Food intake and the risk of endometrial endometrioid adenocarcinoma in Japanese women

Dietary Heat-Treatment Contaminants Exposure and Cancer: A Case Study from Turkey

In this study, the 10-year dietary habits of patients diagnosed with cancer (n = 1155) were retrospectively analyzed, and the relationships between dietary (red meat, white meat, fish meat, French fries, bread, instant coffee, ready-to-drink coffee, Turkish coffee, and black tea) heterocyclic amines, polycyclic aromatic hydrocarbons, acrylamide, and N-nitrosamine-based risk scores and cancer types were statistically evaluated. The foods with the highest and lowest mean dietary heat-treatment contaminant risk scores were red meat and ready-to-drink coffee, respectively. There were statistically significant differences in the dietary heat-treatment contamination risk scores based on the cancer patients' demographic characteristics (sex, age, smoking, and body mass index) (p < 0.05). According to the cancer types, the systems with the highest and lowest dietary heat-treatment contaminant risk scores were determined as other (brain, thyroid, lymphatic malignancies, skin, oro- and hypopharynx, and hematology) and the reproductive (breast, uterus, and ovary) system, respectively. The relationship between instant coffee consumption and respiratory system cancer types, the frequency of consumption of French fries and urinary system cancer types and the consumption of meat products and gastrointestinal system cancer types were determined. It is thought that this study contains important findings regarding the relationship between dietary habits and cancer and will be a good source for other studies to be conducted in this context.

Dietary fatty acids and endometrial cancer risk within the European Prospective Investigation into Cancer and Nutrition

BACKGROUND

Diet may impact important risk factors for endometrial cancer such as obesity and inflammation. However, evidence on the role of specific dietary factors is limited. We investigated associations between dietary fatty acids and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).

METHODS

This analysis includes 1,886 incident endometrial cancer cases and 297,432 non-cases. All participants were followed up for a mean of 8.8 years. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of endometrial cancer across quintiles of individual fatty acids estimated from various food sources quantified through food frequency questionnaires in the entire EPIC cohort. The false discovery rate (q-values) was computed to control for multiple comparisons.

RESULTS

Consumption of n-6 γ-linolenic acid was inversely associated with endometrial cancer risk (HR comparing 5th with 1st quintileQ5-Q1=0.77, 95% CI = 0.64; 0.92, ptrend=0.01, q-value = 0.15). This association was mainly driven by γ-linolenic acid derived from plant sources (HRper unit increment=0.94, 95%CI= (0.90;0.98), p = 0.01) but not from animal sources (HRper unit increment= 1.00, 95%CI = (0.92; 1.07), p = 0.92). In addition, an inverse association was found between consumption of n-3 α-linolenic acid from vegetable sources and endometrial cancer risk (HRper unit increment= 0.93, 95%CI = (0.87; 0.99), p = 0.04). No significant association was found between any other fatty acids (individual or grouped) and endometrial cancer risk.

CONCLUSION

Our results suggest that higher consumption of γ-linolenic acid and α-linoleic acid from plant sources may be associated with lower risk of endometrial cancer.

The influence of dietary vegetables and fruits on endometrial cancer risk: a meta-analysis of observational studies

Fruits and vegetables store many bioactive compounds and micronutrients, making their consumption ideal for maintaining good health. A previous meta-analysis in 2007 provided evidence that high vegetable and cruciferous vegetable intake might help prevent endometrial cancer (EC) development. The current study purposely explored the favorable effects of vegetables, fruits, and their other specific types using a review of the most recent papers. We conducted a systematic search through August 2021 in the PubMed and EMBASE databases on this topic, through which twenty-seven studies, consisting of 21 case-control and 6 cohort studies, were obtained. The results showed that vegetables (pooled odds ratio [OR], relative risk [RR], hazard ratio [HR] = 0.76, 95% confidence interval [CI] 0.63-0.91), cruciferous vegetables (pooled OR = 0.81, 95% CI 0.70-0.94), dark green and yellow/orange combined vegetables (pooled OR = 0.64, 95% CI 0.42-0.97), and fruits (pooled OR = 0.81, 95% CI 0.70-0.92) were strongly associated with a reduced risk of EC. These results were primarily based on studies of high quality and exhibited either by case-control only or a combination of case-control and cohort studies. Additionally, the results varied by geographic location, such as Western areas, the US, and Italy. This meta-analysis suggested that the consumption of fruits and vegetables has beneficial effects on EC risk and that specific kinds of fruits and vegetables should be recommended differently due to their outstanding bioactive components.

