Background Research on diet quality and ovarian cancer is limited. We examined the association between diet quality and ovarian cancer risk and survival in a large prospective cohort. Methods We utilized data from women in the prospective NIH-AARP Diet and Health Study enrolled from 1995-1996 and were 50-71 years old at baseline with follow-up through 12/31/2017. Participants completed a 124-item Food Frequency Questionnaire at baseline and diet quality was assessed via the Healthy Eating Index-2015 (HEI-2015), the alternate Mediterranean diet score (aMED), and the Dietary Approaches to Stop Hypertension score (DASH). Primary outcomes were first primary epithelial ovarian cancer diagnosis from cancer registry data, and among those diagnosed with ovarian cancer all-cause mortality. We used a semi-Markov multi-state model with Cox proportional hazards regression to account for semi-competing events. Results Among 150,643 participants with a median follow-up time of 20.5 years, 1,107 individuals were diagnosed with a first primary epithelial ovarian cancer. There was no evidence of an association between diet quality and ovarian cancer risk. Among those diagnosed with epithelial ovarian cancer, 893 deaths occurred with a median survival of 2.5 years. Better pre-diagnosis diet quality, according to the HEI-2015 (Quintile 5 vs Quintile 1 HR = 0.75 [0.60-0.93]) and aMED (Quintile 5 vs Quintile 1: HR = 0.68, [0.53-0.87]) was associated with lower all-cause mortality. There was no evidence of an association between DASH and all-cause mortality. Conclusions Better pre-diagnosis diet quality was associated with lower all-cause mortality after ovarian cancer diagnosis, but was not associated with ovarian cancer risk.

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饮食质量与卵巢癌风险和生存之间的关联

背景 对饮食质量和卵巢癌的研究是有限的。我们在一个大型前瞻性队列中研究了饮食质量与卵巢癌风险和生存之间的关联。方法 我们利用了 NIH-AARP 饮食与健康研究前瞻性研究中女性的数据，该研究于 1995 年至 1996 年期间入组，基线时年龄为 50-71 岁，随访至 2017 年 12 月 31 日。参与者在基线时完成了 124 项食物频率调查问卷，并通过 2015 年健康饮食指数 (HEI-2015)、替代地中海饮食评分 (aMED) 和高血压饮食方法评分 (DASH) 评估饮食质量。主要结局是根据癌症登记数据首次诊断出原发性上皮性卵巢癌，以及诊断为卵巢癌的全因死亡率。我们使用带有 Cox 比例风险回归的半马尔可夫多状态模型来解释半竞争事件。结果 在 150,643 名参与者中，中位随访时间为 20.5 年，其中 1,107 人被诊断患有首次原发性上皮性卵巢癌。没有证据表明饮食质量与卵巢癌风险之间存在关联。在诊断为上皮性卵巢癌的患者中，有 893 人死亡，中位生存期为 2.5 年。根据 HEI-2015（五分位数 5 与五分位数 1 HR = 0.75 [0.60-0.93]）和 aMED（五分位数 5 与五分位数 1：HR = 0.68，[0.53-0.87]），更好的诊断前饮食质量与降低全因死亡率。没有证据表明 DASH 与全因死亡率之间存在关联。结论 更好的诊断前饮食质量与卵巢癌诊断后较低的全因死亡率相关，但与卵巢癌风险无关。