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Gao Y, Zhai P, Jiang F, Zhou F, Wang X. Association between coffee drinking and endometrial cancer risk: A meta‐analysis. J Obstet Gynaecol Res 2022; 48:774-795. [PMID: 35048465 DOI: 10.1111/jog.15139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/15/2021] [Accepted: 12/16/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Yu Gao
- Department of Obstetrics and Gynecology Liangxiang Hospital of Beijing Fangshan District Beijing China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Peiling Zhai
- Department of Obstetrics and Gynecology The Affiliated Hospital of Weifang Medical University Weifang China
| | - Fang Jiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Fushun Zhou
- Department of Obstetrics and Gynecology Liangxiang Hospital of Beijing Fangshan District Beijing China
| | - Xinbo Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
- Department of Obstetrics and Gynecology The Affiliated Hospital of Weifang Medical University Weifang China
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GAO Y, CAO Z, ZHOU F, ZHAO Y, TANG L, ZHANG H. Association between tea drinking and endometrial cancer risk: a meta-analysis. FOOD SCIENCE AND TECHNOLOGY 2021. [DOI: 10.1590/fst.90021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Yu GAO
- Liangxiang Hospital of Beijing Fangshan District
| | - Zhihong CAO
- Liangxiang Hospital of Beijing Fangshan District
| | - Fushun ZHOU
- Liangxiang Hospital of Beijing Fangshan District
| | - Yanmei ZHAO
- Liangxiang Hospital of Beijing Fangshan District
| | - Lihong TANG
- Liangxiang Hospital of Beijing Fangshan District
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Jamshidi M, Mohammadi Pour S, Mahmoudian-Sani MR. Single Nucleotide Variants Associated with Colorectal Cancer Among Iranian Patients: A Narrative Review. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2020; 13:167-180. [PMID: 32581566 PMCID: PMC7280057 DOI: 10.2147/pgpm.s248349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/19/2020] [Indexed: 12/31/2022]
Abstract
Colorectal cancer has been considered as one of the complicated multi-stage processes after adenoma-carcinoma sequence. Therefore, studies of the molecular dysregulation basis could present information on the recognition of the potent biomarkers and treatment targets for this disease. Even though outcomes of the patients with colorectal cancer have been improved largely with current annual screening plans, it is necessary to have reliable prognostic biomarkers because of the disease heterogeneity. There is a significant relationship between SNP in IL1RN* 2 (IL1ra), −509 C/T (TGFB1), rs11556218 T>G and rs4778889 T/C (IL16), miRNA-binding site polymorphisms in IL16, rs4464148 (SMAD7), rs6983267 (EGF), GSTT1, TACG haplotype (CTLA4), 1793G> A (MTHFR), Leu/Leu genotype of (EXO1), −137 G/C (IL18), C/T genotype (XRCC3), I3434T (XRCC7), MGMT, C3435T (MDR1), ff genotype of FokI, 677CT+TT (MTHFR), G2677T/A (MDR1) and CRC. Increased risk has been observed in VDR ApaI genotype “aa”. Finally, the protective effect has been explored in the TACA haplotype (CTLA4). According to the findings, the genetic polymorphisms in the immunity-associated genes are related to the CRC amongst the Iranian patients. Therefore, more large-scale functional investigations are necessary for confirming the results.
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Affiliation(s)
- Mohammad Jamshidi
- Department of Laboratory Sciences, School of Allied Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Somayeh Mohammadi Pour
- Department of Obstetrics and Gynecology, School of Medicine Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohammad-Reza Mahmoudian-Sani
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Li H, Mao H, Yu Y, Nan Y. Association between dietary fiber and endometrial cancer: a meta-analysis. Nutr Cancer 2019; 72:959-967. [PMID: 31584301 DOI: 10.1080/01635581.2019.1670218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
To explore a potential relationship between dietary fiber consumption and risk of endometrial cancer (EC), eligible studies published up to 30 June 2018 were retrieved via computer searches and manual review of references. Random-effects models were used to calculate summary relative risk (RR) estimates based on contrasting high- and low-fiber intake values. Sensitivity analysis was conducted, and heterogeneity among study results was explored through stratified analyses by study design, geographic region, Newcastle-Ottawa Scale (NOS) score, impact factor, and adjustment for several confounders (age, body mass index, smoking, energy intake, and education). We extracted data from 16 studies (involving 6,563 cases). There was a significant association between dietary fiber intake and EC (RR = 0.86, 95% confidence interval [CI]: 0.78, 0.93). In stratified analysis, this trend was more pronounced in the case-control studies, and in studies conducted in the Americas and Asia. The relationship was further confirmed after adjusting for education level (RR = 0.74; 95% CI: 0.60, 0.88) and age (RR = 0.70; 95% CI: 0.57, 0.83), and NOS scores of 6 (RR = 0.81; 95% CI: 0.67, 0.95) and 7 (RR = 0.75; 95% CI: 0.62, 0.88). In conclusion, our meta-analysis revealed an inverse association between dietary fiber consumption and EC risk. Further efforts should be made to confirm these findings.
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Affiliation(s)
- Hengjie Li
- Department of Emergency, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Hui Mao
- Department of Anesthesiology, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Yi Yu
- Department of Critical Care Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Yong Nan
- Department of Emergency, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
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Chen K, Zhao Q, Li X, Zhao J, Li P, Lin S, Wang H, Zang J, Xiao Y, Xu W, Chen F, Gao Y. Dietary Fiber Intake and Endometrial Cancer Risk: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:E945. [PMID: 30037138 PMCID: PMC6073518 DOI: 10.3390/nu10070945] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 01/09/2023] Open
Abstract
Epidemiological studies are inconclusive regarding the association between dietary fiber intake and endometrial cancer risk. Thus, we aimed to conduct a meta-analysis to clarify the association between dietary fiber and endometrial cancer risk. We searched the PubMed and ISI Web databases for relevant studies through March 2018. The association between dietary fiber and endometrial cancer risk was evaluated by conducting a meta-analysis including 3 cohort and 12 case⁻control studies. A significant negative association was observed between total dietary fiber intake and endometrial cancer risk in 11 case⁻control studies (odds ratios (OR) 0.76, 95% confidence interval (CI): 0.64⁻0.89, I² = 35.2%, p = 0.117), but a marginal positive association was observed in three cohort studies (relative risk (RR) 1.22, 95% CI: 1.00⁻1.49, I² = 0.0%, p = 0.995). Particularly, a negative association was observed in North America (OR = 0.70, 95% CI: 0.59⁻0.83, I² = 8.9%, p = 0.362). In addition, a positive association was observed in cereal fiber (RR = 1.26, 95% CI: 1.03⁻1.52, I² = 0.0%, p = 0.530, 3 cohort studies) and a negative association was observed in vegetable fiber (OR = 0.74, 95% CI: 0.58⁻0.94, I² = 0.0%, p = 0.445, 3 case⁻control studies). In conclusion, negative associations with endometrial cancer risk were observed for higher total dietary fiber intake and higher vegetable fiber intake in the case⁻control studies. However, results from the cohort studies suggested positive relationships of higher total fiber intake and higher cereal fiber intake with endometrial cancer risk.
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Affiliation(s)
- Kangning Chen
- School of Life Sciences, Shanghai University, 333 Nanchen Road, Shanghai 200444, China.
- CAS Key Laboratory of Nutrition, Metabolism and Food safety, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, New Life Science Building, Room A1926, Shanghai 200031, China.
| | - Qianyu Zhao
- CAS Key Laboratory of Nutrition, Metabolism and Food safety, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, New Life Science Building, Room A1926, Shanghai 200031, China.
| | - Xiaofan Li
- CAS Key Laboratory of Nutrition, Metabolism and Food safety, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, New Life Science Building, Room A1926, Shanghai 200031, China.
| | - Jing Zhao
- CAS Key Laboratory of Nutrition, Metabolism and Food safety, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, New Life Science Building, Room A1926, Shanghai 200031, China.
| | - Peiqin Li
- CAS Key Laboratory of Nutrition, Metabolism and Food safety, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, New Life Science Building, Room A1926, Shanghai 200031, China.
| | - Shuchun Lin
- CAS Key Laboratory of Nutrition, Metabolism and Food safety, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, New Life Science Building, Room A1926, Shanghai 200031, China.
| | - Hongwei Wang
- DuPont Nutrition & Health, No. 10, Lane 280, Linhong Rd., Changning District, Shanghai 200335, China.
| | - Jiajie Zang
- Department of Nutrition Hygiene, Division of Health Risk Factor Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Changning District, Shanghai 200336, China.
| | - Ying Xiao
- Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Avenide Wai Long, Taipa, Macau.
| | - Wanghong Xu
- Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China.
| | - Fuxue Chen
- School of Life Sciences, Shanghai University, 333 Nanchen Road, Shanghai 200444, China.
| | - Ying Gao
- CAS Key Laboratory of Nutrition, Metabolism and Food safety, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, New Life Science Building, Room A1926, Shanghai 200031, China.
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Lukic M, Guha N, Licaj I, van den Brandt PA, Stayner LT, Tavani A, Weiderpass E. Coffee Drinking and the Risk of Endometrial Cancer: An Updated Meta-Analysis of Observational Studies. Nutr Cancer 2018; 70:513-528. [PMID: 29708405 DOI: 10.1080/01635581.2018.1460681] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Several compounds contained in coffee have been found to suppress carcinogenesis in experimental studies. We conducted a dose-response meta-analysis to assess the impact of coffee consumption on the risk of endometrial cancer. MATERIALS AND METHODS We searched MEDLINE and EMBASE databases for studies published up to August 2016. Using random effects models, we estimated summary relative risks (RR) for cohort studies and odds ratios (OR) for case-control studies with 95% confidence intervals (CI). Dose-response analyses were conducted by using generalized least square trend estimation. RESULTS We identified 12 cohort studies and 8 case-control studies eligible for inclusion, contributing with 11,663 and 2,746 endometrial cancer cases, respectively. The summary RR for highest compared with lowest coffee intake was 0.74 (95% CI: 0.68-0.81; pheterogeneity = 0.09, I2 = 32%). The corresponding summary RR among cohort studies was 0.78 (95% CI: 0.71-0.85; pheterogeneity = 0.14, I2 = 31.9%) and 0.63 (95% CI: 0.53-0.76; pheterogeneity = 0.57, I2 = 0%) for case-control studies. One-cup increment per day was associated with 3% risk reduction (95% CI: 2-4%) in cohort studies and 12% (95% CI: 5-18%) in case-control studies. After pooling the results from 5 cohort studies, the association remained significant only in women with body mass index over 30 (RR = 0.71, 95% CI: 0.61-0.81). CONCLUSION The results from our meta-analysis strengthen the evidence of a protective effect of coffee consumption on the risk of EC and further suggest that increased coffee intake might be particularly beneficial for women with obesity.
