Introduction: The link between cruciferous vegetables (CVs) and ovarian cancer (OC) is still uncertain. This meta-analysis is intended to investigate the association between CV consumption and the risk of OC, as well as to conduct a dose-response analysis to determine the degree of correlation between them. Methods: We systematically searched PubMed, Web of Science, Embase, and Cochrane Library databases between database creation and October 2023. The present meta-analysis has been duly registered and assigned the registration number CRD42023470299. This study followed the PRISMA guidelines. The statistical analysis was performed using Stata 14.0 software. Results: There were a total of 7 cohort studies and 7 case-control studies with 7,269 cases and 742,952 subjects. The combined relative risk (RR) of the highest intake of CVs was 0.90 (95% confidence intervals [CIs]: 0.84–0.96; I2 = 54.7%; p = 0.007) compared to the lowest intake of CVs. The odds ratio (OR) was 0.97 (95% CIs: 0.86–1.08; p = 0.192) for cohort studies, and the RR was 0.79 (95% CIs: 0.67–0.91; p = 0.167) for case-control studies. The intake of CVs and the risk of OC were linearly correlated. Adding 15 g of CVs to the diet each day decreased the likelihood of developing OC by almost 4% (RR = 0.963, 95% CIs: 0.905–1.025; p = 0.235). Conclusions: Consumption of CVs may be linked to a lower risk of OC.

1.
Sung
H
,
Ferlay
J
,
Siegel
RL
,
Laversanne
M
,
Soerjomataram
I
,
Jemal
A
, et al
.
Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries
.
CA Cancer J Clin
.
2021
;
71
(
3
):
209
49
.
2.
Stewart
C
,
Ralyea
C
,
Lockwood
S
.
Ovarian cancer: an integrated review
.
Semin Oncol Nurs
.
2019
;
35
(
2
):
151
6
.
3.
McManus
H
,
Moysich
KB
,
Tang
L
,
Joseph
J
,
McCann
SE
.
Usual cruciferous vegetable consumption and ovarian cancer: a case-control study
.
Nutr Cancer
.
2018
;
70
(
4
):
678
83
.
4.
Hu
J
,
Hu
Y
,
Hu
Y
,
Zheng
S
.
Intake of cruciferous vegetables is associated with reduced risk of ovarian cancer: a meta-analysis
.
Asia Pac J Clin Nutr
.
2015
;
24
(
1
):
101
9
.
5.
Abdull Razis
AF
,
Noor
NM
.
Cruciferous vegetables: dietary phytochemicals for cancer prevention
.
Asian Pac J Cancer Prev
.
2013
;
14
(
3
):
1565
70
.
6.
Han
B
,
Li
X
,
Yu
T
.
Cruciferous vegetables consumption and the risk of ovarian cancer: a meta-analysis of observational studies
.
Diagn Pathol
.
2014
;
9
:
7
.
7.
Dunneram
Y
,
Greenwood
DC
,
Cade
JE
.
Diet and risk of breast, endometrial and ovarian cancer: UK Women's Cohort Study
.
Br J Nutr
.
2019
;
122
(
5
):
564
74
.
8.
Stang
A
.
Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses
.
Eur J Epidemiol
.
2010
;
25
(
9
):
603
5
.
9.
Egger
M
,
Smith
GD
,
Phillips
AN
.
Meta-analysis: principles and procedures
.
BMJ
.
1997
;
315
(
7121
):
1533
7
.
10.
Higgins
JP
,
Thompson
SG
.
Quantifying heterogeneity in a meta-analysis
.
Stat Med
.
2002
;
21
(
11
):
1539
58
.
11.
Greenland
S
,
Longnecker
MP
.
Methods for trend estimation from summarized dose-response data, with applications to meta-analysis
.
Am J Epidemiol
.
1992
;
135
(
11
):
1301
9
.
12.
Durrleman
S
,
Simon
R
.
Flexible regression models with cubic splines
.
Stat Med
.
1989
;
8
(
5
):
551
61
.
13.
Long
J
,
Liu
Z
,
Liang
S
,
Chen
B
.
Cruciferous vegetable intake and risk of prostate cancer: a systematic review and meta-analysis
.
