Joint exposure to smoking, excessive weight, and physical inactivity and survival of ovarian cancer patients, evidence from the Ovarian Cancer Association Consortium

The Australian Ovarian Cancer Study Group, The Ovarian Cancer Association Consortium

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: Previous epidemiologic studies have shown that smoking, obesity, and physical inactivity are associated with poor survival following a diagnosis of ovarian cancer. Yet, the combined relationship of these unfavorable lifestyle factors on ovarian cancer survival has not been sufficiently investigated. Methods: Using data pooled from 13 studies, we examined the associations between combined exposures to smoking, overweight/obesity weight, and physical inactivity and overall survival (OS) as well as progression-free survival (PFS) among women diagnosed with invasive epithelial ovarian carcinoma (n = 7,022). Using age- and stage-adjusted Cox proportional hazards regression models, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) associated with joint exposure to these factors. Results: Combined exposure to current smoking, overweight/obesity, and physical inactivity prior to diagnosis was associated with a significantly increased risk of mortality compared to women who never smoked, had normal body mass index (BMI), and were physically active (HR = 1.37; 95% CI 1.10–1.70). The association for a joint exposure to these factors exceeded that of each exposure individually. In fact, exposure to both current smoking and overweight/obesity, and current smoking and physical inactivity was also associated with increased risk of death (HR = 1.28; 95% CI 1.08–1.52, and HR = 1.26; 95% CI 1.04–1.54, respectively). The associations were of a similar magnitude when former smoking was assessed in combination with the other exposures and when excessive weight was limited to obesity only. No significant associations were observed between joint exposure to any of these factors and PFS. Conclusions: Joint exposure to smoking, excessive weight, and physical inactivity may negatively impact survival of ovarian cancer patients. These results suggest the importance of examining the combined effect of lifestyle factors on ovarian cancer patients’ survival.

Original languageEnglish (US)
JournalCancer Causes and Control
DOIs
StatePublished - Jan 1 2019

Fingerprint

Ovarian Neoplasms
Joints
Smoking
Weights and Measures
Survival
Obesity
Confidence Intervals
Disease-Free Survival
Life Style
Proportional Hazards Models
Epidemiologic Studies
Body Mass Index
Carcinoma
Mortality

Keywords

  • Obesity
  • Ovarian cancer survival
  • Overweight
  • Physical inactivity
  • Prognosis
  • Smoking cigarettes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Joint exposure to smoking, excessive weight, and physical inactivity and survival of ovarian cancer patients, evidence from the Ovarian Cancer Association Consortium. / The Australian Ovarian Cancer Study Group; The Ovarian Cancer Association Consortium.

In: Cancer Causes and Control, 01.01.2019.

Research output: Contribution to journalArticle

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title = "Joint exposure to smoking, excessive weight, and physical inactivity and survival of ovarian cancer patients, evidence from the Ovarian Cancer Association Consortium",
abstract = "Purpose: Previous epidemiologic studies have shown that smoking, obesity, and physical inactivity are associated with poor survival following a diagnosis of ovarian cancer. Yet, the combined relationship of these unfavorable lifestyle factors on ovarian cancer survival has not been sufficiently investigated. Methods: Using data pooled from 13 studies, we examined the associations between combined exposures to smoking, overweight/obesity weight, and physical inactivity and overall survival (OS) as well as progression-free survival (PFS) among women diagnosed with invasive epithelial ovarian carcinoma (n = 7,022). Using age- and stage-adjusted Cox proportional hazards regression models, we estimated hazard ratios (HRs) and 95{\%} confidence intervals (CIs) associated with joint exposure to these factors. Results: Combined exposure to current smoking, overweight/obesity, and physical inactivity prior to diagnosis was associated with a significantly increased risk of mortality compared to women who never smoked, had normal body mass index (BMI), and were physically active (HR = 1.37; 95{\%} CI 1.10–1.70). The association for a joint exposure to these factors exceeded that of each exposure individually. In fact, exposure to both current smoking and overweight/obesity, and current smoking and physical inactivity was also associated with increased risk of death (HR = 1.28; 95{\%} CI 1.08–1.52, and HR = 1.26; 95{\%} CI 1.04–1.54, respectively). The associations were of a similar magnitude when former smoking was assessed in combination with the other exposures and when excessive weight was limited to obesity only. No significant associations were observed between joint exposure to any of these factors and PFS. Conclusions: Joint exposure to smoking, excessive weight, and physical inactivity may negatively impact survival of ovarian cancer patients. These results suggest the importance of examining the combined effect of lifestyle factors on ovarian cancer patients’ survival.",
keywords = "Obesity, Ovarian cancer survival, Overweight, Physical inactivity, Prognosis, Smoking cigarettes",
author = "{The Australian Ovarian Cancer Study Group} and {The Ovarian Cancer Association Consortium} and Minlikeeva, {Albina N.} and Rikki Cannioto and Allan Jensen and Kjaer, {Susanne K.} and Jordan, {Susan J.} and Brenda Diergaarde and Szender, {J. Brian} and Kunle Odunsi and Hani Almohanna and Paul Mayor and Kirsten Starbuck and Emese Zsiros and Bandera, {Elisa V.} and Cramer, {Daniel W.} and Doherty, {Jennifer A.} and Anna DeFazio and Robert Edwards and Goode, {Ellen L} and Goodman, {Marc T.} and Estrid H{\o}gdall and Keitary Matsuo and Mika Mizuno and Nagle, {Christina M.} and Ness, {Roberta B.} and Paddock, {Lisa E.} and Pearce, {Celeste L.} and Risch, {Harvey A.} and Rossing, {Mary Anne} and Terry, {Kathryn L.} and Wu, {Anna H.} and Francesmary Modugno and Webb, {Penelope M.} and Moysich, {Kirsten B.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s10552-019-01157-3",
language = "English (US)",
journal = "Cancer Causes and Control",
issn = "0957-5243",
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T1 - Joint exposure to smoking, excessive weight, and physical inactivity and survival of ovarian cancer patients, evidence from the Ovarian Cancer Association Consortium

AU - The Australian Ovarian Cancer Study Group

AU - The Ovarian Cancer Association Consortium

AU - Minlikeeva, Albina N.

