Pre- and post-diagnosis body mass index, weight change, and ovarian cancer mortality

Objective: The purpose of this study was (1) to investigate the association between BMI self-reported at three time points (during their 20s, 5 years before diagnosis, and post-diagnosis) and mortality among 388 women with newly diagnosed epithelial ovarian cancer and (2) weight change between these 3 time points and mortality.

Methods: Women completed interview-administered questionnaires on average 9 months post-diagnosis. Women were followed 5 years after diagnosis or until death, whichever came first. Cox proportional hazard regression was used to estimate associations between BMI during the 20s, BMI 5 years prior to diagnosis, BMI post-diagnosis (i.e., at the time of interview) and weight changes between these time points and mortality.

Results: The 5-year survival rate was 54% (178 deaths, 146 from ovarian cancer). BMI measured continuously at all three time points was associated with a higher risk of ovarian cancer mortality (P≤0.05). The strongest association was observed with BMI in the 20s and all-cause mortality comparing women with BMI≥25 kg/m(2) to BMI<25 kg/m(2) (HR=1.82; 95% CI, 1.02-3.27; P for trend=0.045). For weight change from the 20s to 5 years prior to diagnosis and ovarian cancer specific mortality, we observed a 68% higher risk of ovarian cancer mortality (HR=1.68; 95% CI, 1.11-2.55; P for trend=0.015, comparing women with <10 lbs weight gain to women with ≥10 lbs weight gain).

Conclusion: BMI prior to and after diagnosis and weight gain throughout adulthood is associated with ovarian cancer mortality.