):500-11. Abstract
The Iowa Women's Health Study (1986-2001/208).
Kushi LH. Prospective study of diet and ovarian cancer. Am J Epidemiol. 1999 Jan 1;149(1):21-31 Full text
The Netherlands Cohort Study (1986-1995/208).
Mommers M. Consumption of vegetables and fruits and risk of ovarian carcinoma. Cancer. 2005 Oct 1;104(7):1512-9. Full text
The New York State Cohort (1980-1987/77).
Bandera EV. Diet and alcohol consumption and lung cancer risk in the New York State Cohort (United States). Cancer Causes Control. 1997 Nov;8(6):828-40. Abstract
The New York University Women's Health Study (1985-1998/65).
Kato I. Prospective study of diet and female colorectal cancer: the New York University Women's Health Study. Nutr Cancer. 1997;28(3):276-81. Abstract
The Nurses' Health Study A + B (A = 1980-1986/120. B = 1986-2002/315).
Fairfield KM. Risk of ovarian carcinoma and consumption of vitamins A, C, and E and specific carotenoids: a prospective analysis. Cancer. 2001 Nov 1;92(9):2318-26. Full text
The Nurses' Health Study II (1991-2000/52).
Cho E. Premenopausal fat intake and risk of breast cancer. J Natl Cancer Inst. 2003 Jul 16;95(14):1079-85. Full text
The Swedish Mammography Cohort (1987-2004/285).
Larsson SC. Fruit and vegetable consumption in relation to ovarian cancer incidence: the Swedish Mammography Cohort. Br J Cancer. 2004 Jun 1;90(11):2167-70. Full text
The Women's Health Study (1993-2004/104).
Higginbotham S. Dietary glycemic load and breast cancer risk in the Women's Health Study. Cancer Epidemiol Biomarkers Prev. 2004 Jan;13(1):65-70. Full text

RELATIVE RISK:

RR = 0.95 (0.82-1.11) for a 100 g/day increment.

Parity, oral contraceptive use, menopausal status and postmenopausal hormone use, age at menarche, BMI, physical activity, smoking status, and total energy intake. Age in years and year of questionnaire return were included as stratification variables.

7) Mommers M (2005)

The Netherlands Cohort Study

62,573 postmenopausal women aged 55-69.

11,3
(1986-1997)

240

Invasive epithelial ovarian cancer incidence

Brassicas (not defined)

RR = 1.42 (0.88-2.29; P = 0.54) for the highest vs lowest quintile of consumption.

Amount specific data (grams/day):
11: RR = 1.
20: RR = 1.33 (0.82-2.16).
27: RR = 1.49 (0.93-2.38).
37: RR = 1.38 (0.85-2.25).
57: RR = 1.42 (0.88-2.29).

Age, height, current cigarette smoking, duration of cigarette smoking, number of cigarettes smoked daily, duration of oral contraceptive use, parity, and total fruit.
Test for other possible confounders included hormone therapy, weight, BMI, family history of ovarian or breast carcinoma, hysterectomy, age at menarche, age ate menopause, tubal ligation, and socioeconomic status.

5) Nagle CM (2003)

No cohort name defined

609 women aged 18-79 with invasive epithelial ovarian cancer from a population-based case-control study.
(Australia)

7.3
(1990-93 to 1999)

372?

Ovarian cancer mortality

Cruciferous vegetables (broccoli, cauliflower, cabbage, coleslaw, Brussels sprouts)

HR = 0.75 (0.57-0.98; P = 0.03) for the highest vs lowest tertile of consumption.

Amount specific data (servings/day):
< 0.41: HR = 1.
0.41-0.83: HR = 0.87 (0.67-1.13).
> 0.83: HR = 0.75 (0.57-0.98).

FIGO stage, age, grade, total energy, BMI.

4) Fairfield KM (2001)

The Nurses' Health Study

80,326 women aged 38-63. Excluding women with a history of bilateral oophorectomy, hysterectomy with unknown number of ovaries removed, or history of pelvic irradiation.
(USA)

1984-1996

204

Invasive epithelial ovarian cancer incidence

Cruciferous vegetables (broccoli, cabbage, cauliflower, brussels sprouts, and kale)

RR = 1.04 (0.69-1.57; P = 0.58) for the highest vs lowest tertile of consumption.

Amount specific data (servings/week):
≤ 1: RR = 1.
2-3: RR = 1.06 (0.72-1.57).
3+: RR = 1.04 (0.69-1.57).

Age, BMI, duration of oral contraceptive use, smoking history, parity, history of tubal ligation, total energy, and dietary fiber.

Cancer & Diet. A systematic review.

Literature review.

Relating various aspects of our diet
to ovarian cancer risk & mortality.

Cruciferous vegetables and ovarian cancer.

Cancer & Diet. A systematic review.

Literature review.

Relating various aspects of our dietto ovarian cancer risk & mortality.

Cruciferous vegetables and ovarian cancer.

Relating various aspects of our diet
to ovarian cancer risk & mortality.