Diabetes Risk Reduction Diet and Endometrial Cancer Risk

Diabetes increases endometrial cancer risk. We investigated the role of a diabetes risk reduction diet (DRRD) on the risk of endometrial cancer using data from a multicentric, Italian hospital-based case-control study (1992-2006) enrolling 454 histologically confirmed cases of endometrial cancer and 908 controls matched by age and center. We derived a DRRD score assigning higher scores for higher intakes of cereal fiber, fruit, coffee, polyunsaturated:saturated fatty acid ratio, and nuts and for lower glycemic load and lower intakes of red/processed meat and sugar-sweetened beverages/fruit juices. The odds ratios (OR) of endometrial cancer according to the DRRD score were derived by multiple conditional logistic regression models. The OR for high (DRRD score >24, i.e., third tertile) versus medium-low adherence to the DRRD was 0.73 (95% confidence interval, CI, 0.55-0.97). Similar results were observed after the exclusion of diabetic women (OR 0.75; 95% CI, 0.56-1.00) and allowance for total vegetable consumption (OR 0.80; 95% CI, 0.60-1.07). Inverse associations were observed in most of the analyzed subgroups. The OR for high DRRD combined with high vegetable consumption was 0.45 (95% CI, 0.28-0.73). Our results suggest that diets able to reduce diabetes risk may also reduce endometrial cancer risk. High vegetable consumption combined with high adherence to the DRRD may provide additional benefit in endometrial cancer prevention.

Association of Total Nut, Tree Nut, Peanut, and Peanut Butter Consumption with Cancer Incidence and Mortality: A Comprehensive Systematic Review and Dose-Response Meta-Analysis of Observational Studies

Data on the association of nut intake with risk of cancer and its mortality are conflicting. Although previous meta-analyses summarized available findings in this regard, some limitations may distort their findings. Moreover, none of these meta-analyses examined the dose-response associations of total nut intake with the risk of specific cancers as well as associations between specific types of nuts and cancer mortality. Therefore, this study aimed to summarize available findings on the associations of total nut (tree nuts and peanuts), tree nut (walnuts, pistachios, macadamia nuts, pecans, cashews, almonds, hazelnuts, and Brazil nuts), peanut (whole peanuts without considering peanut butter), and peanut butter consumption with risk of cancer and its mortality by considering the above-mentioned points. We searched the online databases until March 2020 to identify eligible articles. In total, 43 articles on cancer risk and 9 articles on cancer mortality were included in the current systematic review and meta-analysis. The summary effect size (ES) for risk of cancer, comparing the highest with lowest intakes of total nuts, was 0.86 (95% CI: 0.81, 0.92, P < 0.001, I2 = 58.1%; P < 0.01), indicating a significant inverse association. Such a significant inverse association was also seen for tree nut intake (pooled ES: 0.87, 95% CI: 0.78-0.96, P < 0.01, I2 = 15.8%; P = 0.28). Based on the dose-response analysis, a 5-g/d increase in total nut intake was associated with 3%, 6%, and 25% lower risks of overall, pancreatic, and colon cancers, respectively. In terms of cancer mortality, we found 13%, 18%, and 8% risk reductions with higher intakes of total nuts, tree nuts, and peanuts, respectively. In addition, a 5-g/d increase in total nut intake was associated with a 4% lower risk of cancer mortality. In conclusion, our findings support the protective association between total nut and tree nut intake and the risk of cancer and its mortality.