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Affiliation(s)
- Marko Lukic
- a Department of Community Medicine , Faculty of Health Sciences, UiT The Arctic University of Norway , Tromsø , Norway
| | - Neela Guha
- b International Agency for Research on Cancer , Lyon , France
| | - Idlir Licaj
- a Department of Community Medicine , Faculty of Health Sciences, UiT The Arctic University of Norway , Tromsø , Norway
- c Clinical Research Department , Normandie University, UNICAEN, INSERM, U1086, Centre François Baclesse , Caen , France
| | - Piet A van den Brandt
- d Department of Epidemiology , School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre (MUMC) , Maastricht , The Netherlands
| | - Leslie Thomas Stayner
- e Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago , Chicago , Illinois , USA
| | - Alessandra Tavani
- f Department of Epidemiology , IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri" , Milan , Italy
| | - Elisabete Weiderpass
- a Department of Community Medicine , Faculty of Health Sciences, UiT The Arctic University of Norway , Tromsø , Norway
- g Department of Research , Cancer Registry of Norway, Institute of Population-Based Cancer Research , Oslo , Norway
- h Department of Medical Epidemiology and Biostatistics , Karolinska Institutet , Stockholm , Sweden
- i Genetic Epidemiology Group, Folkhälsan Research Center , Helsinki , Finland
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Du L, Wang Y, Zhang H, Zhang H, Gao Y. Folate intake and the risk of endometrial cancer: A meta-analysis. Oncotarget 2018; 7:85176-85184. [PMID: 27835893 PMCID: PMC5356727 DOI: 10.18632/oncotarget.13211] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 10/26/2016] [Indexed: 12/03/2022] Open
Abstract
Background Folate may involve in various aspects of carcinogenesis. However, the relationship between folate intake and risk of many cancers, including endometrial cancer, is still inconclusive. We conducted a meta-analysis to systematically review the association. Methods Relevant studies were searched through three electronic databases (PubMed, Embase, and Web of Science) up to April 4, 2016. Population based prospective or case-control studies involving in investigating folate intake and risk of endometrial cancer were considered as eligible. Three investigators independently extracted data. Controversies were reconciled by discussing with a fourth investigator. Effect sizes of studies were pooled via a random effects model. Thereafter to explore the origin of heterogeneity among results of studies, a mixed effects model was employed with study design and dose of folate intake taken as covariates. Results Nine case-control studies and five cohort studies were included in the current meta-analysis. The result pooled from the highest category suggested a marginal negative association between folate intake and risk of endometrial cancer (OR=0.89 95% CI: 0.76-1.05). Based on the mixed effects model, in the highest category, the risk showed an increasing trend along with increment of folate intake (5% risk increase per 100μg/d, P=0.01). Conclusion A marginally negative association was observed between folate intake and endometrial cancer, which might subject to a threshold effect. More finely designed perspective studies or randomized trials are still needed to confirm the association.
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Affiliation(s)
- Li Du
- State Key Laboratory of Genetic Engineering and Institute of Biostatistics, School of Life Sciences, Fudan University, Shanghai, China.,Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Yulong Wang
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Hang Zhang
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Hong Zhang
- State Key Laboratory of Genetic Engineering and Institute of Biostatistics, School of Life Sciences, Fudan University, Shanghai, China
| | - Ying Gao
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
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Dairy Products Intake and Endometrial Cancer Risk: A Meta-Analysis of Observational Studies. Nutrients 2017; 10:nu10010025. [PMID: 29283380 PMCID: PMC5793253 DOI: 10.3390/nu10010025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 11/28/2017] [Accepted: 12/11/2017] [Indexed: 01/28/2023] Open
Abstract
Observational studies have suggested inconsistent findings on the relationship between dairy products intake and endometrial cancer risk. This study aimed to conduct a meta-analysis to evaluate this correlation; moreover, databases including PubMed, ISI Web of Science, and Embase were screened for relevant studies up to 26 February 2017. The inverse variance weighting method and random effects models were used to calculate the overall OR (odds ratio) values and 95% confidence interval (CI). A total of 2 cohort study and 16 case-control studies were included in the current analysis. No significant association was observed between endometrial cancer risk and the intake of total dairy products, milk, or cheese for the highest versus the lowest exposure category (total dairy products (14 studies): OR 1.04, 95% CI: 0.97-1.11, I² = 73%, p = 0.000; milk (6 studies): 0.99, 95% CI: 0.89-1.10, I² = 0.0%, p = 0.43; cheese (5 studies): 0.89, 95% CI: 0.76-1.05, I² = 39%, p = 0.16). The only cohort study with a total of 456,513 participants reported a positive association of butter intake with endometrial cancer risk (OR = 1.14; 95% CI = 1.03-1.26, I² = 2.6%, p = 0.31). There was a significant negative association of dairy products intake and endometrial cancer risk among women with a higher body mass index (BMI) (5 studies, OR 0.66, 95% CI = 0.46-0.96, I² = 75.8%, p = 0.002). Stratifying the analyses by risk factors including BMI should be taken into account when exploring the association of dairy products intake with endometrial cancer risk. Further well-designed studies are needed.
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Wu QJ, Gong TT, Wang YZ. Dietary fatty acids intake and endometrial cancer risk: a dose-response meta-analysis of epidemiological studies. Oncotarget 2016; 6:36081-97. [PMID: 26462150 PMCID: PMC4742163 DOI: 10.18632/oncotarget.5555] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 09/25/2015] [Indexed: 02/02/2023] Open
Abstract
Epidemiological studies have provided controversial evidence of the association between dietary fatty acids intake and endometrial cancer risk. The continuous update project of World Cancer Research Fund failed to focus on this issue. To address this inconsistency, we conducted this dose-response meta-analysis based on epidemiological studies published up to the end of June 2015 identified from PubMed, EMBASE and Web of Science. Two authors independently performed the eligibility evaluation and data extraction. Random-effects models were used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs). Fourteen epidemiological studies (4 cohort and 10 case-control studies) were included in this dose-response meta-analysis. The summary RR for an intake increment of 10g/day was 1.02 (95% CI = 0.97–1.08; I2 = 66.0%) for saturated fatty acids, 0.98 (95% CI = 0.96–1.001; I2 = 0%) for monounsaturated fatty acids, and 1.00 (95% CI = 0.95–1.06; I2 = 0%) for polyunsaturated fatty acids intake. Non-significant results were observed in the majority of subgroup analyses stratified by study characteristics and adjustment for potential confounders in analyses of aforementioned associations. In conclusion, results from this dose-response meta-analysis provided limited evidence that dietary saturated, monounsaturated, and polyunsaturated fatty acids consumption was associated with endometrial cancer risk. Further studies, especial prospective designed or pooled studies are warranted to confirm our findings.
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Affiliation(s)
- Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ya-Zhu Wang
- Department of Hematology, The First Affiliated Hospital of China Medical University, Shenyang, China
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Zhao J, Lyu C, Gao J, Du L, Shan B, Zhang H, Wang HY, Gao Y. Dietary fat intake and endometrial cancer risk: A dose response meta-analysis. Medicine (Baltimore) 2016; 95:e4121. [PMID: 27399120 PMCID: PMC5058849 DOI: 10.1097/md.0000000000004121] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Since body fatness is a convincing risk factor for endometrial cancer, dietary fat intake was speculated to be associated with endometrial cancer risk. However, epidemiological studies are inconclusive. We aimed to conduct a meta-analysis to assess the associations between dietary fat intake and endometrial cancer risk. We searched the PubMed, Embase, and Web of science databases updated to September 2015. In total, 7 cohort and 14 case-control studies were included. Pooled analysis of case-control studies suggested that endometrial cancer risk was significantly increased by 5% per 10% kilocalories from total fat intake (P=0.02) and by 17% per 10 g/1000 kcal of saturated fat intake (P < 0.001). Summary of 3 cohort studies showed significant inverse association between monounsaturated fatty acids and endometrial cancer risk (odds ratio = 0.84, 95% confidence interval = 0.73-0.98) with a total of 524583 participants and 3503 incident cases. No significant associations were found for polyunsaturated fatty acids and linoleic acid. In conclusion, positive associations with endometrial cancer risk were observed for total fat and saturated fat intake in the case-control studies. Results from the cohort studies suggested higher monounsaturated fatty acids intake was significantly associated with lower endometrial cancer risk.
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Affiliation(s)
- Jing Zhao
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
| | - Chen Lyu
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
- Department of Applied Health Science, School of Public Health, Indiana University Bloomington, Bloomington, IN
| | - Jian Gao
- Department of Nutrition, Zhongshan Hospital
| | - Li Du
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
- Institute of Biostatistics
| | - Boer Shan
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | | | - Hua-Ying Wang
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ying Gao
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
- Correspondence: Ying Gao, 320 Yueyang Road, New Life Science Building, Room A1926, Shanghai, 200031, People's Republic of China (e-mail: )
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11
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Dietary fat intake and endometrial cancer risk: dose-response meta-analysis of epidemiological studies. Sci Rep 2015; 5:16693. [PMID: 26568366 PMCID: PMC4645223 DOI: 10.1038/srep16693] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 10/19/2015] [Indexed: 12/11/2022] Open
Abstract
Epidemiological studies have provided controversial evidence of the association between dietary fat intake and endometrial cancer (EC) risk. To address this inconsistency, we conducted this dose-response meta-analysis by total dietary fat intake, based on epidemiological studies published up to the end of June 2015 identified from PubMed, EMBASE and Web of Science. Two authors (RH and Q-JW) independently performed the eligibility evaluation and data extraction. All differences were resolved by discussion with the third investigator (LJ). Random-effects models were used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs). Overall, the search yielded 16 studies (6 cohort and 10 case-control studies) that involved a total of 7556 EC cases and 563,781 non-cases. The summary RR for EC for each 30g/day increment intake was 0.98 (95%CI = 0.95–1.001; I2 = 0%; n = 11) for total dietary fat. Non-significant results were observed in plant-based fat (summary RR = 1.05, 95%CI = 0.94–1.18; I2 = 0%; n = 5) and animal-based fat (summary RR = 1.17, 95%CI = 0.92–1.36; I2 = 85.0%; n = 6). Additionally, the null associations were observed in almost all the subgroup and sensitivity analyses. In conclusion, findings of the present meta-analysis suggested a lack of association between total dietary fat intake and EC risk. Further studies, especially prospective designed studies are warranted to confirm our findings.