AU - Cannioto, Rikki

AU - Jensen, Allan

AU - Kjaer, Susanne K.

AU - Jordan, Susan J.

AU - Diergaarde, Brenda

AU - Szender, J. Brian

AU - Odunsi, Kunle

AU - Almohanna, Hani

AU - Mayor, Paul

AU - Starbuck, Kirsten

AU - Zsiros, Emese

AU - Bandera, Elisa V.

AU - Cramer, Daniel W.

AU - Doherty, Jennifer A.

AU - DeFazio, Anna

AU - Edwards, Robert

AU - Goode, Ellen L

AU - Goodman, Marc T.

AU - Høgdall, Estrid

AU - Matsuo, Keitary

AU - Mizuno, Mika

AU - Nagle, Christina M.

AU - Ness, Roberta B.

AU - Paddock, Lisa E.

AU - Pearce, Celeste L.

AU - Risch, Harvey A.

AU - Rossing, Mary Anne

AU - Terry, Kathryn L.

AU - Wu, Anna H.

AU - Modugno, Francesmary

AU - Webb, Penelope M.

AU - Moysich, Kirsten B.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: Previous epidemiologic studies have shown that smoking, obesity, and physical inactivity are associated with poor survival following a diagnosis of ovarian cancer. Yet, the combined relationship of these unfavorable lifestyle factors on ovarian cancer survival has not been sufficiently investigated. Methods: Using data pooled from 13 studies, we examined the associations between combined exposures to smoking, overweight/obesity weight, and physical inactivity and overall survival (OS) as well as progression-free survival (PFS) among women diagnosed with invasive epithelial ovarian carcinoma (n = 7,022). Using age- and stage-adjusted Cox proportional hazards regression models, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) associated with joint exposure to these factors. Results: Combined exposure to current smoking, overweight/obesity, and physical inactivity prior to diagnosis was associated with a significantly increased risk of mortality compared to women who never smoked, had normal body mass index (BMI), and were physically active (HR = 1.37; 95% CI 1.10–1.70). The association for a joint exposure to these factors exceeded that of each exposure individually. In fact, exposure to both current smoking and overweight/obesity, and current smoking and physical inactivity was also associated with increased risk of death (HR = 1.28; 95% CI 1.08–1.52, and HR = 1.26; 95% CI 1.04–1.54, respectively). The associations were of a similar magnitude when former smoking was assessed in combination with the other exposures and when excessive weight was limited to obesity only. No significant associations were observed between joint exposure to any of these factors and PFS. Conclusions: Joint exposure to smoking, excessive weight, and physical inactivity may negatively impact survival of ovarian cancer patients. These results suggest the importance of examining the combined effect of lifestyle factors on ovarian cancer patients’ survival.

AB - Purpose: Previous epidemiologic studies have shown that smoking, obesity, and physical inactivity are associated with poor survival following a diagnosis of ovarian cancer. Yet, the combined relationship of these unfavorable lifestyle factors on ovarian cancer survival has not been sufficiently investigated. Methods: Using data pooled from 13 studies, we examined the associations between combined exposures to smoking, overweight/obesity weight, and physical inactivity and overall survival (OS) as well as progression-free survival (PFS) among women diagnosed with invasive epithelial ovarian carcinoma (n = 7,022). Using age- and stage-adjusted Cox proportional hazards regression models, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) associated with joint exposure to these factors. Results: Combined exposure to current smoking, overweight/obesity, and physical inactivity prior to diagnosis was associated with a significantly increased risk of mortality compared to women who never smoked, had normal body mass index (BMI), and were physically active (HR = 1.37; 95% CI 1.10–1.70). The association for a joint exposure to these factors exceeded that of each exposure individually. In fact, exposure to both current smoking and overweight/obesity, and current smoking and physical inactivity was also associated with increased risk of death (HR = 1.28; 95% CI 1.08–1.52, and HR = 1.26; 95% CI 1.04–1.54, respectively). The associations were of a similar magnitude when former smoking was assessed in combination with the other exposures and when excessive weight was limited to obesity only. No significant associations were observed between joint exposure to any of these factors and PFS. Conclusions: Joint exposure to smoking, excessive weight, and physical inactivity may negatively impact survival of ovarian cancer patients. These results suggest the importance of examining the combined effect of lifestyle factors on ovarian cancer patients’ survival.

KW - Obesity

KW - Ovarian cancer survival

KW - Overweight

KW - Physical inactivity

KW - Prognosis

KW - Smoking cigarettes

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U2 - 10.1007/s10552-019-01157-3

DO - 10.1007/s10552-019-01157-3

M3 - Article

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AN - SCOPUS:85064174358

JO - Cancer Causes and Control

JF - Cancer Causes and Control

SN - 0957-5243

ER -