A case-control study was conducted in China during 19992000 to investigate the effects of intensity and duration of physical activity on the risk of epithelial ovarian cancer. Cases were 254 patients with histologically confirmed epithelia[ ovarian cancer. The 652 controls comprised 340 hospital visitors, 261 non-neoplasm hospital outpatients and S I women recruited from the community. Physical activity was measured by a validated questionnaire. The risks of ovarian cancer were assessed using multivariate logistic regression analysis accounting for age, demographic, lifestyle and familial factors, hormonal status, family ovarian cancer history and total energy intake. The study found that increasing total physical activity was associated with a lower ovarian cancer risk among Chinese women. The odds ratio was 0.54 (9S% Cl 0.34-0.87) for high vs. low levels of total weekly metabolic equivalent tasks. Ovarian cancer risk tended to decline with increasing duration of strenuous sports and frequency of activity-induced sweating among pre-menopausal women with adjusted OR 0.13 (95% Cl 0.03-0.64) and 0.45 (95% Cl 0.24-0.85), respectively. Increasing duration of moderate activity in post-menopausal women also appeared to be protective against ovarian cancer, with adjusted OR 0.36 (9S% Cl 0.18-0.73). (C) 2003 Wiley-Liss, Inc.