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12
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Filomeno M, Bosetti C, Bidoli E, Levi F, Serraino D, Montella M, La Vecchia C, Tavani A. Mediterranean diet and risk of endometrial cancer: a pooled analysis of three Italian case-control studies. Br J Cancer 2015; 112:1816-21. [PMID: 26010500 PMCID: PMC4647248 DOI: 10.1038/bjc.2015.153] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/26/2015] [Accepted: 04/07/2015] [Indexed: 12/21/2022] Open
Abstract
Background: Some components of the Mediterranean diet have favourable effects on endometrial cancer, and the Mediterranean diet as a whole has been shown to have a beneficial role on various neoplasms. Methods: We analysed this issue pooling data from three case-control studies carried out between 1983 and 2006 in various Italian areas and in the Swiss Canton of Vaud. Cases were 1411 women with incident, histologically confirmed endometrial cancer, and controls were 3668 patients in hospital for acute diseases. We measured the adherence to the Mediterranean diet using a Mediterranean Diet Score (MDS), based on the nine dietary components characteristics of this diet, that is, high intake of vegetables, fruits/nuts, cereals, legumes, fish; low intake of dairy products and meat; high monounsaturated to saturated fatty acid ratio; and moderate alcohol intake. We estimated the odds ratios (OR) and the corresponding 95% confidence intervals (CI) for increasing levels of the MDS (varying from 0, no adherence, to 9, maximum adherence) using multiple logistic regression models, adjusted for major confounding factors. Results: The adjusted OR for a 6–9 components of the MDS (high adherence) compared with 0–3 (low adherence) was 0.43 (95% CI 0.34–0.56). The OR for an increment of one component of MDS diet was 0.84 (95% CI 0.80–0.88). The association was consistent in strata of various covariates, although somewhat stronger in older women, in never oral contraceptive users and in hormone-replacement therapy users. Conclusions: Our study provides evidence for a beneficial role of the Mediterranean diet on endometrial cancer risk, suggesting a favourable effect of a combination of foods rich in antioxidants, fibres, phytochemicals, and unsaturated fatty acids.
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Affiliation(s)
- M Filomeno
- Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri, Via Giuseppe La Masa 19, 20156 Milan, Italy
| | - C Bosetti
- Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri, Via Giuseppe La Masa 19, 20156 Milan, Italy
| | - E Bidoli
- S.O.C. Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, IRCCS, 33081 Aviano (PN), Italy
| | - F Levi
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, 1010 Lausanne, Switzerland
| | - D Serraino
- S.O.C. Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, IRCCS, 33081 Aviano (PN), Italy
| | - M Montella
- Unit of Epidemiology, Struttura Complessa di Statistica Medica, Biometria e Bioinformatica, Fondazione IRCCS Istituto Nazionale Tumori, 80131 Naples, Italy
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133 Milan, Italy
| | - A Tavani
- Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri, Via Giuseppe La Masa 19, 20156 Milan, Italy
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13
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Brasky TM, Rodabough RJ, Liu J, Kurta ML, Wise LA, Orchard TS, Cohn DE, Belury MA, White E, Manson JE, Neuhouser ML. Long-chain ω-3 fatty acid intake and endometrial cancer risk in the Women's Health Initiative. Am J Clin Nutr 2015; 101:824-34. [PMID: 25739930 PMCID: PMC4381777 DOI: 10.3945/ajcn.114.098988] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 02/05/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Inflammation may be important in endometrial cancer development. Long-chain ω-3 (n-3) polyunsaturated fatty acids (LCω-3PUFAs) may reduce inflammation and, therefore, reduce cancer risk. Because body mass is associated with both inflammation and endometrial cancer risk, it may modify the association of fat intake on risk. OBJECTIVE We examined whether intakes of LCω-3PUFAs were associated with endometrial cancer risk overall and stratified by body size and histologic subtype. DESIGN Women were n = 87,360 participants of the Women's Health Initiative Observational Study and Clinical Trials who were aged 50-79 y, had an intact uterus, and completed a baseline food-frequency questionnaire. After 13 y of follow-up, n = 1253 incident invasive endometrial cancers were identified. Cox regression models were used to estimate HRs and 95% CIs for the association of intakes of individual ω-3 fatty acids and fish with endometrial cancer risk. RESULTS Intakes of individual LCω-3PUFAs were associated with 15-23% linear reductions in endometrial cancer risk. In women with body mass index (BMI; in kg/m(2)) <25, those in the upper compared with lowest quintiles of total LCω-3PUFA intake (sum of eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids) had significantly reduced endometrial cancer risk (HR: 0.59; 95% CI: 0.40, 0.82; P-trend = 0.001), whereas there was little evidence of an association in overweight or obese women. The reduction in risk observed in normal-weight women was further specific to type I cancers. CONCLUSIONS Long-chain ω-3 intake was associated with reduced endometrial cancer risk only in normal-weight women. Additional studies that use biomarkers of ω-3 intake are needed to more accurately estimate their effects on endometrial cancer risk. This trial was registered at clinicaltrials.gov as NCT00000611.
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Affiliation(s)
- Theodore M Brasky
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Rebecca J Rodabough
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Jingmin Liu
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Michelle L Kurta
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Lauren A Wise
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Tonya S Orchard
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - David E Cohn
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Martha A Belury
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Emily White
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - JoAnn E Manson
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
| | - Marian L Neuhouser
- From the Department of Internal Medicine, Division of Cancer Prevention and Control, College of Medicine (TMB), the Department of Human Sciences, College of Education and Human Ecology (TSO and MAB), and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, College of Medicine (DEC), The Ohio State University, Columbus, OH; the Women's Health Initiative Clinical Coordinating Center(RJR and JL) and the Cancer Prevention Program (EW and MLN), Fred Hutchinson Cancer Research Center, Seattle, WA; the Office of Epidemiology and Biostatistics, Allegheny County Health Department, Pittsburgh, PA (MLK); the Department of Epidemiology, Slone Epidemiology Center at Boston University, Boston University School of Public Health, Boston, MA (LAW); and the Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (JEM)
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14
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Yang TO, Crowe F, Cairns BJ, Reeves GK, Beral V. Tea and coffee and risk of endometrial cancer: cohort study and meta-analysis. Am J Clin Nutr 2015; 101:570-8. [PMID: 25733642 PMCID: PMC4340062 DOI: 10.3945/ajcn.113.081836] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 12/15/2014] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Previous reports, mostly from retrospective studies, suggested possible protective effects of both tea and coffee against endometrial cancer, but recent reports from prospective studies generally showed weaker or null associations. OBJECTIVES We investigated endometrial cancer risk in relation to tea and coffee consumption in a large prospective study and did a meta-analysis of published results. DESIGN Daily consumption of tea and coffee was recorded in 560,356 participants (without a hysterectomy) in the UK Million Women Study of whom 4067 women developed endometrial cancer during 5.2 million person-years of follow up (average: 9.3 y per woman). RESULTS With the use of Cox proportional hazards regression, we showed no significant association between endometrial cancer risk and consumption of either tea (multivariate adjusted RR per cup daily: 1.00; 95% CI: 0.98, 1.02) or coffee (RR per cup daily: 0.98; 95% CI: 0.96, 1.01). Our meta-analyses showed no significant association between endometrial cancer risk and tea consumption and a weak association for coffee consumption in prospective studies, but there may have been selective publication of only part of the evidence. CONCLUSIONS There is little or no association between tea consumption and endometrial cancer risk. If there is any association with coffee consumption, it appears to be weak.
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Affiliation(s)
- TienYu Owen Yang
- From the Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Francesca Crowe
- From the Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Benjamin J Cairns
- From the Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Gillian K Reeves
- From the Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Valerie Beral
- From the Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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15
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Weiderpass E, Sandin S, Lof M, Oh JK, Inoue M, Shimazu T, Tsugane S, Adami HO. Endometrial cancer in relation to coffee, tea, and caffeine consumption: a prospective cohort study among middle-aged women in Sweden. Nutr Cancer 2014; 66:1132-43. [PMID: 25181598 DOI: 10.1080/01635581.2014.948214] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This study aimed to add to prospective data on the possible inverse association between coffee consumption and endometrial cancer risk, already supported by several case-control studies. Coffee and tea consumption and possible confounding factors were assessed among 42,270 women aged 30-49 years at enrollment in 1991-1992 in the Swedish Women's Lifestyle and Health cohort study, with complete follow-up through 2009. We calculated caffeine intake per day; Cox proportional hazard models were used to estimate multivariable relative risks (mRR) for endometrial cancer with 95% confidence intervals (CIs). One hundred forty-four endometrial cancers were diagnosed during follow-up. Women with and without endometrial cancer had a similar mean daily coffee consumption (549 vs. 547 g), tea consumption (104 vs. 115 g), and caffeine intake (405 vs. 406 mg). Compared to those consuming <2 cups of coffee per day, women consuming >3 cups had a mRR of 1.56 (95% CI: 0.94-2.59; P for trend = 0.17). Compared with the lowest tertile of caffeine intake, the highest tertile had a mRR of 1.32 (95% CI: 0.87-1.99; P for trend = 0.27). Our study provides no convincing evidence of an association between coffee consumption, tea consumption, or caffeine intake and endometrial cancer risk among middle-aged women.
