Fat and Ovarian Cancer Publication Genkinger, JM, et al.. Cancer Causes Control 2006 Apr;17(3):273-85. Genkinger, JM, et al. A Pooled Analysis of 12 Cohort.

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Fat and Ovarian Cancer Publication Genkinger, JM, et al.. Cancer Causes Control 2006 Apr;17(3): Genkinger, JM, et al. A Pooled Analysis of 12 Cohort Studies of Dietary Fat, Cholesterol and Egg intake and Ovarian Cancer. Cancer Causes Control 2006 Apr;17(3):

Genkinger et al, 2006 Swedish Mammography Cohort (SMC) Netherlands Cohort Study (NLCS) New York State Cohort (NYSC) Iowa Women’s Health Study (IWHS) Canadian National Breast Screening Study (CNBSS) Cohort studies in the pooled analysis of dietary fat, cholesterol and egg intake and ovarian cancer Cancer Prevention Study II Nutrition Cohort (CPS II) Adventist Health Study (AHS) New York University Women’s Health Study (NYU) Breast Cancer Detection Demonstration Project Follow-up Study (BCDDP) Total cohort size= 553,217 Total # of cases = 2,132 Nurses’ Health Study (NHSa, NHSb), Nurses’ Health Study II (NHS II), Women’s Health Study (WHS)

Genkinger et al, 2006 Cohort studies in the pooled analysis of fat, cholesterol and egg intake and ovarian cancer Study Follow-upYearsBaselineCohort#Cases Mean Time to Diagnosis (SD) AHS , (4) BCDDP , (3) CNBSS , (5) CPS II , (2) IWHS , (5) NLCS , (2) NYSC , (2) NYU , (3) NHSa , (2) NHSb , (4) NHS II , (3) SMC , (4) WHS , (3)

Genkinger et al, 2006 Median (IQR) intake of total fat and types of fat by Study StudyTotalSaturatedMonoPolyTransAnimalVegetable AHS 37 (35-39) 11 (10-13) 13 (12-14) 9 (8-10) 9 (8-10)… 12 (10-16) 22 (20-24) BCDDP 35 (29-41) 12 (9-14) 12 (10-14) 7 (5-9) ……… CNBSS 43 (39-47) 17 (15-19) 16 (15-18) 5 (4-6) … 30 (26-35) 12 (9-15) CPS II 34 (27-40) 11 (8-13) 12 (10-15) 6 (5-8) ……… IWHS 34 (30-38) 12 (10-14) 13 (11-14) 6 (5-7) 2 (1-2) 19 (16-23) 14 (11-17) NLCS 39 (36-43) 15 (14-18) 14 (13-16) 7 (5-10) 7 (5-10)… 28 (23-33 ) 11 (5-16) NYSC 34 (32-37) 12 (11-13) 11 (10-12 ) 5 (5-6) … 25 (22-28) 9 (8-11) 9 (8-11) NYU 41 (36-45) 16 (14-18) 14 (12-15) 6 (5-7) … 21 (17-26) 19 (14-23) NHS (34-44) 16 (13-18) 16 (13-19 ) 5 (4-6) 2 (2-3) 29 (23-35) 9 (6-13) 9 (6-13) NHS (29-36) 12 (10-13) 12 (10-14) 6 (5-7) 1 (1-2) 18 (15-21) 14 (11-17) NHS II 32 (28-35) 11 (10-13) 12 (10-14) 5 (5-6 ) 2 (1-2) 17 (14-20) 14 (11-16) SMC 30 (27-34) 13 (11-15) 11 (10-13) 4 (4-5) ……… WHS 30 (26-34) 10 (9-12) 11 (9-13) 6 (5-7) 1 (1-1) 16 (13-19) 13 (11-16)

Genkinger et al, 2006 Pooled Multivariate RR and 95% CI for Ovarian Cancer According to Percent of Calories from Total Fat <25 25-<30 30-<35 (Ref) 35-<40 40-<45 >45 Relative Risk Cases RR % CI ( ) ( ) (Ref) ( ) ( ) ( ) Percent of Calories from Total Fat

Genkinger et al, 2006 Multivariate Adjusted RR and 95% CI for Ovarian Cancer According to Percent of Calories from Total Fat (5% of Total Caloric Increase) by Study p-value, test for between-studies heterogeneity = 0.45

