Cancer Epidemiol Biomarkers Prev. , 2020., 2;cebp.1477.2019. doi: 10.1158/1055-9965.EPI-19-1477.

Dietary and circulating fatty acids and ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition.

Yammine S Huybrechts I Biessy C et al.


Background: Fatty acids impact obesity, estrogens and inflammation, risk factors for ovarian cancer. Few epidemiological studies have investigated the association of fatty acids with ovarian cancer. Methods: Within the European Prospective Investigation into Cancer and nutrition, 1,486 incident ovarian cancer cases were identified. Cox Proportional Hazard models with adjustment for ovarian cancer risk factors were used to estimate hazard ratios of ovarian cancer across quintiles of intake of fatty acids. False discovery rate was computed to control for multiple testing. Multivariable conditional logistic regression models were used to estimate odds ratios of ovarian cancer across tertiles of plasma fatty acids among 633 cases and two matched controls in a nested case-control analysis. Results: A positive association was found between ovarian cancer and intake of industrial trans elaidic acid (Hazard Ratio comparing 5th with 1st quintileQ5-Q1=1.29; 95% CI=1.03-1.62; p trend=0.02, q-value=0.06). Dietary intakes of n-6 linoleic acid (HRQ5-Q1=1.10; 95% CI=1.01-1.21; p trend=0.03) and n-3 α-linolenic acid (HRQ5-Q1=1.18; 95% CI=1.05-1.34; p trend=0.007) from deep frying fats were also positively associated with ovarian cancer. Suggestive associations were reported for circulating elaidic (Odds Ratio comparing 3rd with 1st tertileT3-T1 = 1.39; 95% CI=0.99-1.94; p trend=0.06) and α-linolenic acids (ORT3-T1=1.30; 95% CI=0.98-1.72; p trend=0.06). Conclusions: Our results suggest that higher intakes and circulating levels of industrial trans elaidic acid, and higher intakes of linoleic acid and α-linolenic acid from deep frying fat, may be associated with greater risk of ovarian cancer. Impact: If causal, eliminating industrial trans fatty acids could offer a straightforward public health action for reducing ovarian cancer.

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Key Points

The aim of this study was to prospectively investigate the association between individual fatty acids intake from various food sources as well as circulating biomarker levels and EOC risk in the EPIC study. Findings showed evidence of a higher risk of EOC associated with higher dietary intakes of trans elaidic acid, linoleic acid and alpha- linolenic acid. Suggestive positive associations were reported for plasma phospholipid trans elaidic acid and α-linolenic acid. These associations did not vary according to histological subtypes of EOC.

Regarding α-linolenic acid, the positive association with EOC is mainly driven by deep frying fat and margarine. Other positive trends with α-linolenic acid from cereal and cereal products, meat and meat products, fat, sugar and confectionaries, cakes and biscuits and condiments and sauces, were reported but are not significant. These data might suggest that linoleic and alpha-linolenic acids may not exert a direct effect on EOC development which might be rather associated to co-exposure to other potentially carcinogenic compounds occurring in foods exposed to deep frying fat, such as aldehydes, oxidized lipids, heterocyclic compounds, trans fatty acids, polymers, sterol derivatives, acrylamide, and acrolein.