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Affiliation(s)
- Elisabete Weiderpass
- a Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm , Sweden
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16
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Je Y, De Vivo I, Giovannucci E. Long-term alcohol intake and risk of endometrial cancer in the Nurses' Health Study, 1980-2010. Br J Cancer 2014; 111:186-94. [PMID: 24853180 PMCID: PMC4090729 DOI: 10.1038/bjc.2014.257] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 04/24/2014] [Accepted: 04/24/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Previous epidemiologic studies have shown inconsistent results for the association between alcohol intake and endometrial cancer risk. Most of the studies, however, assessed alcohol intake after cancer diagnosis, or measured alcohol intake at baseline only. METHODS We prospectively examined the association between alcohol intake and endometrial cancer risk in the Nurses' Health Study with 68 067 female participants aged 34-59 years in 1980. Alcohol intake was measured several times with validated dietary questionnaires. We calculated cumulative average alcohol intake to represent long-term intakes of individual subjects. Using Cox proportional hazards models, we estimated incidence rate ratios (RRs) and 95% confidence intervals (CIs) for endometrial cancer risk after controlling for several risk factors simultaneously. RESULTS We identified a total of 794 invasive endometrial adenocarcinoma from 1980 to 2010. We found an inverse association among alcohol drinkers (multivariable RR=0.81; 95% CI: 0.68-0.96) compared with nondrinkers. Women with light alcohol intake of <5 g per day (∼half drink per day) had a 22% lower risk of endometrial cancer (multivariable RR=0.78; 95% CI: 0.66-0.94). Higher intake of alcohol, however, did not provide additional benefits against endometrial cancer: multivariable RRs for 5-14.9 g (∼1 drink), 15-29.9 g (∼2 drinks), or ≥ 30 g (≥ 2 drinks) versus 0 g per day were 0.88, 0.83, and 0.78 (95% CI: 0.49-1.25), respectively. The lower risk among drinkers (∼half drink per day) appeared to be stronger for obese women, but no significant interaction by body mass index was found. CONCLUSIONS This study provides prospective evidence for an inverse association between light alcohol intake (∼half drink per day) in the long term and endometrial cancer risk, but above that level no significant association was found.
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Affiliation(s)
- Y Je
- Department of Food and Nutrition, Kyung Hee University, 26 Kyunghee-daero, Dongdaemun-gu, Seoul 130-701, South Korea
| | - I De Vivo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - E Giovannucci
- 1] Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA [2] Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA
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17
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Brasky TM, Neuhouser ML, Cohn DE, White E. Associations of long-chain ω-3 fatty acids and fish intake with endometrial cancer risk in the VITamins And Lifestyle cohort. Am J Clin Nutr 2014; 99:599-608. [PMID: 24500149 PMCID: PMC3927693 DOI: 10.3945/ajcn.113.070524] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Inflammation plays an important role in endometrial cancer etiology. Long-chain ω-3 (n-3) polyunsaturated fatty acids (PUFAs), derived from marine sources, are thought to be antiinflammatory; however, several studies of fish consumption suggest an increase in risk. OBJECTIVE This study examined whether intakes of long-chain ω-3 PUFAs, including eicosapentaenoic acid (EPA; 20:5ω-3) and docosahexaenoic acid (DHA; 22:6ω-3), from diet and supplements and intake of fish are associated with endometrial cancer risk. DESIGN Between 2000 and 2002, 22,494 women aged 50-76 y, living in western Washington State, were recruited to the VITamins And Lifestyle cohort study. Incident endometrial cancers (n = 263) were identified through the Surveillance, Epidemiology, and End Results cancer registry after 9 y of follow-up. Multivariable-adjusted HRs and 95% CIs for the association of intakes of individual long-chain ω-3 PUFAs and fish with endometrial cancer risk were estimated by using Cox proportional hazards. RESULTS Women in the highest compared with the lowest quintile of dietary EPA + DHA intake had a 79% increased risk of endometrial cancer (95% CI: 16%, 175%; P-trend = 0.026). Results were similar for EPA and DHA measured individually and for fish intake. When data were stratified by body mass index (in kg/m²; <25 or ≥ 25), increases in risk of long-chain ω-3 PUFAs were restricted to overweight and obese women, and statistically significant reductions in risk were observed for normal-weight women. CONCLUSIONS The overall increased risk reported here confirms the findings of several prior observational studies of fish intake, which observed similar increases in risk. Randomized trials are needed to confirm these findings.
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Affiliation(s)
- Theodore M Brasky
- Department of Internal Medicine, Division of Cancer Prevention and Control (TMB) and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology (DEC), The Ohio State University College of Medicine, Columbus, OH, and the Fred Hutchinson Cancer Research Center, Cancer Prevention Program, Seattle, WA (MLN and EW)
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18
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Friedenreich CM, Speidel TP, Neilson HK, Langley AR, Courneya KS, Magliocco AM, Cook LS. Case-control study of lifetime alcohol consumption and endometrial cancer risk. Cancer Causes Control 2013; 24:1995-2003. [PMID: 23929278 PMCID: PMC3824213 DOI: 10.1007/s10552-013-0275-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 07/31/2013] [Indexed: 11/25/2022]
Abstract
Purpose Alcohol consumption is hypothesized to increase the risk of endometrial cancer by increasing circulating estrogen levels. This study sought to investigate the association between lifetime alcohol consumption and endometrial cancer risk. Methods We recruited 514 incident endometrial cancer cases and 962 frequency age-matched controls in this population-based case–control study in Alberta, Canada, from 2002 to 2006. Participants completed in-person interviews querying lifetime alcohol consumption and other relevant health and lifestyle factors. Participants reported the usual number of drinks of beer, wine, and liquor consumed; this information was compiled for each drinking pattern reported over the lifetime to estimate average lifetime exposure to alcohol. Results Lifetime average alcohol consumption was relatively low (median intake: 3.9 g/day for cases, 4.9 g/day for controls). Compared with lifetime abstainers, women consuming >2.68 and ≤8.04 g/day alcohol and >8.04 g/day alcohol on average over the lifetime showed 38 and 35 % lower risks of endometrial cancer, respectively (p trend = 0.023). In addition, average lifetime consumption of all types of alcohol was associated with decreased risks. There was no evidence for effect modification by body mass index, physical activity, menopausal status, and hormone replacement therapy use combined and effects did not differ by type of endometrial cancer (type I or II). Conclusion This study provides epidemiologic evidence for an inverse association between relatively modest lifetime average alcohol consumption (approximately 1/4 to 1/2 drink/day) and endometrial cancer risk. The direction of this relation is consistent with previous studies that examined similar levels of alcohol intake.
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Affiliation(s)
- Christine M Friedenreich
- Department of Population Health Research, Cancer Control Alberta, Alberta Health Services, Box ACB, 2210-2nd St SW, Calgary, AB, T2S 3C3, Canada,
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19
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Rossi M, Edefonti V, Parpinel M, Lagiou P, Franchi M, Ferraroni M, Decarli A, Zucchetto A, Serraino D, Dal Maso L, Negri E, La Vecchia C. Proanthocyanidins and other flavonoids in relation to endometrial cancer risk: a case-control study in Italy. Br J Cancer 2013; 109:1914-20. [PMID: 23922105 PMCID: PMC3790154 DOI: 10.1038/bjc.2013.447] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 07/10/2013] [Accepted: 07/12/2013] [Indexed: 11/09/2022] Open
Abstract
Background: Because of their antioxidant and antimutagenic properties, flavonoids may reduce cancer risk. Some flavonoids have antiestrogenic effects that can inhibit the growth and proliferation of endometrial cancer cells. Methods: In order to examine the relation between dietary flavonoids and endometrial cancer, we analysed data from an Italian case–control study including 454 incident, histologically confirmed endometrial cancers and 908 hospital-based controls. Information was collected through a validated food-frequency questionnaire. We applied data on food and beverage composition to estimate the intake of flavanols, flavanones, flavonols, anthocyanidins, flavones, isoflavones, and proanthocyanidins. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from multiple logistic regression models conditioned on age and study centre and adjusted for major confounding factors. Results: Women in the highest quartile category of proanthocyanidins with ⩾3 mers vs the first three quartile categories had an OR for endometrial cancer of 0.66 (95% CI=0.48–0.89). For no other class of flavonoids, a significant overall association was found. There was a suggestion of an inverse association for flavanones and isoflavones among women with body mass index <25 kg m−2, and, for flavanones, among parous or non-users of hormone-replacement therapy women. Conclusion: High consumption of selected proanthocyanidins may reduce endometrial cancer risk.
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Affiliation(s)
- M Rossi
- 1] Department of Epidemiology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, via G. La Masa, 19, 20156 Milan, Italy [2] Department of Clinical Sciences and Community Health, University of Milan, via G. Venezian 1, 20133 Milan, Italy
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20
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Arem H, Gunter MJ, Cross AJ, Hollenbeck AR, Sinha R. A prospective investigation of fish, meat and cooking-related carcinogens with endometrial cancer incidence. Br J Cancer 2013; 109:756-60. [PMID: 23695021 PMCID: PMC3738127 DOI: 10.1038/bjc.2013.252] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 04/24/2013] [Accepted: 04/27/2013] [Indexed: 12/11/2022] Open
Abstract
Background: There are limited prospective studies of fish and meat intakes with risk of endometrial cancer and findings are inconsistent. Methods: We studied associations between fish and meat intakes and endometrial cancer incidence in the large, prospective National Institutes of Health-AARP Diet and Health Study. Intakes of meat mutagens 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP), 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx), 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx) and benzo(a)pyrene (BaP) were also calculated. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: We observed no associations with endometrial cancer risk comparing the highest to lowest intake quintiles of red (HR=0.91, 95% CI 0.77–1.08), white (0.98, 0.83–1.17), processed meats (1.02, 0.86–1.21) and fish (1.10, 95% CI 0.93–1.29). We also found no associations between meat mutagen intakes and endometrial cancer. Conclusion: Our findings do not support an association between meat or fish intakes or meat mutagens and endometrial cancer.
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Affiliation(s)
- H Arem
- Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Rockville, MD 20852, USA.
