Correlation between Physical Activities and Risk of Ovarian Cancer: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 ZHANGMeng-ting ¹ , TIANJin-hui ² , WANGZi-jing ³ ,  YANGYong-xiu ⁴

1. Department of Obstetrics, Affiliated Hospital of Xi'an Medical University, Xi'an 710077, China;
2. Evidence-based Medicine Center, Lanzhou University, Lanzhou 730000, China;
3. First Clinical Medical College of Lanzhou University, Lanzhou 730000, China;
4. Department of Gynecology and Obstetrics, First Hospital of Lanzhou University, Lanzhou 730000, China;

Corresponding author：

YANGYong-xiu, Email: yongxiuyang@163.com

Keywords：

Ovarian cancer; Physical activity; Systematic review; Meta-analysis; Cohort study

DOI：

10.7507/1672-2531.20140193

Video：

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Objective To systematiclly review the correlation between physical activity and the risk of ovarian cancer. Methods Such databases as CBM, CNKI, WanFang Data, VIP, The Cochrane Library (Issue 10, 2013), PubMed, EMbase were searched from database establishment to October 2013 to collect prospective cohort studies about physical activities and the risk of ovarian cancer. Relevant magazines and references of included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. Results A total of 8 cohort studies involving 580 581 subjects, of which there were 2 444 cases of patients with ovarian cancer. The results of meta-analysis showed that, women who participated in moderate level physical activities tended to have a lower incidence of ovarian cancer, compared with those who participated in low level physical activities (age-adjusted:RR=0.87, 95%CI 0.75 to 1.01, P=0.06; multivariate-adjusted:RR=0.97, 95%CI 0.83 to 1.14, P=0.71) but with no significant difference; while women who participated in high level physical activities tended to have a higher incidence of ovarian cancer with a significant difference found in the multivariate-adjusted results (age-adjusted:RR=1.19, 95%CI 0.91 to 1.56, P=0.21; multivariate-adjusted:RR=1.35, 95%CI 1.08 to 1.67, P=0.008). Along with the increase of sedentariness, the incidence of ovarian cancer rose, but with no significant difference. Conclusion Current evidence shows that, compared with low level physical activities, high level ones increase the risk of ovarian caner; while the effects of moderate level ones and sedentariness on the risk of ovarian caner still remain uncertain. However, more high-quality studies are required to verify the conclusion of this study because of the limited quantity of the included studies as well as many confounding factors.

Citation： ZHANGMeng-ting, TIANJin-hui, WANGZi-jing, YANGYong-xiu. Correlation between Physical Activities and Risk of Ovarian Cancer: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(10): 1194-1200. doi: 10.7507/1672-2531.20140193 Copy

