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

Ann Oncol. 2003 Jan;14(1):78-84. doi: 10.1093/annonc/dkg022.


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.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / metabolism*
  • Case-Control Studies
  • Dietary Carbohydrates / adverse effects*
  • Female
  • Glycemic Index*
  • Humans
  • Hyperinsulinism / complications
  • Insulin / blood
  • Insulin Resistance
  • Italy / epidemiology
  • Menopause
  • Middle Aged
  • Odds Ratio
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / etiology*
  • Risk Factors


  • Blood Glucose
  • Dietary Carbohydrates
  • Insulin