We evaluated the impact of recreational and occupational physical activity on ovarian cancer risk using data from a population-based case-control study of 442 cases with histologically confirmed incident ovarian cancer and 2,135 controls aged 20-76 years, conducted in 1994-1997 in Canada. Frequency and intensity of physical activity were collected through self-administered questionnaires. Compared to women in the lowest tertiles of moderate, vigorous and total recreational activity, those in the highest tertiles had multivariable-adjusted odds ratios (and 95% confidence intervals) of 0.67 (0.50-0.88), 0.93 (0.70-1.24) and 0.73 (0.58-0.98), respectively. There were statistically significant trends of decreasing risk with increasing levels of moderate and total recreational activity, with similar patterns for premenopausal and postmenopausal women. A significant reduction in risk associated with higher level of moderate recreational activity was observed for serous, endometrioid and other but not mucinous types of tumors. The analyses in one province with the largest number of cases and controls indicated that occupational activity was associated with reduced ovarian cancer risk by lifetime activity and by various life periods (early 20s, early 30s, early 50s and 2 years before interview). Our study suggests that occupational and regular moderate recreational physical activity reduce ovarian cancer risk. ' 2005 Wiley-Liss, Inc.Key words: case-control studies; exercise; ovarian neoplasms; occupation; recreation Although the evidence for a protective effect of physical activity on colon and breast cancer is convincing, the evidence for an inverse association between physical activity and ovarian cancer is insufficient. 1,2 If proven to reduce ovarian cancer risk, physical activity-a modifiable lifestyle factor-could provide a method to prevent this fourth most common neoplasm in women, which has a poor prognosis.The influence of physical activity on ovarian cancer risk was examined in 10 studies with inconsistent results. [3][4][5][6][7][8][9][10][11][12] Five studies suggested a decreased risk of ovarian cancer with high levels of physical activity, 3-7 3 found no association, [8][9][10] and 2 observed a positive association. 11,12 The discrepancy could be due to the fact that different studies assessed different parameters (including type, frequency, duration, intensity) of physical activity in populations with different profiles.Using data from the Canadian National Enhanced Cancer Surveillance System (NECSS), which collected detailed information on recreational physical activity, occupational physical activity (in 1 province) and other risk factors for cancers, we further evaluated the relation of physical activity to ovarian cancer risk.
Material and methods
Study populationThe NECSS was a multicomponent, collaborative project of Health Canada and the provincial cancer registries. The case-control component included individual data from 21,020 Canadians with 1 of 19 types of cancers and 5,039 population contro...