1.	Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2):69-90.
2.	Oh HK, Sin JI, Choi J, et al. Overexpression of CD73 in epithelial ovarian carcinoma is associated with better prognosis, lower stage, better differentiation and lower regulatory T cell infiltration. J Gynecol Oncol, 2012, 23(4): 274-281.
3.	Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin, 2008, 58(2):71-96.
4.	Permuth-Wey J, Sellers TA. Epidemiology of ovarian cancer. Methods Mol Biol, 2009, 472:413-437.
5.	Mink PJ, Folsom AR, Sellers TA, et al. Physical activity, waist-to-hip ratio, and other risk factors for ovarian cancer:a follow-up study of older women. Epidemiology, 1996, 7(1):38-45.
6.	Bertone ER, Willett WC, Rosner BA, et al. Prospective study of recreational physical activity and ovarian cancer. J Natl Cancer Inst, 2001, 93(12):942-948.
7.	Anderson JP, Ross J, AFolsom AR. Anthropometric variables, physical activity, and incidence of ovarian cancer:The Iowa Women's Health Study. Cancer, 2004, 100(7):1515-1521.
8.	Schnohr P, Gronbaek M, Petersen L, et al. Physical activity in leisure-time and risk of cancer:14-year follow-up of 28 000 Danish men and women. Scand J Public Health, 2005, 33(4):244-249.
9.	Patel AV, Rodriguez C, Pavluck AL, et al. Recreational physical activity and sedentary behavior in relation to ovarian cancer risk in a large cohort of US women. Am J Epidemiol, 2006, 163(8):709-716.
10.	Weiderpass E, Margolis KL, Sandin S, et al. Prospective study of physical activity in different periods of life and the risk of ovarian cancer. Int J Cancer, 2006, 118(12):3153-3160.
11.	Leitzmann MF, Koebnick C, Moore SC, et al. Prospective study of physical activity and the risk of ovarian cancer. Cancer Causes Control, 2009, 20(5):765-773.
12.	Xiao Q, Yang HP, Wentzensen N, et al. Physical activity in different periods of life, sedentary behavior, and the risk of ovarian cancer in the NIH-AARP diet and health study. Cancer Epidemiol Biomarkers Prev, 2013, 10(8):1538-7755.
13.	Westerlind KC. Physical activity and cancer prevention mechanisms. Med Sci Sports Exerc, 2003, 35(11): 1834-1840.
14.	Kramer MM, Wells CL. Does physical activity reduce risk of estrogen-dependent cancer in women? Med Sci Sports Exerc, 1996, 28(3):322-334.
15.	Shephard RJ. Physical activity and cancer. Int J Sports Med, 1990, 11(6):413-420.
16.	Pasquali R. Obesity and androgens:facts and perspectives. Fertil Steril, 2006, 85(5):1319-1340.
17.	Calle EE, Kaaks R. Overweight, obesity and cancer:epidemiological evidence and proposed mechanisms. Nat Rev Cancer, 2004, 4(8):579-591.
18.	Key TJ, Allen NE, Verkasalo PK, et al. Energy balance and cancer:the role of sex hormones. Proc Nutr Soc, 2001, 60(1):81-89.
19.	Campbell KL, McTiernan A. Exercise and biomarkers for cancer prevention studies. J Nutr, 2007, 137(1 Suppl): 161S-169S.
20.	Shephard RJ, Rhind S, Shek PN. The impact of exercise on the immune system:NK cells, interleukins 1 and 2, and related responses. Exerc Sport Sci Rev, 1995, 23:215-241.
21.	Cannavo S, Curto L, Trimarchi F. Exercise-related female reproductive dysfunction. J Endocrinol Invest, 2001, 24(10):823-832.
22.	de Souza MJ. Menstrual disturbances in athletes:a focus on luteal phase defects. Med Sci Sports Exerc, 2003, 35(9): 1553-1563.
23.	Godwin AK, Perez RP, Johnson SW, et al. Growth regulation of ovarian cancer. Hematol Oncol Clin North Am, 1992, 6(4):829-841.
24.	Olsen CM, Bain CJ, Jordan SJ, et al. Recreational physical activity and epithelial ovarian cancer:a case-control study, systematic review, and meta-analysis. Cancer Epidemiol Biomarkers Prev, 2007, 16(11):2321-2330.
25.	Biesma RG, Schouten LJ, Dirx MJ, et al. Physical activity and risk of ovarian cancer:results from the Netherlands Cohort Study (The Netherlands). Cancer Causes Control, 2006, 17(1):109-115.
26.	Zhang M, Lee AHBinns CW. Physical activity and epithelial ovarian cancer risk:a case-control study in China. Int J Cancer, 2003, 105(6):838-843.
27.	丁燕君, 体力活动和坐与卵巢癌的病例对照研究.浙江大学, 2007.

1. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2):69-90.
2. Oh HK, Sin JI, Choi J, et al. Overexpression of CD73 in epithelial ovarian carcinoma is associated with better prognosis, lower stage, better differentiation and lower regulatory T cell infiltration. J Gynecol Oncol, 2012, 23(4): 274-281.
3. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin, 2008, 58(2):71-96.
4. Permuth-Wey J, Sellers TA. Epidemiology of ovarian cancer. Methods Mol Biol, 2009, 472:413-437.
5. Mink PJ, Folsom AR, Sellers TA, et al. Physical activity, waist-to-hip ratio, and other risk factors for ovarian cancer:a follow-up study of older women. Epidemiology, 1996, 7(1):38-45.
6. Bertone ER, Willett WC, Rosner BA, et al. Prospective study of recreational physical activity and ovarian cancer. J Natl Cancer Inst, 2001, 93(12):942-948.
7. Anderson JP, Ross J, AFolsom AR. Anthropometric variables, physical activity, and incidence of ovarian cancer:The Iowa Women's Health Study. Cancer, 2004, 100(7):1515-1521.
8. Schnohr P, Gronbaek M, Petersen L, et al. Physical activity in leisure-time and risk of cancer:14-year follow-up of 28 000 Danish men and women. Scand J Public Health, 2005, 33(4):244-249.
9. Patel AV, Rodriguez C, Pavluck AL, et al. Recreational physical activity and sedentary behavior in relation to ovarian cancer risk in a large cohort of US women. Am J Epidemiol, 2006, 163(8):709-716.
10. Weiderpass E, Margolis KL, Sandin S, et al. Prospective study of physical activity in different periods of life and the risk of ovarian cancer. Int J Cancer, 2006, 118(12):3153-3160.
11. Leitzmann MF, Koebnick C, Moore SC, et al. Prospective study of physical activity and the risk of ovarian cancer. Cancer Causes Control, 2009, 20(5):765-773.
12. Xiao Q, Yang HP, Wentzensen N, et al. Physical activity in different periods of life, sedentary behavior, and the risk of ovarian cancer in the NIH-AARP diet and health study. Cancer Epidemiol Biomarkers Prev, 2013, 10(8):1538-7755.
13. Westerlind KC. Physical activity and cancer prevention mechanisms. Med Sci Sports Exerc, 2003, 35(11): 1834-1840.
14. Kramer MM, Wells CL. Does physical activity reduce risk of estrogen-dependent cancer in women? Med Sci Sports Exerc, 1996, 28(3):322-334.
15. Shephard RJ. Physical activity and cancer. Int J Sports Med, 1990, 11(6):413-420.
16. Pasquali R. Obesity and androgens:facts and perspectives. Fertil Steril, 2006, 85(5):1319-1340.
17. Calle EE, Kaaks R. Overweight, obesity and cancer:epidemiological evidence and proposed mechanisms. Nat Rev Cancer, 2004, 4(8):579-591.
18. Key TJ, Allen NE, Verkasalo PK, et al. Energy balance and cancer:the role of sex hormones. Proc Nutr Soc, 2001, 60(1):81-89.
19. Campbell KL, McTiernan A. Exercise and biomarkers for cancer prevention studies. J Nutr, 2007, 137(1 Suppl): 161S-169S.
20. Shephard RJ, Rhind S, Shek PN. The impact of exercise on the immune system:NK cells, interleukins 1 and 2, and related responses. Exerc Sport Sci Rev, 1995, 23:215-241.
21. Cannavo S, Curto L, Trimarchi F. Exercise-related female reproductive dysfunction. J Endocrinol Invest, 2001, 24(10):823-832.
22. de Souza MJ. Menstrual disturbances in athletes:a focus on luteal phase defects. Med Sci Sports Exerc, 2003, 35(9): 1553-1563.
23. Godwin AK, Perez RP, Johnson SW, et al. Growth regulation of ovarian cancer. Hematol Oncol Clin North Am, 1992, 6(4):829-841.
24. Olsen CM, Bain CJ, Jordan SJ, et al. Recreational physical activity and epithelial ovarian cancer:a case-control study, systematic review, and meta-analysis. Cancer Epidemiol Biomarkers Prev, 2007, 16(11):2321-2330.
25. Biesma RG, Schouten LJ, Dirx MJ, et al. Physical activity and risk of ovarian cancer:results from the Netherlands Cohort Study (The Netherlands). Cancer Causes Control, 2006, 17(1):109-115.
26. Zhang M, Lee AHBinns CW. Physical activity and epithelial ovarian cancer risk:a case-control study in China. Int J Cancer, 2003, 105(6):838-843.
27. 丁燕君, 体力活动和坐与卵巢癌的病例对照研究.浙江大学, 2007.

Chinese Journal of Evidence-Based Medicine

Correlation between Physical Activities and Risk of Ovarian Cancer: A Meta-Analysis

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