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21
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Aarestrup J, Kyrø C, Christensen J, Kristensen M, Würtz AML, Johnsen NF, Overvad K, Tjønneland A, Olsen A. Whole grain, dietary fiber, and incidence of endometrial cancer in a Danish cohort study. Nutr Cancer 2013; 64:1160-8. [PMID: 23163844 DOI: 10.1080/01635581.2012.723786] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Whole grains and dietary fiber might be inversely associated with endometrial cancer risk through their effects on sex hormone metabolism and body fat. We investigated whether a higher intake of whole grains and dietary fiber was associated with a lower incidence of endometrial cancer in the Diet, Cancer and Health cohort of 29,875 women aged 50-64 years at enrollment in 1993-1997. Information on diet and lifestyle was derived from self-administered questionnaires. The incidence rate ratios and 95% confidence intervals were estimated based on a Cox proportional hazards model. Of the 24,418 women included as cohort members, 217 had a diagnosis of endometrial cancer. No clear associations were found between intake of whole grains or dietary fiber and the incidence of endometrial cancer.
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Arem H, Neuhouser ML, Irwin ML, Cartmel B, Lu L, Risch H, Mayne ST, Yu H. Omega-3 and omega-6 fatty acid intakes and endometrial cancer risk in a population-based case-control study. Eur J Nutr 2012; 52:1251-60. [PMID: 22915050 DOI: 10.1007/s00394-012-0436-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 08/06/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE Animal and laboratory studies suggest that long-chain omega-3 (n-3) fatty acids, a type of polyunsaturated fat found in fatty fish, may protect against carcinogenesis, but human studies on dietary intake of polyunsaturated fats and fish with endometrial cancer risk show mixed results. METHODS We evaluated the associations between endometrial cancer risk and intake of fatty acids and fish in a population-based sample of 556 incident cancer cases and 533 age-matched controls using multivariate unconditional logistic regression methods. RESULTS Although total n-3 fatty acid intake was not associated with endometrial cancer risk, higher intakes of eicosapentaenoic (EPA 20:5) and docosahexaenoic (DHA 22:6) fatty acids were significantly associated with lower risks (OR = 0.57, 95 % CI: 0.39-0.84; OR = 0.64, 95 % CI: 0.44-0.94; respectively) comparing extreme quartiles. The ratio of n-3:n-6 fatty acids was inversely associated with risk only on a continuous scale (OR = 0.84, 95 % CI: 0.71-0.99), while total fish intake was not associated with risk. Fish oil supplement use was significantly associated with reduced risk of endometrial cancer: OR = 0.63 (95 % CI: 0.45-0.88). CONCLUSIONS Our results suggest that dietary intake of the long-chain polyunsaturated fatty acids EPA and DHA in foods and supplements may have protective associations against the development of endometrial cancer.
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Affiliation(s)
- Hannah Arem
- Yale School of Public Health, 60 College Street, P.O. Box 208034, New Haven, CT 06520, USA.
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Gifkins D, Olson SH, Demissie K, Lu SE, Kong ANT, Bandera EV. Total and individual antioxidant intake and endometrial cancer risk: results from a population-based case-control study in New Jersey. Cancer Causes Control 2012; 23:887-95. [PMID: 22527166 DOI: 10.1007/s10552-012-9958-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 04/05/2012] [Indexed: 01/05/2023]
Abstract
We evaluated the role of total dietary antioxidant capacity and of individual antioxidants on endometrial cancer risk in a population-based case-control study in New Jersey, including 417 cases and 395 controls. Dietary intake was ascertained using a food-frequency questionnaire (FFQ), and total antioxidant capacity (TAC) intake was estimated using the USDA Oxygen Radical Absorbance Capacity (ORAC) database and the University of Oslo's Antioxidant Food Database (AFD) and FFQ-derived estimates of intake. Odds ratios and 95 % confidence intervals were derived using multivariate logistic regression controlling for major endometrial cancer risk factors. Using the ORAC database, after adjusting for major covariates, we found decreased risks for the highest tertile of total phenolic intake compared with the lowest (OR: 0.62; 95 % CI: 0.39-0.98). There was no association for TAC intake based on the AFD, which utilized the ferric-reducing ability of plasma (FRAP) assay to assess antioxidant capacity. There was no strong evidence for an association with intake of any of the individual antioxidants. Our findings suggest that total phenolic consumption may decrease endometrial cancer risk.
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Affiliation(s)
- Dina Gifkins
- The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, 195 Little Albany St., New Brunswick, NJ 08903, USA
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24
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Je Y, Giovannucci E. Coffee consumption and risk of endometrial cancer: Findings from a large up-to-date meta-analysis. Int J Cancer 2012; 131:1700-10. [DOI: 10.1002/ijc.27408] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Accepted: 12/09/2011] [Indexed: 12/21/2022]
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Je Y, Hankinson SE, Tworoger SS, De Vivo I, Giovannucci E. A prospective cohort study of coffee consumption and risk of endometrial cancer over a 26-year follow-up. Cancer Epidemiol Biomarkers Prev 2011; 20:2487-95. [PMID: 22109346 DOI: 10.1158/1055-9965.epi-11-0766] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Coffee has been reported to lower levels of estrogen and insulin, two hormones implicated in endometrial carcinogenesis, but prospective data on the relation between coffee consumption and risk of endometrial cancer are limited. METHODS We prospectively assessed coffee consumption in relation to endometrial cancer risk in the Nurses' Health Study (NHS) with 67,470 female participants aged 34 to 59 in 1980. Cumulative average coffee intake was calculated with all available questionnaires to assess long-term effects. Cox regression models were used to calculate incidence rate ratios (RR), controlling for other risk factors. RESULTS Fewer than 4 cups of coffee per day were not associated with endometrial cancer risk. However, women who consumed 4 or more cups of coffee had 25% lower risk of endometrial cancer than those who consumed less than 1 cup per day (multivariable RR = 0.75; 95% CI = 0.57-0.97; P(trend) = 0.02). We found the similar association with caffeinated coffee consumption (RR for ≥4 vs. <1 cup/d = 0.70; 95% CI = 0.51-0.95). For decaffeinated coffee consumption, a suggestive inverse association was found among women who consumed 2 or more cups per day versus <1 cup/mo. Tea consumption was not associated with endometrial cancer risk. CONCLUSIONS These prospective data suggest that four or more cups of coffee per day are associated with a lower risk of endometrial cancer. IMPACT Drinking of coffee, given its widespread consumption, might be an additional strategy to reduce endometrial cancer risk. However, addition of substantial sugar and cream to coffee could offset any potential benefits.
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Affiliation(s)
- Youjin Je
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
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26
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Ganmaa D, Cui X, Feskanich D, Hankinson SE, Willett WC. Milk, dairy intake and risk of endometrial cancer: a 26-year follow-up. Int J Cancer 2011; 130:2664-71. [PMID: 21717454 DOI: 10.1002/ijc.26265] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Accepted: 06/03/2011] [Indexed: 12/18/2022]
Abstract
Estrogens have a central role in the etiology of endometrial cancer. Milk and dairy products are a source of steroid hormones and growth factors that might have physiological effects in humans. We hypothesized that high intakes of milk and dairy products are associated with an increased risk of endometrial cancer, particularly among postmenopausal women not using hormone therapy. This was a prospective cohort study with 68,019 female participants in the Nurses' Health Study aged 34-59 in 1980. Milk and dairy consumption were assessed in 1980, 1984, 1986, 1990, 1994, 1998 and 2002 as servings per day and the follow-up continued through 2006. The multivariate relative risks (RRs) of adenocarcinoma of the endometrium across categories of cumulatively averaged total dairy consumption compared with < 1 svg/day were: 0.94 (95% CI = 0.71-1.25) for 1-1.4 svg/day, 1.14 (0.87-1.49) for 1.5-1.9 svg/day, 1.10 (0.84-1.44) for 2-2.9 svg/day, 1.26 (0.94-1.70) for ≥ 3 svg/day (p for trend = 0.06). The association between total dairy intake and endometrial cancer was significant only among the postmenopausal women (for ≥ 3 svg/day RR = 1.41, 95% CI = 1.01-1.98, p for trend = 0.02) and was evident only among those who were not currently using hormone therapy (RR = 1.58, 95% CI = 1.05-2.36, p for trend = 0.003). Total dairy intake was not significantly associated with risk of preinvasive endometrial cancer. In conclusion, we observed a marginally significant overall association between dairy intake and endometrial cancer and a stronger association among postmenopausal women who were not using estrogen-containing hormones.
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Affiliation(s)
- Davaasambuu Ganmaa
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
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27
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Risk of endometrial cancer in relation to individual nutrients from diet and supplements. Public Health Nutr 2011; 14:1948-60. [PMID: 21752313 DOI: 10.1017/s1368980011001066] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Intake of nutrients may influence the risk of endometrial cancer (EC). We aimed to estimate the association of intake of individual nutrients from food and from food plus supplements with EC occurrence. DESIGN A population-based case-control study conducted in Canada (2002-2006). SETTING Nutrient intakes from food and supplements were assessed using an FFQ. Logistic regression was used to estimate EC risk within quartile levels of nutrient intakes. SUBJECTS Incident EC cases (n 506) were identified from the Alberta Cancer Registry, and population controls were frequency- and age-matched to cases (n 981). RESULTS There existed little evidence of an association with EC for the majority of macronutrients and micronutrients examined. We observed a statistically significant increased risk associated with the highest, compared with the lowest, quartile of intake of dietary cholesterol (multivariable-adjusted OR = 1·51, 95 % CI 1·08, 2·11; P for trend = 0·02). Age-adjusted risk at the highest level of intake was significantly reduced for Ca from food sources (OR = 0·73, 95 % CI 0·54, 0·99) but was attenuated in the multivariable model (OR = 0·82, 95 % CI 0·59, 1·13). When intake from supplements was included in Ca intake, risk was significantly reduced by 28 % with higher Ca (multivariable-adjusted OR = 0·72, 95 % CI 0·51, 0·99, P for trend = 0·04). We also observed unexpected increased risks at limited levels of intakes of dietary soluble fibre, vitamin C, thiamin, vitamin B6 and lutein/zeaxanthin, with no evidence for linear trend. CONCLUSIONS The results of our study suggest a positive association between dietary cholesterol and EC risk and an inverse association with Ca intake from food sources and from food plus supplements.