Intake of fish and long-chain n-3 polyunsaturated fatty acids and risk of diseases in a Japanese population: a narrative review

Since the 1970s, the potential benefit of fish intake in terms of noncommunicable diseases has been one of the most important themes in disease prevention. Epidemiological studies have revealed the extent to which fish consumption affects the incidence of and mortality from diseases. Meta-analyses summarized the effect of fish and long-chain n-3 polyunsaturated fatty acid intake on noncommunicable diseases, especially cardiovascular diseases in Western countries. However, few reviews have spotlighted the effect of fish intake in East-Asian countries that have high population levels of fish intake such as Japan. We narratively reviewed the epidemiological studies concerned with the associations of fish and long-chain n-3 polyunsaturated fatty acid intake with risk of noncommunicable diseases, mainly of cardiovascular disease, among Japanese, whose fish intake has been twice or more than that of most Westerners. Overall, fish or long-chain n-3 polyunsaturated fatty acid intake may be beneficial for prevention of noncommunicable diseases, especially coronary heart disease and heart failure in Japanese as well as in Westerners. However, the beneficial effects of their intakes seemed to be nonlinear and varied according to disease severity and culture. Studies on other noncommunicable disease were also narratively reviewed.

Global, Regional, and National Burden of Endometrial Cancer, 1990-2017: Results From the Global Burden of Disease Study, 2017

Endometrial cancer (EC) is the most common malignancy affecting women in developed countries. Recently, the EC disease burden has changed; therefore, the Global Burden of Disease (GBD) 2017 was used to comprehensively analyze the global, regional, and national burden of EC between 1990 and 2017. General GBD cancer estimation methods were used with the data input from vital registration systems and cancer registries. Annual percent changes were calculated to quantify the trends of EC burden estimates during the study period. Furthermore, the sociodemographic index (SDI) was used to assess the relationship between the EC burden estimates and development level. From 1990 to 2017, the age-standardized incidence and prevalence rate of EC increased globally by 0.58 and 0.89% per year, respectively. In contrast, the age-standardized death rate and disability-adjusted-life years (DALYs) decreased by 1.19 and 1.21% per year, respectively. Increasing trends in both the incidence and prevalence were observed in all SDI quintiles, except for the low SDI quintiles, whereas decreasing trends were observed in all SDI quintiles for mortality and DALYs. Additionally, a non-linear association existed for the level of mortality rate, DALYs, and SDI. Of note, there was a strong positive association between a high body mass index and DALYs across all SDI quintiles. In conclusion, EC incidence and prevalence rates are growing globally, whereas the death rate and DALYs decreased between 1990 and 2017. Greater efforts, particularly detailed prevention strategies for reducing obesity, should be performed to reverse this phenomenon.

Nut and peanut butter intake are not directly associated with the risk of endometrial or ovarian cancer: Results from a Dutch prospective cohort study

BACKGROUND & AIMS

Nut intake has been associated with reduced cancer-related mortality and cancer risk. However, very few studies investigated the association between nut consumption and the risk of endometrial and ovarian cancer, with inconclusive results. We prospectively examined the relation between total nut, tree nut, peanut, and peanut butter intake and the risk of endometrial and ovarian cancer in the prospective Netherlands Cohort Study (NLCS).

METHODS

In 1986, 62,573 women aged 55-69 years were included in the NLCS. At baseline, all participants filled in a questionnaire and a subcohort of 2589 women was randomly selected. After 20.3 years of follow-up, 389 endometrial and 347 ovarian cancer cases with complete data were included in the analysis. Hazard ratios (HRs) were calculated in multivariable-adjusted Cox regression analyses, using a case-cohort approach.