Genkinger et al, 2006 Pooled Multivariate RR of Ovarian Cancer According to Fat Intake Nutrient Intake (Quartiles) Saturated Fat Cases MV RR 95% CI 1.00 (Ref) (Ref)1.11( )0.99( )1.14( ) Monounsaturated Fat Cases MV RR 95% CI 1.00 (Ref) (Ref)1.06 ( ) ( )1.08( )0.98( ) Polyunsaturated Fat Cases MV RR 95% CI 1.00 (Ref) (Ref)0.99( )1.00( )0.94( ) Animal Fat Cases MV RR 95% CI 1.00 (Ref) (Ref)1.04( )0.98( )1.15( ) Vegetable Fat Cases MV RR 95% CI 1.00 (Ref) (Ref)1.08( )1.10( )1.01( )

Genkinger et al, 2006 Multivariate Adjusted Pooled Relative Risks for Ovarian Cancer according to Dietary Fat and Cholesterol Intake, continuous model Increment Multivariate RR (95% CI) P Value for Heterogeneity Total Fat 1.01 ( ) 0.45 Saturated Fat 5% 1.07 ( ) 0.09 Monounsaturated Fat 5% 1.02 ( ) 0.61 Polyunsaturated Fat 5% 0.94 ( ) 0.62 Animal Fat 5% 1.04 ( ) 0.74 Vegetable Fat 5% 0.98 ( ) 0.60 Cholesterol 100 mg 100 mg 1.03 ( ) 0.81

Genkinger et al, 2006 Multivariate Adjusted Pooled RR for Histological Subtypes of Ovarian Cancer According to Dietary Fat, and Cholesterol Intake Increment Endometrioid Cases MucinousCasesSerousCases Total Fat 1.01 ( ) 0.97 ( ) 1.03 ( ) Saturated Fat Saturated Fat5% 1.05 ( ) 1.06 ( ) 1.12 ( ) Monounsaturated Fat Monounsaturated Fat5% 1.02 ( ) 0.91 ( ) 1.07 ( ) Polyunsaturated Fat Polyunsaturated Fat5% 1.02 ( ) 0.82 ( ) 0.96 ( ) Animal Fat Animal Fat5% 1.07 ( ) 1.00 ( ) 1.05 ( ) Vegetable Fat Vegetable Fat5% 0.98 ( ) 0.96 ( ) 0.99 ( ) Cholesterol 100 mg 1.02 ( ) 1.04 ( ) 1.05 ( )

Genkinger et al, 2006 Pooled Multivariate RR and 95% CI of Ovarian Cancer for Fat, Types of Fat, and Cholesterol Intake of Ovarian Cancer by Menopausal Status, Continuous Model Menopausal Status at Diagnosis PremenopausalPostmenopausalP-value Total Fat 1.02 ( ) 1.02 ( ) 0.50 Saturated Fat 1.01 ( ) 1.11 ( ) 0.42 Monounsaturated Fat 0.97 ( ) 1.03 ( ) 0.18 Polyunsaturated Fat 1.30 ( ) 0.94 ( ) 0.37 Animal Fat 0.99 ( ) 1.06 ( ) 0.34 Vegetable Fat 1.02 ( ) 0.97 ( ) 0.93 Cholesterol 0.97 ( ) 1.03 ( ) 0.62

Genkinger et al, 2006 Pooled Multivariate RR and 95% CI of Ovarian Cancer for Fat, Types of Fat, and Cholesterol Intake of Ovarian Cancer by Oral Contraceptive Use, Continuous Model Oral Contraceptive Use NeverEverP-value Total Fat 1.02 ( ) 1.00 ( ) 0.76 Saturated Fat 1.11 ( ) 1.00 ( ) 0.30 Monounsaturated Fat 1.02 ( ) 1.03 ( ) 0.93 Polyunsaturated Fat 0.94 ( ) 1.05 ( ) 0.44 Animal Fat 1.06 ( ) 1.01 ( ) 0.55 Vegetable Fat 0.96 ( ) 1.03 ( ) 0.39 Cholesterol 1.06 ( ) 1.01 ( ) 0.54

Genkinger et al, 2006 Pooled Multivariate RR and 95% CI of Ovarian Cancer for Fat, Types of Fat, and Cholesterol Intake of Ovarian Cancer by Postmenopausal Hormone Use, Continuous Model Postmenopausal Hormone Use NeverPastCurrentP-value Total Fat 1.00 ( ) 1.02 ( ) 1.00 ( ) 0.94 Saturated Fat 1.07 ( ) 1.06 ( ) 1.07 ( ) 0.81 Monounsaturated Fat 0.98 ( ) 1.05 ( ) 0.99 ( ) 0.98 Polyunsaturated Fat 0.91 ( ) 0.96 ( ) 0.86 ( ) 0.47 Animal Fat 1.07 ( ) 1.11 ( ) 0.99 ( ) 0.51 Vegetable Fat 0.93 ( ) 1.02 ( ) 0.98 ( ) 0.80 Cholesterol 1.05 ( ) 0.99 ( ) 1.07 ( ) 0.77