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Biel RK, Friedenreich CM, Csizmadi I, Robson PJ, McLaren L, Faris P, Courneya KS, Magliocco AM, Cook LS. Case-control study of dietary patterns and endometrial cancer risk. Nutr Cancer 2011; 63:673-86. [PMID: 21614724 DOI: 10.1080/01635581.2011.563025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Dietary patterns, rather than intakes of specific foods or nutrients, may influence risk of endometrial cancer (EC). This population-based case-control study in Canada (2002-2006) included incident EC cases (n = 506) from the Alberta Cancer Registry and controls frequency age-matched to cases (n = 981). Past-year dietary patterns were defined using factor analysis of food frequency questionnaire data. Logistic regression was used to estimate EC risk within quartiles of dietary patterns. Three patterns (sweets, meat, plants) explained 23% of the variance in the dietary data. In multivariable models, EC risk was significantly reduced by 30% for women in the highest quartile of the healthier plants pattern (OR = 0.70, 95% CI 0.50-0.98, P trend = 0.02). When stratified by body mass index (BMI; kg/m(2)), risk was further reduced among overweight or obese women with a BMI ≥25 (OR = 0.57, 95% CI 0.39-0.83; P trend = 0.004). EC was not associated with the less healthy sweets and meat patterns. However, risk was modestly, but not significantly, elevated for higher intakes of the meat pattern among overweight or obese women. A mostly plant-based dietary pattern may reduce EC risk. Recommendations for risk reduction should focus on maintaining a healthy weight and the role of diet should be studied further.
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Affiliation(s)
- Rita K Biel
- Department of Population Health Research, Division of Cancer Care, Alberta Health Services, Calgary, Canada.
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Butler LM, Wu AH. Green and black tea in relation to gynecologic cancers. Mol Nutr Food Res 2011; 55:931-40. [PMID: 21595018 DOI: 10.1002/mnfr.201100058] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 03/31/2011] [Accepted: 04/06/2011] [Indexed: 12/13/2022]
Abstract
SCOPE Observational studies have evaluated the relationship between green tea intake and cancers of the ovary and endometrium, but we are not aware of the published studies on green tea intake and risk of human papillomavirus (HPV)-related cancers of the cervix, vagina, or vulva. METHODS AND RESULTS A critical review of the published literature on tea intake and risk of ovarian and endometrial cancers was conducted. In meta-analyses, we report inverse associations for green tea intake and risk of ovarian cancer (odds ratio [OR]=0.66; 95% confidence interval [CI]: 0.54, 0.80), and for green tea and risk of endometrial cancer (OR=0.78, 95% CI: 0.62, 0.98). There was no association for black tea and ovarian cancer risk (OR=0.94, 95% CI: 0.87, 1.02) and a positive association with endometrial cancer risk (OR=1.20, 95% CI: 1.05, 1.38). We summarized the experimental evidence supporting the antiviral and immunomodulatory activities of green tea catechins, and results from randomized clinical trials that demonstrated green tea catechin efficacy on treatment of cervical lesions and external genital warts. CONCLUSION Observational data support a protective role of green tea on risk of ovarian and endometrial cancers. Observational data are needed to evaluate whether green tea reduces risk of human papillomavirus-related cancers.
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Affiliation(s)
- Lesley M Butler
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1681, USA.
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Cui X, Rosner B, Willett WC, Hankinson SE. Dietary fat, fiber, and carbohydrate intake in relation to risk of endometrial cancer. Cancer Epidemiol Biomarkers Prev 2011; 20:978-89. [PMID: 21393567 DOI: 10.1158/1055-9965.epi-10-1089] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Macronutrients such as fat and fiber have been hypothesized to play a role in the etiology of endometrial cancer. METHODS To investigate these associations, the authors analyzed data from the Nurses' Health Study. From 1980 to 2006, 669 invasive adenocarcinoma cases were identified over 1.3 million person-years of follow-up. Dietary intake was assessed in 1980 and updated every 2-4 years. Cox proportional hazard models were used to calculate relative risks (RRs), controlling for total energy and other risk factors. RESULTS Overall, the authors found no significant associations between most dietary factors and endometrial cancer risk. Total fat was associated with a borderline significant decreased risk (top vs. bottom quintile RR = 0.78; 95% CI = 0.60-0.99; P(trend) = 0.18). Findings for animal fat were similar. No inverse associations between dietary fibers and cancer risk were observed. Cereal fiber was modestly positively associated with risk (top vs. bottom quintile RR = 1.38, 95% CI = 1.07-1.79; P(trend) = 0.05). The inverse association with animal fat intake and a positive association with carbohydrate intake were observed among premenopausal but not among postmenopausal women. CONCLUSIONS In this large prospective study, no overall association was observed between dietary fat, fiber, and carbohydrates with endometrial cancer risk, although several of the relationships may vary by menopausal status. IMPACT Dietary fat and fiber intake do not seem to play a major role in endometrial cancer etiology overall. However, further evaluation of these associations, particularly in premenopausal women, is needed.
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Affiliation(s)
- Xiaohui Cui
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
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31
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Cui X, Rosner B, Willett WC, Hankinson SE. Antioxidant intake and risk of endometrial cancer: results from the Nurses' Health Study. Int J Cancer 2011; 128:1169-78. [PMID: 20473915 DOI: 10.1002/ijc.25425] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To investigate the associations between antioxidant intake and risk of endometrial cancer, the authors analyzed data from the prospective Nurses' Health Study. From 1980 to 2006, 669 invasive adenocarcinoma cases were identified over 1.3 million person-years of follow-up. Information on dietary intake was collected in 1980 and updated every 2-4 years. Cox proportional hazard models were used to calculate the multivariate relative risks (RR), controlling for total energy and potential risk factors for endometrial cancer. Overall, the authors found no association between intakes of vitamins A, C, E or carotenoids from foods or supplements and cancer risk. The RR and 95% confidence intervals (CI) for the highest vs. lowest quintiles of vitamins A, C, E and total carotenoids were 1.09 (95% CI: 0.85-1.39), 0.98 (95% CI: 0.76-1.25), 1.07 (95% CI: 0.83-1.38) and 1.12 (95% CI: 0.86-1.45), respectively. Similarly, the use of multivitamins or specific vitamins A, C or E supplements was unassociated with risk. In subgroup analyses, several associations seemed to vary by postmenopausal hormone use. Our results suggest that there is no overall association between dietary antioxidant intake or use of antioxidant supplements with risk of endometrial cancer.
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Affiliation(s)
- Xiaohui Cui
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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Chandran U, Bandera EV, Williams-King MG, Sima C, Bayuga S, Pulick K, Wilcox H, Zauber AG, Olson SH. Adherence to the dietary guidelines for Americans and endometrial cancer risk. Cancer Causes Control 2010; 21:1895-904. [PMID: 20652737 PMCID: PMC3065196 DOI: 10.1007/s10552-010-9617-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 07/09/2010] [Indexed: 11/26/2022]
Abstract
The Healthy Eating Index (HEI) was developed by the US Department of Agriculture with the goal of quantifying adherence to the Dietary Guidelines for Americans. The purpose of this study was to evaluate the impact of the HEI-2005 score and each of its components on endometrial cancer risk in a population-based case-control study in New Jersey. A total of 424 cases and 398 controls completed a Food Frequency Questionnaire, which was used to derive the HEI-2005 score. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression while adjusting for potential covariates, which included all major endometrial cancer risk factors. The adjusted OR for women in the highest quartile when compared to the lowest quartile was 0.83 (95% CI: 0.52-1.34). For the meat and beans component comprising meat, eggs, poultry, fish, and beans, the OR was 0.70 (95% CI: 0.45-1.11; p for trend: 0.07), with little evidence of an association with any of the individual foods. There was no indication of an association for any of the other components of the HEI or of effect modification by body mass index. This study suggested limited value for the HEI-2005 in predicting endometrial cancer risk.
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Affiliation(s)
- Urmila Chandran
- The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, 195 Little Albany St., New Brunswick, NJ 08903, USA
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Yang HP, Gierach GL, Danforth KN, Sherman ME, Park Y, Wentzensen N, Hollenbeck A, Schatzkin A, Brinton LA. Alcohol and endometrial cancer risk in the NIH-AARP diet and health study. Int J Cancer 2010; 128:2953-61. [PMID: 20725997 DOI: 10.1002/ijc.25623] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 08/05/2010] [Indexed: 11/06/2022]
Abstract
Previous investigations have provided conflicting results regarding whether alcohol consumption affects endometrial cancer risk, although in many of these studies the highest category of alcohol intake examined was limited. Further, most were unable to resolve how alcohol associations are affected by beverage type, the presence of other endometrial cancer risk factors, or tumor characteristics. To address these issues, we prospectively evaluated the association between alcohol intake and incident endometrial cancer (n = 1,491) in a cohort of 114,414 US women enrolled in the NIH-AARP Diet and Health Study. We calculated relative risks (RR) and 95% confidence intervals (CI) using Cox proportional hazards regression. After adjustment for age, body mass index (BMI), smoking and other potential confounders, the multivariable RRs (and 95% CIs) compared with nondrinkers were 0.97 (0.87-1.09) for >0-<12 g of alcohol/day, 1.06 (0.87-1.31) for 12-<24 g/day and 0.93 (0.71-1.20) for ≥ 24 g/day (p trend = 0.90). There was, however, some suggestion of higher risks associated with alcohol consumption among lean women (BMI, <25) and users of menopausal hormone therapy, with significant interactions with both parameters (respective interaction p-values of 0.002 and 0.005). The relationship was also enhanced, albeit nonsignificantly so, for low grade cancers. Our results do not support that alcohol is a strong contributor to endometrial cancer risk, but slight risk increases may prevail among some users or for selected tumor characteristics.
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Affiliation(s)
- Hannah P Yang
- Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20852, USA.
