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Annals of Oncology 14:78-84, 2003
© 2003 European Society for Medical Oncology

Original Paper

Dietary glycemic index, glycemic load and ovarian cancer risk: a case–control study in Italy

L. S. A. Augustin1,2, J. Polesel1, C. Bosetti1,3, C. W. C. Kendall2, C. La Vecchia3,4, M. Parpinel1, E. Conti5, M. Montella6, S. Franceschi1,7, D. J. A. Jenkins2 and L. Dal Maso1,+

1 Servizio di Epidemiologia, Centro di Riferimento Oncologico, Istituto Nazionale Tumori, Aviano, Italy; 2 Department of Nutritional Sciences, Faculty of Medicine, University of Toronto and the Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, Ontario, Canada; 3 Istituto di Ricerche Farmacologiche "Mario Negri", Milan; 4 Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Milan; 5 Servizio Integrato di Epidemiologia e Sistemi Informativi, Rome; 6 Istituto Tumori "Fondazione Pascale", Naples, Italy; 7 International Agency for Research on Cancer, Lyon, France

Received 3 April 2002; Revised 3 July 2002; accepted 18 July 2002

Background:

Dietary carbohydrates vary in their ability to raise blood glucose and insulin levels, which, in turn, influence levels of sex hormones and insulin-like growth factors. We analyzed the effect of type and amount of carbohydrates on ovarian cancer risk, using the glycemic index (GI) and the glycemic load (GL) measurement in a large case–control study conducted in Italy.

Materials and methods:

Cases included 1031 women with incident, histologically confirmed epithelial ovarian cancer, from four Italian regions. Controls included 2411 women admitted to the same hospital networks for acute, non-neoplastic conditions. Average daily GI and GL were calculated from a validated food frequency questionnaire. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) were computed using multiple logistic regression.

Results:

Ovarian cancer was directly associated with dietary GI (OR for highest versus lowest quartile = 1.7, 95% CI 1.3–2.1) and GL (OR = 1.7, 95% CI 1.3–2.1). The associations were observed in pre- and postmenopausal women, and they remained consistent across strata of major covariates identified.

Conclusions:

This study supports the hypothesis of a direct association between GI and GL and ovarian cancer risk and, consequently, of a possible role of hyperinsulinemia/insulin resistance in ovarian cancer development.

Key words: carbohydrate, case–control study, glycemic load, ovarian cancer


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