Anthropometry and ovarian cancer: The inflammation connection

Abstract

Ovarian cancer affects over 200,000 women worldwide each year and has one of the highest case-fatality rates of any of the major cancers. Overweight and obesity have been associated with an increased risk of a variety of different illnesses and some types of cancer, in part, due to hormonal and metabolic factors that may drive tumorigenesis. Recent studies have demonstrated that obesity may play a role in ovarian carcinogenesis. Individuals who carry excess adipose tissue have been shown to have a characteristic state of systemic, low-grade inflammation. Many of the risk factors for ovarian cancer, including endometriosis, polycystic ovarian syndromes (PCOS), talc and asbestos exposure, and pelvic inflammatory disease (PID), have a recognized inflammatory component. Evidence linking obesity with an elevated risk of ovarian cancer, to date, has been conflicting; however, many prospective studies have shown that excess adiposity in young adulthood is related to both premenopausal and postmenopausal ovarian cancer risk. Other risk factors for ovarian cancer often affect women in their earlier, reproductive years; thus, the association between obesity in a woman's younger years and ovarian cancer is plausible. Moderate physical activity may be protective against ovarian cancer by decreasing estrogen levels, while vigorous activity may promote ovarian carcinogenesis via aberrations in androgen and progesterone levels. This chapter will review the traditional hypotheses of ovarian cancer-including incessant ovulation, gonadotropin stimulation, and the inflammatory hypothesis-and discuss the most relevant research on adiposity, diet and physical activity, and ovarian cancer risk. A brief overview of obesity and ovarian cancer survival is also included.