RESULTS

Compared to nonconsumers, the HRs (95% confidence intervals) for women consuming 10 + g total nuts/day were 1.23 (0.82-1.87) for endometrial cancer and 0.84 (0.57-1.24) for ovarian cancer. For tree nut, peanut, and peanut butter intake, also no significant relations with endometrial or ovarian cancer were observed. In the endometrial cancer analyses, significant interactions of total nut intake with body mass index and cigarette smoking status were found.

CONCLUSIONS

The results of this study suggest that intake of total nuts, tree nuts, peanuts, and peanut butter is not related to the risk of endometrial or ovarian cancer. The observed interactions in the endometrial cancer analyses, in particular with cigarette smoking status, require confirmation in other studies.

Clinical significance and role of up-regulation of SERPINA3 expression in endometrial cancer

BACKGROUND

Serpin peptidase inhibitor, clade A member 3 (SERPINA3) belongs to the serpin family with an inhibitory activity against proteases. Its aberrant expression has been observed in a wide range of tumor cells. However, its clinical significance and biological function in endometrial cancer have been rarely studied. We designed a study to determine the levels of SERPINA3 and its significance in patients with endometrial cancer.

AIM

To investigate the clinical significance and role of SERPINA3 expression in endometrial cancer cells.

METHODS

Eighty endometrial tissue samples collected from patients with endometrial cancer were included in an observation group and 80 paraffin-embedded tissues samples collected from patients with normal endometrial tissues undergoing myomectomy were employed as a control group between January 2014 and December 2018. The expression of SERPINA3 mRNA was detected by quantitative polymerase chain reaction (PCR) for all endometrial tissues included in the study.

RESULTS

The positive expression rate of SERPINA3 protein in endometrial cancer cells was 71.25% in the observation group, which was significantly higher than that in the control group (31.25%; P < 0.05). There was no correlation between SERPINA3 protein in endometrial cancer cells and the age range at which women experienced menopause (P > 0.05). However, it was associated with pathological grade, clinical stage, vascular invasion, and lymph node metastasis (P < 0.05). Pathological grade, clinical stage, vascular invasion, and lymph node metastasis were independent prognostic factors for endometrial cancer.

CONCLUSION

The follow-up study of SERPINA3 can be used as a prognostic biomarker for endometrial cancer and as one of the targets for bio-targeted therapy for endometrial cancer.

The relation of healthy and Western dietary patterns to the risk of endometrial and ovarian cancers: a systematic review and meta-analysis

Dietary patterns have been used to explore the association between dietary factors and risk of endometrial (EC) and ovarian cancer (OC); however, the results are inconclusive. This meta-analysis aimed to analyze these associations. Methods: Pertinent studies published prior to March 2016 were systematically searched. The common dietary patterns were selected and adjusted risk estimates were derived by comparing the highest with the lowest categories of dietary pattern scores. Results: A total of 8 studies, 5 for endometrial cancer (1 cohort and 4 case-control studies including 2617 cases and 78082 participants/controls) and 3 for ovarian cancer (1 cohort and 2 case-control studies with 2025 cases and 101482 participants/controls) were included in this meta-analysis. A lower risk of EC was shown for the highest compared with the lowest category of the healthy dietary pattern (OR = 0.84, 95% CI: 0.72-0.98; P for heterogeneity = 0.10), whereas the Western dietary pattern was related to the higher risk of EC (OR = 1.19, 95% CI: 1.01-1.41; P for heterogeneity = 0.35). No significant relationship was found between the healthy dietary pattern (OR = 1.03, 95% CI: 0.69-1.53; P for heterogeneity = 0.01) and OC, while, adherence to the western pattern was associated with a 73% higher risk of OC (OR = 1.73, 95% CI: 1.08-2.37; P for heterogeneity = 0.06). Conclusion: A Western dietary pattern might be associated with a higher risk of endometrial and ovarian cancer.

Assessing the effect of guideline introduction on clinical practice and outcome in patients with endometrial cancer in Japan: a project of the Japan Society of Gynecologic Oncology (JSGO) guideline evaluation committee

Objective

The Japan Society of Gynecologic Oncology (JSGO) published the first practice guideline for endometrial cancer in 2006. The JSGO guideline evaluation committee assessed the effect of this guideline introduction on clinical practice and patient outcome using data provided by the Japan Society of Obstetrics and Gynecology (JSOG) cancer registration system.