Urol Int
.
2023
;
107
(
7
):
723
33
.
14.
Peters
JL
,
Sutton
AJ
,
Jones
DR
,
Abrams
KR
,
Rushton
L
.
Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry
.
J Clin Epidemiol
.
2008
;
61
(
10
):
991
6
.
15.
Sterne
JA
,
Egger
M
.
Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis
.
J Clin Epidemiol
.
2001
;
54
(
10
):
1046
55
.
16.
Egger
M
,
Davey Smith
G
,
Schneider
M
,
Minder
C
.
Bias in meta-analysis detected by a simple, graphical test
.
BMJ
.
1997
;
315
(
7109
):
629
34
.
17.
Begg
CB
,
Mazumdar
M
.
Operating characteristics of a rank correlation test for publication bias
.
Biometrics
.
1994
;
50
(
4
):
1088
101
.
18.
Fairfield
KM
,
Hankinson
SE
,
Rosner
BA
,
Hunter
DJ
,
Colditz
GA
,
Willett
WC
.
Risk of ovarian carcinoma and consumption of vitamins A, C, and E and specific carotenoids: a prospective analysis
.
Cancer
.
2001
;
92
(
9
):
2318
26
.
19.
Larsson
SC
,
Holmberg
L
,
Wolk
A
.
Fruit and vegetable consumption in relation to ovarian cancer incidence: the Swedish Mammography Cohort
.
Br J Cancer
.
2004
;
90
(
11
):
2167
70
.
20.
Schulz
M
,
Lahmann
PH
,
Boeing
H
,
Hoffmann
K
,
Allen
N
,
Key
TJ
, et al
.
Fruit and vegetable consumption and risk of epithelial ovarian cancer: the European Prospective Investigation into Cancer and Nutrition
.
Cancer Epidemiol Biomarkers Prev
.
2005
;
14
(
11 Pt 1
):
2531
5
.
21.
Mommers
M
,
Schouten
LJ
,
Goldbohm
RA
,
van den Brandt
PA
.
Consumption of vegetables and fruits and risk of ovarian carcinoma
.
Cancer
.
2005
;
104
(
7
):
1512
9
.
22.
Chang
ET
,
Lee
VS
,
Canchola
AJ
,
Clarke
CA
,
Purdie
DM
,
Reynolds
P
, et al
.
Diet and risk of ovarian cancer in the California Teachers Study cohort
.
Am J Epidemiol
.
2007
;
165
(
7
):
802
13
.
23.
Gates
MA
,
Tworoger
SS
,
Hecht
JL
,
De Vivo
I
,
Rosner
B
,
Hankinson
SE
.
A prospective study of dietary flavonoid intake and incidence of epithelial ovarian cancer
.
Int J Cancer
.
2007
;
121
(
10
):
2225
32
.
24.
La Vecchia
C
,
Decarli
A
,
Negri
E
,
Parazzini
F
,
Gentile
A
,
Cecchetti
G
, et al
.
Dietary factors and the risk of epithelial ovarian cancer
.
J Natl Cancer Inst
.
1987
;
79
(
4
):
663
9
.
25.
Zhang
M
,
Yang
ZY
,
Binns
CW
,
Lee
AH
.
Diet and ovarian cancer risk: a case-control study in China
.
Br J Cancer
.
2002
;
86
(
5
):
712
7
.
26.
Pan
SY
,
Ugnat
AM
,
Mao
Y
,
Wen
SW
,
Johnson
KC
;
Canadian Cancer Registries Epidemiology Research Group
.
A case-control study of diet and the risk of ovarian cancer
.
Cancer Epidemiol Biomarkers Prev
.
2004
;
13
(
9
):
1521
7
.
27.
Kolahdooz
F
,
Ibiebele
TI
,
van der Pols
JC
,
Webb
PM
.
Dietary patterns and ovarian cancer risk
.
Am J Clin Nutr
.
2009
;
89
(
1
):
297
304
.
28.
Gates
MA
,
Vitonis
AF
,
Tworoger
SS
,
Rosner
B
,
Titus-Ernstoff
L
,
Hankinson
SE
, et al
.
