Alcohol intake and the risk of epithelial ovarian cancer

Insomnia and Female Reproductive Diseases: A Cross-Sectional and Mendelian Randomization Study

Background

Insomnia is increasingly emerging as a significant concern in public health, with a longstanding emphasis on its relationship with overall well-being. Nevertheless, few research has been devoted to investigating the relationship between insomnia and female reproductive health.

Methods

In our study, we conducted a Mendelian randomization (MR) study to estimate the causal relationship between insomnia and female reproductive diseases. A total of 268 independent genetic variants associated with insomnia at the genome-wide significance level (P < 5×10-8) were used as instrumental variables. Summary-level data were obtained from the UK Biobank and Finn Gen study, including ovarian cysts, polycystic ovarian syndrome (PCOS), endometriosis, premature ovarian insufficiency (POI), ovarian cancer (OC), uterine fibroids, endometrial cancer (EC) and female infertility. We performed logistic regression to assess the associations between insomnia and the risk of OC and EC by using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014.

Results

Our research reveals that genetic liability to insomnia constitutes a risk factor for ovarian cysts (odds ratio [OR]: 1.44, 95% confidence interval [CI]: 1.21-1.72, P< 0.05), PCOS (OR: 1.67, 95% CI: 1.44-1.94, P< 0.05), and endometriosis (OR: 1.43, 95% CI: 1.16-1.76, P< 0.05). However, we found no statistically significant associations between insomnia and POI, OC, uterine fibroids, EC, or female infertility. Additionally, body mass index (BMI) was found to mediate about 10% of the effect of the insomnia on ovarian cysts and PCOS. Moreover, in cross-sectional study, insomnia was not associated with OC and EC.

Conclusion

Our study provides causal evidence that genetically predicted insomnia increases the risk of ovarian cysts, PCOS, and endometriosis. Accordingly, the potential significance of weight control and good sleep in keeping fit need to be emphasized.

Consumption of Red Versus White Wine and Cancer Risk: A Meta-Analysis of Observational Studies

BACKGROUND/OBJECTIVES

While alcoholic beverage consumption increases cancer risk, red wine has been touted as a healthier option. To address this unexplored question, we conducted a meta-analysis to summarize evidence from observational studies.

METHODS

A literature search of PubMed and EMBASE through December 2023 identified studies examining wine and cancer risk. A random-effects meta-analysis was performed to estimate relative risks (RRs) and 95% confidence intervals (CIs) for an association between wine intake and overall cancer risk.

RESULTS

A total of 20 cohort and 22 case-control studies were included. Wine intake was not associated with overall cancer risk (n = 95,923) when comparing the highest vs. lowest levels of consumption, with no differences observed by wine type (red: summary RR = 0.98 [95% CI = 0.87, 1.10], white: 1.00 [0.91, 1.10]; Pdifference = 0.74). However, white wine intake was significantly associated with an increased risk of cancer among women (white: 1.26 [1.05, 1.52], red: 0.91 [95% CI: 0.72, 1.16], Pdifference = 0.03) and in analyses restricted to cohort studies (white: 1.12 [1.03, 1.22], red: 1.02 [95% CI: 0.96, 1.09], Pdifference = 0.02). For individual cancer sites, there was a significant difference in associations between red and white wine intake only in skin cancer risk [6 studies, white: 1.22 (1.14, 1.30), red: 1.02 (0.95, 1.09); Pdifference = 0.0003].

CONCLUSIONS

We found no differences in the association between red or white wine consumption and overall cancer risk, challenging the common belief that red wine is healthier than white wine. Our significant results related to white wine intake in subgroup analyses warrant further investigation.

Alcohol Consumption and Breast and Ovarian Cancer Development: Molecular Pathways and Mechanisms

Alcohol consumption has been consistently linked to an increased risk of several cancers, including breast and ovarian cancer. Despite substantial evidence supporting this association, the precise mechanisms underlying alcohol's contribution to cancer pathogenesis remain incompletely understood. This narrative review focuses on the key current literature on the biological pathways through which alcohol may influence the development of breast and ovarian cancer. Key mechanisms discussed include the modulation of estrogen levels, the generation of reactive oxygen species, the production of acetaldehyde, the promotion of chronic inflammation, and the induction of epigenetic changes. Alcohol's impact on estrogenic signaling, particularly in the regulation of estrogen and progesterone, is explored in the context of hormone-dependent cancers. Additionally, the role of alcohol-induced DNA damage, mutagenesis, and immune system modulation in tumor initiation and progression is examined. Overall, this review emphasizes the importance of alcohol as a modifiable risk factor for breast and ovarian cancer and highlights the need for further research to clarify its role in cancer biology.

Endometriosis-Associated Ovarian Cancer: From Molecular Pathologies to Clinical Relevance

Endometriosis is a chronic condition affecting reproductive-aged women, characterized by the growth of ectopic endometrial tissue. Despite being benign, endometriosis is associated with an increased risk of certain cancers, including endometriosis-associated ovarian cancer (EAOC). Ovarian cancer is rare, but more common in women with endometriosis, particularly endometrioid and clear-cell carcinomas. Factors such as hormonal imbalance, reproductive history, environmental exposures, and genetic predisposition contribute to the malignant transformation of endometriosis. Thus, understanding potential risk factors causing malignancy is crucial. Over the past few decades, various genetic mutations, microRNAs, as well as tumor microenvironmental factors have been identified, impacting pathways like PI3K/AKT/mTOR, DNA repair mechanisms, oxidative stress, and inflammation. Thus, this review aims to summarize molecular studies involved in EAOC pathogenesis as potential therapeutic targets. However, further research is needed to better understand the molecular and environmental factors driving EAOC development, to target the susceptibility of endometriotic lesions to malignant progression, and to identify effective therapeutic strategies.

Early-Onset Ovarian Cancer <30 Years: What Do We Know about Its Genetic Predisposition?

Ovarian cancer (OC) is one of the leading causes of cancer-related deaths in women. Most patients are diagnosed with advanced epithelial OC in their late 60s, and early-onset adult OC diagnosed ≤30 years is rare, accounting for less than 5% of all OC cases. The most significant risk factor for OC development are germline pathogenic/likely pathogenic variants (GPVs) in OC predisposition genes (including BRCA1, BRCA2, BRIP1, RAD51C, RAD51D, Lynch syndrome genes, or BRIP1), which contribute to the development of over 20% of all OC cases. GPVs in BRCA1/BRCA2 are the most prevalent. The presence of a GPV directs tailored cancer risk-reducing strategies for OC patients and their relatives. Identification of OC patients with GPVs can also have therapeutic consequences. Despite the general assumption that early cancer onset indicates higher involvement of hereditary cancer predisposition, the presence of GPVs in early-onset OC is rare (<10% of patients), and their heritability is uncertain. This review summarizes the current knowledge on the genetic predisposition to early-onset OC, with a special focus on epithelial OC, and suggests other alternative genetic factors (digenic, oligogenic, polygenic heritability, genetic mosaicism, imprinting, etc.) that may influence the development of early-onset OC in adult women lacking GPVs in known OC predisposition genes.