Methods

Data of patients with endometrial cancer registered between 2000 and 2012 were analyzed, and epidemiological and clinical trends were assessed. The influence of guideline introduction on survival was determined by analyzing data of patients registered between 2004 and 2009 using competing risk model.

Results

In total, 65,241 cases of endometrial cancer were registered. Total number of patients registered each year increased about 3 times in the analyzed period, and the proportion of older patients with type II endometrial cancer rapidly increased. The frequency of lymphadenectomy had decreased not only among the low-recurrence risk group but also among the intermediate- or high-recurrence risk group. Adjuvant therapy was integrated into chemotherapy (p<0.001). Overall survival did not significantly differ before and after the guideline introduction (hazard ratio [HR]=0.891; p=0.160). Additional analyses revealed patients receiving adjuvant chemotherapy showed better prognosis than those receiving adjuvant radiation therapy when limited to stage I or II (HR= 0.598; p=0.003).

Conclusion

It was suggested that guideline introduction influenced the management of endometrial cancer at several aspects. Better organized information and continuous evaluation are necessary to understand the causal relationship between the guideline and patient outcome.

Peanut consumption associated with a reduced risk of esophageal squamous cell carcinoma: A case-control study in a high-risk area in China

Background

Esophageal cancer (EC) is ranked as the top 10th malignancy in China; however, an association between peanut consumption and EC risk has not yet been identified. This study explored the protective effects of peanut consumption against the risk of developing esophageal squamous cell carcinoma (ESCC) in a high‐risk area.

Methods

A case–control design was applied, with frequency matching by age and gender. A logistic regression model was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Two hundred and twenty‐two cases and 222 controls were recruited from Yanting County from 2011 to 2012.

Results

Peanut consumption 1–3 times per week reduced cancer risk by 38% (OR 0.62, 95% CI 0.34–1.13), while consumption ≥ 4 times per week reduced the risk by 70% (OR 0.31, 95% CI 0.16–0.59). A significant association was observed among individuals with negative family EC history (OR 0.25, 95% CI 0.12–0.49).

Conclusion

Peanut consumption may act as a protector against the occurrence of ESCC in high‐risk areas, thus production and consumption should be promoted in high‐risk areas in order to reduce the ESCC burden.

Dietary n-3 polyunsaturated fatty acids, fish consumption, and endometrial cancer risk: a meta-analysis of epidemiological studies

The relationship between intake of fish and n-3 fatty acids and endometrial cancer risk has not been consistent across epidemiological studies. We quantitatively assessed the aforementioned association through a systematic review and meta-analysis. PubMed and Embase were searched through March 2017 for eligible epidemiological studies. Fixed or random-effects models were used to pool relative risks (RRs) and 95% confidence intervals (CIs). The dose-response relationship was also evaluated. Based on the literature search, five prospective studies and 11 case-control studies were identified. All 16 studies were categorized as high-quality studies. After pooling available risk estimates, no significant association was detected between overall fish intake and endometrial cancer risk. In subgroup analyses, every one additional serving/week of fish intake was significantly associated with inversed endometrial cancer risk in studies adjusted for smoking (RR (95% CI): 0.95 (0.91-1.00)), or studies performed in Europe (RR (95% CI): 0.90 (0.84-0.97)), but not in other tested subgroups. In studies conducted in Asia, there was significant positive association (RR (95% CI): 1.15 (1.10-1.21)). Regarding n-3 PUFA intake, marginally inverse associations of high EPA or DHA intake were detected (EPA: RR (95% CI) = 0.79 (0.61-1.04); DHA: RR (95% CI) = 0.85 (0.64-1.11)). Dose-response analyses suggested a significant nonlinear relationship between DHA intake and endometrial cancer risk (p: 0.04). Overall, this meta-analysis suggests that intake of n-3 PUFA may be inversely associated with endometrial cancer risk at some level of evidence, although the exact relationship, especially for fish intake, needs further characterization. Further well-designed studies are warranted.