Flavonoid intake and ovarian cancer risk in a population-based case-control study
.
Int J Cancer
.
2009
;
124
(
8
):
1918
25
.
29.
Bosetti
C
,
Filomeno
M
,
Riso
P
,
Polesel
J
,
Levi
F
,
Talamini
R
, et al
.
Cruciferous vegetables and cancer risk in a network of case-control studies
.
Ann Oncol
.
2012
;
23
(
8
):
2198
203
.
30.
Permuth-Wey
J
,
Sellers
TA
.
Epidemiology of ovarian cancer
.
Methods Mol Biol
.
2009
;
472
:
413
37
.
31.
La Vecchia
C
.
Ovarian cancer: epidemiology and risk factors
.
Eur J Cancer Prev
.
2017
;
26
(
1
):
55
62
.
32.
Murillo
G
,
Mehta
RG
.
Cruciferous vegetables and cancer prevention
.
Nutr Cancer
.
2001
;
41
(
1–2
):
17
28
.
33.
Kennelley
GE
,
Amaye-Obu
T
,
Foster
BA
,
Tang
L
,
Paragh
G
,
Huss
WJ
.
Mechanistic review of sulforaphane as a chemoprotective agent in bladder cancer
.
Am J Clin Exp Urol
.
2023
;
11
(
2
):
103
20
.
34.
Nebert
DW
,
Dalton
TP
.
The role of cytochrome P450 enzymes in endogenous signalling pathways and environmental carcinogenesis
.
Nat Rev Cancer
.
2006
;
6
(
12
):
947
60
.
35.
Jancova
P
,
Anzenbacher
P
,
Anzenbacherova
E
.
Phase II drug metabolizing enzymes
.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub
.
2010
;
154
(
2
):
103
16
.
36.
Li
G
,
Sepkovic
DW
,
Bradlow
HL
,
Telang
NT
,
Wong
GY
.
Lycium barbarum inhibits growth of estrogen receptor positive human breast cancer cells by favorably altering estradiol metabolism
.
Nutr Cancer
.
2009
;
61
(
3
):
408
14
.
37.
Seeger
H
,
Wallwiener
D
,
Kraemer
E
,
Mueck
AO
.
Comparison of possible carcinogenic estradiol metabolites: effects on proliferation, apoptosis and metastasis of human breast cancer cells
.
Maturitas
.
2006
;
54
(
1
):
72
7
.
38.
Sies
H
,
Berndt
C
,
Jones
DP
.
Oxidative stress
.
Annu Rev Biochem
.
2017
;
86
:
715
48
.
39.
Scherz-Shouval
R
,
Elazar
Z
.
Regulation of autophagy by ROS: physiology and pathology
.
Trends Biochem Sci
.
2011
;
36
(
1
):
30
8
.
40.
Li
D
,
Shao
R
,
Wang
N
,
Zhou
N
,
Du
K
,
Shi
J
, et al
.
Sulforaphane Activates a lysosome-dependent transcriptional program to mitigate oxidative stress
.
Autophagy
.
2021
;
17
(
4
):
872
87
.
41.
Abbaoui
B
,
Lucas
CR
,
Riedl
KM
,
Clinton
SK
,
Mortazavi
A
.
Cruciferous vegetables, isothiocyanates, and bladder cancer prevention
.
Mol Nutr Food Res
.
2018
;
62
(
18
):
e1800079
.
42.
Jo
GH
,
Kim
GY
,
Kim
WJ
,
Park
KY
,
Choi
YH
.
Sulforaphane induces apoptosis in T24 human urinary bladder cancer cells through a reactive oxygen species-mediated mitochondrial pathway: the involvement of endoplasmic reticulum stress and the Nrf2 signaling pathway
.
Int J Oncol
.
2014
;
45
(
4
):
1497
506
.
43.
Jiang
X
,
Liu
Y
,
Ma
L
,
Ji
R
,
Qu
Y
,
Xin
Y
, et al
.
Chemopreventive activity of sulforaphane
.
Drug Des Devel Ther
.
2018
;
12
:
2905
13
.
You do not currently have access to this content.