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Back to Cancer

Milk Products and Ovarian Cancer

According to the Third Expert Report by the World Cancer Research Fund and the American Institute for Cancer Research, there is no strong or even suggestive evidence of a link between dairy products and ovarian cancer.

Highlights

The evidence of the relationship between milk products and ovarian cancer is limited.

Basic Facts on Ovarian Cancer

There are a number of known risk factors for ovarian cancer including the following, among others:1

  • Family history of ovarian cancer;
  • BRCA gene mutations;
  • Never being pregnant or giving birth;
  • Personal history of breast cancer;
  • Tall adult height;
  • Hormone replacement therapy;
  • Smoking;
  • Endometriosis

About 2,800 Canadian women were diagnosed with ovarian cancer in 2017. 1

The Evidence

According to the Third Expert Report published in 2018 by the World Cancer Research Fund and the American Institute for Cancer Research, the evidence on milk and dairy products was judged as “limited - no conclusion.”2

In the Nurses’ Health Study I (n = 76,243) and II (n = 88,356), it was assessed whether dairy intake was associated with epithelial ovarian cancer risk over 28 years of follow-up.3

  • Consumption of skim milk, whole milk, lactose, dairy calcium or dairy fat during adulthood was not associated with ovarian cancer risk;
  • No association was also observed for intakes during high school, pre-menopause or post-menopause;
  • In analyses by type of ovarian cancer, no association was observed for serous ovarian cancer, but the highest quintile of lactose intake was associated with a 68% risk reduction in endometrioid ovarian cancer.

Using data from the European Prospective Investigation into Cancer and Nutrition study and the Netherlands Cohort Study, Merritt et al. evaluated an extensive list of dietary factors in relation to epithelial ovarian cancer risk:4

  • The consumption of milk, yogurt and cheese was not associated with epithelial ovarian cancer risk.

Potential Mechanisms

Calcium and vitamin D
There are concerns that high intakes of calcium may depress the active form of vitamin D (1,25‑[OH]2 vitamin D) in the blood. The vitamin D receptor is found in human ovarian tumour specimens and cell lines, and active vitamin D inhibits cell proliferation in ovarian cell lines and induces apoptosis.

In contrast, high intakes of calcium may protect against carcinogenesis by down-regulating the production of parathyroid hormone, which may reduce mitosis and increase apoptosis. Calcium in milk also binds carcinogens such as bile salts and fatty acids.1,5

In addition, findings from a meta-analysis suggest that there may in fact be an inverse association between vitamin D and ovarian cancer risk.6

The Third Expert Report by the World Cancer Research Fund and the American Institute for Cancer Research states that the evidence on calcium and vitamin D and ovarian cancer is limited and no conclusion can be drawn.2

Lactose and galactose
It has been suggested that lactose, in particular its metabolite galactose, may be toxic to oocytes. Yet, according to study findings, lactose and galactose do not appear to be associated with ovarian cancer risk.3,4 In addition, the Third Expert Report by the World Cancer Research Fund and the American Institute for Cancer Research states that the evidence on lactose and ovarian cancer is limited and no conclusion can be drawn.2

IGF-1 (insulin-like growth factor-1)

There are also concerns about IGF-1, a hormone with a mitotic effect that is present in milk.
However, the role of IGF-1 in ovarian cancer is unclear, as IGF-1 synthesis is upregulated by parathyroid hormone (PTH), whereas the calcium found in milk suppresses PTH production.7

Conclusion

The scientific evidence does not support an association between milk and milk products and an increased risk of ovarian cancer.

References

  1. Canadian Cancer Society. 2018. Ovarian cancer. Available at www.cancer.ca. Accessed September 27, 2018.
  2. World Cancer Research Fund / American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: a Global Perspective, Continuous Update Project Expert Report 2018. Available at dietandcancerreport.org  Accessed September 27, 2018.
  3. Merritt MA et al. Dairy food and nutrient intake in different life periods in relation to risk of ovarian cancerCancer Causes Control 2014;25:795-808.
  4. Merritt MA et al. Nutrient-wide association study of 57 foods/nutrients and epithelial ovarian cancer in the European Prospective Investigation into Cancer and Nutrition study and the Netherlands Cohort StudyAm J Clin Nutr 2016;103:161-167.
  5. Weaver CM. Role of dairy beverages in the dietPhysiol Behav 2010;100:63-66.
  6. Yin L et al. Meta-analysis: circulating vitamin D and ovarian cancer riskGynecol Oncol 2011;121:369-375.
  7. Kiani F et al. Dietary risk factors for ovarian cancer: the Adventist Health Study (United States)Cancer Causes Control 2006;17:137-146.

Keywords: ovarian cancer , cancer , calcium


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