Nut consumption and risk of cancer and type 2 diabetes: a systematic review and meta-analysis

CONTEXT

The identification of foods that can decrease the risk of cancer and type 2 diabetes may be helpful in reducing the burden of these diseases. Although nut consumption has been suggested to have a disease-preventive role, current evidence remains inconsistent.

OBJECTIVE

The aim of this systematic review and meta-analysis was to clarify the association between nut consumption and risk of cancer or type 2 diabetes.

DATA SOURCES

Six databases were searched for relevant studies from the time of database inception to August 2014. Reference lists of relevant review articles were hand searched, and authors were contacted when data were insufficient.

STUDY SELECTION

Eligible studies included epidemiological studies (case-control and cohort) or clinical trials that reported an association between nut consumption and the outcome of type 2 diabetes or specific cancers.

DATA EXTRACTION

Two investigators independently extracted descriptive, quality, and risk data from included studies.

DATA SYNTHESIS

Random-effects meta-analysis was used to pool relative risks from the included studies. The I(2) statistic was used to assess heterogeneity. A total of 36 eligible observational studies, which included 30,708 patients, were identified. The studies had fair methodological quality, and length of follow-up ranged between 4.6 years and 30 years. Comparison of the highest category of nut consumption with the lowest category revealed significant associations between nut consumption and decreased risk of colorectal cancer (3 studies each with separate estimates for males and females, RR 0.76, 95% confidence interval [95%CI] 0.61-0.96), endometrial cancer (2 studies, RR 0.58, 95%CI 0.43-0.79), and pancreatic cancer (1 study, RR 0.68, 95%CI 0.48-0.96). No significant association was found with other cancers or type 2 diabetes. Overall, nut consumption was significantly associated with a reduced risk of cancer incidence (RR 0.85, 95%CI 0.76-0.95).

CONCLUSIONS

Nut consumption may play a role in reducing cancer risk. Additional studies are needed to more accurately assess the relationship between nut consumption and the prevention of individual types of cancer, given the scarcity of available data.

Green tea, black tea consumption and risk of endometrial cancer: a systematic review and meta-analysis

BACKGROUND

Several studies have assessed the association between green and black tea consumption and the risk of endometrial cancer (EC) and have yielded inconsistent results.

OBJECTIVE

The purpose of this meta-analysis is to systematically analyze the effect of green tea and black tea on EC risk.

METHODS

PubMed, Embase, Cochrane Library and China Biological Medicine Database were searched through February 2, 2015 to identify studies that met pre-stated inclusion criteria. Overall relative risk (RR) was estimated based on the highest and lowest levels of green/black tea consumption. Dose-response relationships were evaluated with the data from categories of green/black tea intake in each study.

RESULTS

For green tea, the summary RR indicated that the highest green tea consumption was associated with a reduced risk of EC (RR 0.78, 95 % CI 0.66-0.92). Furthermore, an increase in green tea consumption of one cup per day was associated with an 11 % decreased risk of developing EC. (RR 0.89, 95 % CI 0.84-0.94). For black tea, no statistically significant association was observed in the meta-analysis (highest versus non/lowest, RR 0.99, 95 % CI 0.79-1.23; increment of one cup/day, RR 0.99, 95 % CI 0.94-1.03). The power of the estimate of green tea and black tea with risk of EC was 84.33 and 5.07 %, respectively. The quality of evidence for the association between green and black tea with EC risk was moderate and very low, respectively.

CONCLUSIONS

The results from this meta-analysis indicate that green tea, but not black tea, may be related to a reduction of EC risk. Large population-based randomized controlled trials and large prospective cohort studies are required to obtain a definitive conclusion and determine the mechanisms underlying this association.