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Kabat GC, Park Y, Hollenbeck AR, Schatzkin A, Rohan TE. Intake of fruits and vegetables, and risk of endometrial cancer in the NIH-AARP Diet and Health Study. Cancer Epidemiol 2010; 34:568-73. [PMID: 20619761 PMCID: PMC3495318 DOI: 10.1016/j.canep.2010.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 06/10/2010] [Accepted: 06/13/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Fruits and vegetables contain a wide variety of phytochemicals which may have anti-carcinogenic effects. Although the results of case-control studies have suggested a possible protective effect of fruit and vegetable intake on the risk of endometrial carcinoma, few cohort studies have examined this association. MATERIALS AND METHODS We used data from the NIH-AARP Diet and Health Study to assess the association of fruit and vegetable consumption, as well as intake of specific botanical groupings of fruits and vegetables, with endometrial cancer risk among 112,088 women who completed a food-frequency questionnaire at baseline, in 1995-1996. During 8 years of follow-up 1142 incident cases of endometrial cancer were ascertained. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). RESULTS After adjustment for covariates, HRs for the highest compared to the lowest quintile of total fruit and total vegetable intake were 1.30 (95% CI 1.04-1.61, P for trend 0.05) and 1.09 (95% CI 0.90-1.33, P for trend 0.55), respectively. No inverse associations were observed for intake of any of 13 botanical groupings of fruits and vegetables. CONCLUSIONS Results from this large prospective study do not support a protective role of a high intake of fruits or vegetables on the risk of endometrial cancer in older women.
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Affiliation(s)
- Geoffrey C Kabat
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
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Bandera EV, Williams-King MG, Sima C, Bayuga-Miller S, Pulick K, Wilcox H, Zauber AG, Olson SH. Coffee and tea consumption and endometrial cancer risk in a population-based study in New Jersey. Cancer Causes Control 2010; 21:1467-73. [PMID: 20467800 DOI: 10.1007/s10552-010-9575-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Accepted: 04/29/2010] [Indexed: 11/28/2022]
Abstract
We evaluated the role of tea and coffee and substances added (sugar/honey, creamers, and milk) on endometrial cancer risk in a population-based case-control study in six counties in New Jersey, including 417 cases and 395 controls. Multivariate odds ratios (OR) and 95% confidence intervals (CI) were computed using unconditional logistic regression. There was a moderate inverse association with coffee consumption, with an adjusted OR of 0.65 (95% CI: 0.36-1.17) for women who reported more than two cups/day of coffee compared to none. Tea consumption appeared to increase risk (OR: 1.93; 95% CI: 1.08-3.45), but after including the variables sugar/honey and cream/milk added to tea in the model, the risk estimate was attenuated and no longer statistically significant (OR: 1.77; 95% CI: 0.96-3.28 for those consuming more than one cup/day of tea compared to nonusers). There was a suggestion of a decreased risk associated with green tea, but the confidence interval included one (adjusted OR for one or more cups/week vs. none: 0.75; 95% CI: 0.48-1.18). We found an association with adding sugar/honey to tea, with those adding two or more teaspoons/cup having an OR of 2.66 (95% CI: 1.42-4.98; p for trend <0.01) after adjusting for relevant confounders. For sugar/honey added to coffee the corresponding OR was 1.43 (95% CI: 0.81-2.55). Our results indicate that sugars and milk/cream added to coffee and tea should be considered in future studies evaluating coffee and tea and endometrial cancer risk.
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Affiliation(s)
- Elisa V Bandera
- The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ 08903, USA.
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Alcohol and endometrial cancer risk: a case-control study and a meta-analysis. Cancer Causes Control 2010; 21:1285-96. [PMID: 20396942 DOI: 10.1007/s10552-010-9556-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 03/24/2010] [Indexed: 10/19/2022]
Abstract
To evaluate the association between alcohol consumption and endometrial cancer risk, we analyzed data from a hospital-based case-control study, conducted in Italy between 1992 and 2006, on 454 endometrial cancer cases and 908 controls, and performed a meta-analysis updated to October 2009. Compared to never alcohol drinkers, the odds ratio was 1.03 (95% confidence interval, CI, 0.76-1.41) for < or = 7, 1.27 (95% CI 0.86-1.87) for 8-14, and 1.19 (95% CI 0.80-1.77) for > or = 15 drinks/week, with no trend in risk. No association emerged for wine, beer, and spirit consumption analyzed separately. The meta-analysis included 20 case-control and seven cohort studies, for a total of 13,120 cases. Compared to non/low drinkers, the pooled relative risks for drinkers were 0.90 (95% CI 0.80-1.01) for case-control studies, 1.01 (95% CI 0.90-1.14) for cohort studies, and 0.95 (95% CI 0.88-1.03) overall, with no heterogeneity between study design (p = 0.156). The overall estimate for heavy versus non/low drinkers was 1.12 (95% CI 0.87-1.45). The results were consistent according to selected study characteristics, including geographic area, definition of alcohol drinkers, and type of controls in case-control studies. Our findings provide evidence that alcohol drinking is not associated with endometrial cancer risk, although a weak positive association for very high drinkers cannot be excluded.
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Kallianpur AR, Lee SA, Xu WH, Zheng W, Gao YT, Cai H, Ruan ZX, Xiang YB, Shu XO. Dietary iron intake and risk of endometrial cancer: a population-based case-control study in Shanghai, China. Nutr Cancer 2010; 62:40-50. [PMID: 20043258 DOI: 10.1080/01635580903191544] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Dietary red meat and animal fat have been linked to endometrial cancer (EC) risk, but the impact of bioavailable iron in animal-derived foods has been less well studied. Our objective was to investigate the effects of iron and fats on the risk of EC in a large, population-based, case-control study. The Shanghai Endometrial Cancer Study enrolled 1,204 EC cases and 1,212 controls who completed in-person interviews, including a food frequency questionnaire. Animal-derived iron and fat intakes were calculated from dietary intakes and food composition tables. Logistic regression models were used to evaluate independent and joint effects of iron and fat on EC risk. Animal-derived iron intake was positively associated with EC risk [adjusted OR = 1.9; 95% CI = 1.4-2.7, P(trend) < 0.01, highest vs. lowest quartile], predominantly after menopause (OR = 2.2; 95%CI = 1.4-3.4, P(trend) < 0.01) and in women with BMI >or= 25 kg/m(2)(OR = 3.2; 95% CI = 1.4-7.5 in postmenopausal obese women, P(trend) < 0.01). Animal-derived fat was also associated with postmenopausal EC risk (OR = 1.7; 95% CI = 1.2-2.5, P(trend) < 0.01). Multiplicative interactions between animal-derived iron and BMI or animal-derived fat intake were not observed. Animal-derived iron intake is associated with increased risk of EC after menopause and among obese women. Avoidance of animal-derived (heme) iron may reduce the risk of EC in these women.
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Affiliation(s)
- Asha R Kallianpur
- Institute for Medicine and Public Health, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee 37203-1738, USA.
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Bravi F, Scotti L, Bosetti C, Zucchetto A, Talamini R, Montella M, Greggi S, Pelucchi C, Negri E, Franceschi S, La Vecchia C. Food groups and endometrial cancer risk: a case-control study from Italy. Am J Obstet Gynecol 2009; 200:293.e1-7. [PMID: 19091304 DOI: 10.1016/j.ajog.2008.09.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Revised: 07/22/2008] [Accepted: 09/11/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Although several studies have been conducted on the relation between dietary habits and endometrial cancer risk, the evidence for specific food groups is still controversial. STUDY DESIGN We analyzed data from an Italian case-control study including 454 women with histologically confirmed endometrial cancer and 908 controls admitted to the same hospitals for acute, nonneoplastic conditions. Multivariate odds ratios (ORs) were obtained after allowance for major potential confounding factors. RESULTS A significant increase in risk was observed for red meat, with an OR of 2.07 for an increment of 1 serving per day. Inverse associations were observed for coffee (OR, 0.83), cereals (OR, 0.92), and vegetables (OR, 0.83). CONCLUSION Our results support the existence of a relation between dietary habits and endometrial cancer risk and in particular suggest that a diet rich in red meat and poor in vegetables may have an unfavorable effect.
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Bravi F, Scotti L, Bosetti C, Gallus S, Negri E, La Vecchia C, Tavani A. Coffee drinking and endometrial cancer risk: a metaanalysis of observational studies. Am J Obstet Gynecol 2009; 200:130-5. [PMID: 19110217 DOI: 10.1016/j.ajog.2008.10.032] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Revised: 09/23/2008] [Accepted: 10/07/2008] [Indexed: 11/30/2022]
Abstract
We conducted a metaanalysis of published studies on the relation between coffee drinking and endometrial cancer risk, which included 2 cohort (201 cases) and 7 case-control studies (2409 cases). The summary relative risk (RR) for coffee drinkers vs nondrinkers was 0.80 (95% confidence interval [CI], 0.68-0.94), with significant heterogeneity between studies. Compared with nondrinkers, the summary RR was 0.87 (95% CI, 0.78-0.97) for low-to-moderate coffee drinkers and 0.64 (95% CI, 0.48-0.86) for heavy coffee drinkers. The summary RR for an increase of 1 cup/d was 0.93 (95% CI, 0.89-0.97), which suggests an inverse relation between coffee and endometrial cancer. However, the causality must be confirmed.
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Affiliation(s)
- Francesca Bravi
- Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
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Yeh M, Moysich KB, Jayaprakash V, Rodabaugh KJ, Graham S, Brasure JR, McCann SE. Higher intakes of vegetables and vegetable-related nutrients are associated with lower endometrial cancer risks. J Nutr 2009; 139:317-22. [PMID: 19074206 DOI: 10.3945/jn.108.099960] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A limited number of studies have investigated diet in association with endometrial cancer (EC). We examined the association between intakes of selected food groups and nutrients with EC risk among 541 women with histologically confirmed EC and 541 women with an intact uterus and noncancer diagnoses seen at Roswell Park Cancer Institute between 1982 and 1998. Self-reported dietary and other epidemiologic data were collected by questionnaire. Unconditional logistic regression was used to estimate odds ratios (OR) and 95% CI, adjusting for age, BMI, hormone replacement therapy use, cigarette smoking, lifetime duration of menstruation, and total energy intake. We observed significant inverse associations for women in the highest vs. lowest quartiles of intake of total vegetables (OR, 0.51; 95% CI, 0.34-0.75), vitamin E (OR, 0.44; 95% CI, 0.27-0.70), dietary fiber (OR, 0.60; 95% CI, 0.39-0.94), beta-carotene (OR, 0.55; 95% CI, 0.37-0.82), lutein (OR, 0.52; 95% CI, 0.34-0.78), and folate (OR, 0.57; 95% CI, 0.36-0.91). Our results support that vegetables and related nutrients are associated with decreased risk of EC.
