据观察，成年后期身体过度肥胖会增加患卵巢癌的风险，但这种关联相对较弱。身体脂肪会随着时间的推移而变化，而且时间可能会以不同的方式影响风险。我们采用生命全程流行病学方法来确定身体肥胖与卵巢癌风险之间的关系是否可以通过关键期、累积期或敏感期假说来最好地描述。加拿大蒙特利尔开展的一项基于人群的卵巢癌病例对照研究（2011-16）提供了从 20 岁开始每十年的体重指数 (BMI) 数据。在 363 名年龄≥50 岁的病例和 707 名对照者中，我们使用贝叶斯相关生命历程暴露模型来估计 BMI 在成人生命历程中三个预先指定的时期（即生育早期、生育晚期和生育年龄）的相对重要性。围绝经期/绝经后，卵巢癌风险。累积假说最好地描述了 BMI 与卵巢癌的总体关系，BMI（每增加 5 kg/m2）的终生效应的比值比 (OR) 为 1.10（95% 可信区间 [CrI]：0.90-1.35）。对于浸润性卵巢癌，终生影响的 OR (95% CrI) 为 1.16 (0.92-1.48)，育龄早期的 BMI 显示出最高的相对重要性，表明这可能是一个敏感期。对于交界性癌症，终生效应 OR 并不强烈支持相关性（OR：0.90，95% CrI：0.53-1.32）。结果表明，生育早期的敏感期是进一步研究的候选假设。© 2024。Springer Nature B.V.

Excess body fatness in late adulthood has been observed to increase ovarian cancer risk, but the association is relatively weak. Body fatness can change over time, and timing may differently influence risk. We used a life course epidemiology approach to identify whether the relation between body fatness and ovarian cancer risk is best described by a critical period, accumulation or sensitive period hypothesis. In a population-based case-control study of ovarian cancer in Montreal, Canada (2011-16), data on body mass index (BMI) at each decade starting at age 20 was available. Among 363 cases and 707 controls aged ≥ 50 years, we used a Bayesian relevant life course exposure model to estimate the relative importance of BMI for three pre-specified periods across the adult life course, i.e., early childbearing years, late childbearing years, and peri/postmenopause, on ovarian cancer risk. The accumulation hypothesis best described BMI in relation to ovarian cancer overall, with an odds ratio (OR) for the lifetime effect of BMI (per 5 kg/m2 increase) of 1.10 (95% credible interval [CrI]: 0.90-1.35). For invasive ovarian cancer, the OR (95% CrI) for the lifetime effect was 1.16 (0.92-1.48), with BMI during early childbearing years showing the highest relative importance, suggesting this may be a sensitive period. For borderline cancer, the lifetime effect OR was not strongly supportive of an association (OR: 0.90, 95% CrI: 0.53-1.32). The results suggest that a sensitive period of early childbearing years is a candidate hypothesis for further investigation.© 2024. Springer Nature B.V.