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Affiliation(s)
- Michael Yeh
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
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Bandera EV, Gifkins DM, Moore DF, McCullough ML, Kushi LH. Antioxidant vitamins and the risk of endometrial cancer: a dose-response meta-analysis. Cancer Causes Control 2008; 20:699-711. [PMID: 19083131 DOI: 10.1007/s10552-008-9283-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Accepted: 11/26/2008] [Indexed: 02/04/2023]
Abstract
Antioxidant vitamins may reduce cancer risk by limiting oxidative DNA damage. To summarize and quantify the current epidemiologic evidence of an association between antioxidant vitamin intake and endometrial cancer, we conducted a systematic literature review and meta-analysis. One cohort and 12 case-control studies presenting relevant risk estimates were identified by conducting bibliographical searches through June 2008. Dose-response meta-analyses were conducted for beta-carotene, vitamin C, and vitamin E from food sources. Intake from supplements was not considered in the meta-analyses because of the few studies that reported relevant information. Based on case-control data, the random-effects summary odds ratios (OR) were, for beta-carotene: 0.88 (95% CI: 0.79-0.98) per 1,000 mcg/1,000 kcal (I2: 77.7%; p < 0.01); for vitamin C: 0.85 (95% CI: 0.73-0.98) per 50 mg/1,000 kcal (I2: 66.1%; p < 0.01); and, for vitamin E: 0.91 (95% CI: 0.84-0.99) per 5 mg/1,000 kcal (I2: 0.0%; p: 0.45). In contrast, the only prospective study identified provided little indication of an association. Although the current case-control data suggest an inverse relationship of endometrial cancer risk with dietary intakes of beta-carotene, vitamin C, and vitamin E from food sources, additional studies are needed, particularly cohort studies, to confirm an association.
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Affiliation(s)
- Elisa V Bandera
- The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, 195 Little Albany St, New Brunswick, NJ 08903, USA.
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Shimazu T, Inoue M, Sasazuki S, Iwasaki M, Kurahashi N, Yamaji T, Tsugane S. Coffee consumption and risk of endometrial cancer: A prospective study in Japan. Int J Cancer 2008; 123:2406-10. [DOI: 10.1002/ijc.23760] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Case–control study of coffee consumption and the risk of endometrial endometrioid adenocarcinoma. Eur J Cancer Prev 2008; 17:358-63. [DOI: 10.1097/cej.0b013e3282f0c02c] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Although folic acid has been investigated for its potential to inhibit carcinogenesis, few epidemiologic studies have assessed the effects of intake of thiamin, riboflavin, and niacin, which may reduce cancer risk by acting as cofactors in folate metabolism or by other mechanisms. Using data from a large cohort of Canadian women, we examined the association of dietary intake of these nutrients, as well as intake of folate, methionine, and alcohol, with cancers of the breast, endometrium, ovary, colorectum, and lung ascertained during an average of 16.4 years of follow-up. After exclusions, the following numbers of incident cases were available for analysis: breast, n=2491; endometrium, n=426; ovary, n=264; colorectum, n=617; and lung, n=358. Cox proportional hazard models were used to estimate risk of each cancer with individual nutrients and to explore possible effect modification by combinations of nutrients on cancer risk. Few significant associations of intake of individual B vitamins with the five cancers were observed. Alcohol consumption showed a modest positive association with breast cancer risk but not with risk of the other cancers. There was no evidence of effect modification among the nutrients. This large study provides little support for an association of dietary intake thiamin, riboflavin, niacin, folate, or methionine with five major cancers in women.
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Dietary intake of carotenoids and retinol and endometrial cancer risk in an Italian case–control study. Cancer Causes Control 2008; 19:1209-15. [DOI: 10.1007/s10552-008-9190-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2007] [Accepted: 06/09/2008] [Indexed: 11/26/2022]
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Zhou B, Yang L, Sun Q, Cong R, Gu H, Tang N, Zhu H, Wang B. Cigarette smoking and the risk of endometrial cancer: a meta-analysis. Am J Med 2008; 121:501-508.e3. [PMID: 18501231 DOI: 10.1016/j.amjmed.2008.01.044] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2007] [Revised: 01/14/2008] [Accepted: 01/15/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Epidemiologic findings are inconsistent concerning the association of endometrial cancer risk with cigarette smoking. We conducted a meta-analysis of epidemiologic studies to examine this relation. METHODS A systematic literature search up to June of 2007 was performed in MEDLINE and EMBASE. Study-specific risk estimates were pooled using a random-effects model. RESULTS Ten prospective and 24 case-control studies were included in the analysis of the effect of ever smoking. Ever smoking was statistically significantly associated with a reduced risk of endometrial cancer among prospective studies (relative risk 0.81; 95% confidence interval [CI], 0.74-0.88) and case-control studies (odds ratio 0.72; 95% CI, 0.66-0.79). The inverse association was significant among current and former smokers. Six prospective and 6 case-control studies were included in the quantitative analysis. We noted that an increase in smoking of 20 cigarettes per day was statistically significantly associated with 16% and 27% reduced risks of endometrial cancer in prospective and case-control studies, respectively. We also found that cigarette smoking was significantly associated with a decreased risk of endometrial cancer among postmenopausal women (relative risk 0.71; 95% CI, 0.65-0.78) but not among premenopausal women. In addition, the risk reduction seemed to be stronger among hormone replacement therapy users than nonusers. CONCLUSION Cigarette smoking was found to be significantly associated with a reduced risk of endometrial cancer, especially among postmenopausal women.
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Affiliation(s)
- Bo Zhou
- Key Laboratory of Reproductive Medicine, Department of Pharmacology, Nanjing Medical University, Nanjing, Jiangsu Province, China
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Bandera EV, Kushi LH, Moore DF, Gifkins DM, McCullough ML. Association between dietary fiber and endometrial cancer: a dose-response meta-analysis. Am J Clin Nutr 2007; 86:1730-7. [PMID: 18065593 PMCID: PMC2214669 DOI: 10.1093/ajcn/86.5.1730] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Endometrial cancer is the most common female gynecologic cancer in the United States. Excessive and prolonged exposure of the endometrium to estrogens unopposed by progesterone and a high body mass are well-established risk factors for endometrial cancer. Although dietary fiber has been shown to beneficially reduce estrogen concentrations and prevent obesity, its role in endometrial cancer has received relatively little attention. OBJECTIVE The objective was to summarize and quantify the current evidence of a role of dietary fiber consumption in endometrial cancer risk and to identify research gaps in this field. DESIGN We conducted a systematic literature review of articles published through February 2007 to summarize the current evidence of a relation between dietary fiber consumption and endometrial cancer risk and to quantify the magnitude of the association by conducting a dose-response meta-analysis. RESULTS Ten articles representing 1 case-cohort study and 9 case-control studies that evaluated several aspects of fiber consumption and endometrial cancer risk were identified through searches in various databases. On the basis of 7 case-control studies, the random-effects summary risk estimate was 0.82 (95% CI: 0.75, 0.90) per 5 g/1000 kcal dietary fiber, with no evidence of heterogeneity (I(2): 0%, P for heterogeneity: 0.55). The random-effects summary estimate was 0.71 (95% CI: 0.59, 0.85) for the comparison of the highest with the lowest dietary fiber intake in 8 case-control studies, with little evidence of heterogeneity (I(2): 20.8%, P for heterogeneity: 0.26). In contrast, the only prospective study that evaluated this association did not find an association. CONCLUSIONS Although the current evidence, based on data from case-control studies, supports an inverse association between dietary fiber and endometrial cancer, additional population-based studies, particularly cohort studies, are needed before definitive conclusions can be drawn.
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Affiliation(s)
- Elisa V Bandera
- The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ 08903, USA.
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Cust AE, Slimani N, Kaaks R, van Bakel M, Biessy C, Ferrari P, Laville M, Tjønneland A, Olsen A, Overvad K, Lajous M, Clavel-Chapelon F, Boutron-Ruault MC, Linseisen J, Rohrmann S, Nöthlings U, Boeing H, Palli D, Sieri S, Panico S, Tumino R, Sacerdote C, Skeie G, Engeset D, Gram IT, Quirós JR, Jakszyn P, Sánchez MJ, Larrañaga N, Navarro C, Ardanaz E, Wirfält E, Berglund G, Lundin E, Hallmans G, Bueno-de-Mesquita HB, Du H, Peeters PHM, Bingham S, Khaw KT, Allen NE, Key TJ, Jenab M, Riboli E. Dietary carbohydrates, glycemic index, glycemic load, and endometrial cancer risk within the European Prospective Investigation into Cancer and Nutrition cohort. Am J Epidemiol 2007; 166:912-23. [PMID: 17670911 DOI: 10.1093/aje/kwm161] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The associations of dietary total carbohydrates, overall glycemic index, total dietary glycemic load, total sugars, total starch, and total fiber with endometrial cancer risk were analyzed among 288,428 women in the European Prospective Investigation into Cancer and Nutrition cohort (1992-2004), including 710 incident cases diagnosed during a mean 6.4 years of follow-up. Cox proportional hazards models were used to estimate relative risks and 95% confidence intervals. There were no statistically significant associations with endometrial cancer risk for increasing quartile intakes of any of the exposure variables. However, in continuous models calibrated by using 24-hour recall values, the multivariable relative risks were 1.61 (95% confidence interval: 1.06, 2.45) per 100 g/day of total carbohydrates, 1.40 (95% confidence interval: 0.99, 1.99) per 50 units/day of total dietary glycemic load, and 1.36 (95% confidence interval: 1.05, 1.76) per 50 g/day of total sugars. These associations were stronger among women who had never used postmenopausal hormone therapy compared with ever users (total carbohydrates p(heterogeneity) = 0.04). Data suggest no association of overall glycemic index, total starch, and total fiber with risk, and a possible modest positive association of total carbohydrates, total dietary glycemic load, and total sugars with risk, particularly among never users of hormone replacement therapy.
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Affiliation(s)
- Anne E Cust
- Nutrition and Hormones Unit, International Agency for Research on Cancer, Lyon, France.
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