Diet in the epidemiology of endometrial cancer in Western New York (United States)

State University of New York at Buffalo
Cancer Causes and Control (Impact Factor: 2.96). 11/2000; 11(10):965-974. DOI: 10.1023/A:1026551309873

ABSTRACT Objectives: We examined diet and risk of endometrial cancer among women in the Western New York Diet Study (1986–1991).
Methods: Self-reported frequency of use of 172 foods and beverages during the 2 years before the interview and other relevant data were collected by detailed interviews from 232 endometrial cancer cases and 639 controls, frequency-matched for age and county of residence. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by unconditional logistic regression, adjusting for age, education, body mass index (BMI), smoking history, hypertension, diabetes, age at menarche, parity, oral contraceptive use, menopausal status, menopausal estrogen use, and energy.
Results: Risks were reduced for women in the highest quartiles of intake of protein (OR 0.4, 95% CI: 0.2–0.9), dietary fiber (OR 0.5, 95% CI: 0.3–1.0), phytosterols (OR 0.6, 95% CI: 0.3–1.0), vitamin C (OR 0.5, 95% CI: 0.3–0.8) folate (OR 0.4, 95% CI: 0.2–0.7), alpha-carotene (OR 0.6, 95% CI: 0.4–1.0), beta-carotene (OR 0.4, 95% CI: 0.2–0.6), lycopene (OR 0.6, 95% CI: 0.4–1.0), lutein + zeaxanthin (OR 0.3, 95% CI: 0.2–0.5) and vegetables (OR 0.5, 95% CI: 0.3–0.9), but unrelated to energy (OR 0.9, 95% CI: 0.6–1.5) or fat (OR 1.6, 95% CI: 0.7–3.4).
Conclusions: Our results support previous findings of reduced endometrial cancer risks associated with a diet high in plant foods.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Intrauterine devices (IUDs), long-acting and reversible contraceptives, induce a number of immunological and biochemical changes in the uterine environment that could affect endometrial cancer (EC) risk. We addressed this relationship through a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We combined individual-level data from 4 cohort and 14 case-control studies, in total 8,801 EC cases and 15,357 controls. Using multivariable logistic regression, we estimated pooled odds ratios (pooled-ORs) and 95% confidence intervals (CIs) for EC risk associated with ever use, type of device, ages at first and last use, duration of use, and time since last use, stratified by study and adjusted for confounders. Ever use of IUDs was inversely related to EC risk (pooled-OR=0.81, 95% CI=0.74-0.90). Compared with never use, reduced risk of EC was observed for inert IUDs (pooled-OR=0.69, 95% CI=0.58-0.82), older age at first use (≥35 years pooled-OR=0.53, 95% CI=0.43-0.67), older age at last use (≥45 years pooled-OR=0.60, 95% CI=0.50-0.72), longer duration of use (≥10 years pooled-OR=0.61, 95% CI=0.52-0.71), and recent use (within 1 year of study entry pooled-OR=0.39, 95% CI=0.30-0.49). Future studies are needed to assess the respective roles of detection biases and biologic effects related to foreign body responses in the endometrium, heavier bleeding (and increased clearance of carcinogenic cells), and localized hormonal changes. © 2014 Wiley Periodicals, Inc.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although preclinical and epidemiological studies have shown the importance of n-3 polyunsaturated fatty acids (PUFAs) in the prevention of hormone-responsive cancers such as breast cancer, evidence of the association between n-3 PUFAs and endometrial cancer risk is limited and no previous study has examined the effect of n-3 PUFAs on endometrial cancer in cellular and animal models. In this study, we demonstrated that docosahexenoic acid (DHA) dose-and time-dependently inhibited endometrial cancer cell proliferation, colony formation and migration, and promoted apoptosis. Dietary n-3 PUFAs efficiently prevented endometrial cancer cell growth in xenograft models. Moreover, ectopic expression of fat-1, a desaturase, catalyzed the conversion of n-6 to n-3 PUFAs and produced n-3 PUFAs endogenously, also suppressed endometrial tumor cell growth and migration, and potentiated apoptosis in endometrial cancer cell lines. Interestingly, implanted endometrial cancer cells were unable to grow in fat-1 transgenic SCID (severe combined immune deficiency) mice. Further study revealed that mammalian target of rapamycin (mTOR) signaling, which plays an essential role in cell proliferation and endometrial tumorigenesis, is a target of n-3 PUFAs. Exogenous or endogenous n-3 PUFAs efficiently suppressed both mTOR complex 1 (mTORC1) and mTORC2 in vitro and in vivo. Moreover, both dietary n-3 PUFAs and transgenic expression of fat-1 in mice effectively repressed mTORC1/2 signaling and endometrial growth elicited by unopposed oestrogen. Taken together, our findings provide comprehensive preclinical evidences that n-3 PUFAs efficiently prevent endometrial cancer and establish mTORC1/2 as a target of n-3 PUFAs.
    Cancer Prevention Research 05/2014; 7(8). DOI:10.1158/1940-6207.CAPR-13-0378-T · 5.27 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Uterine leiomyomata (UL) are the primary indication for hysterectomy and are 2-3 times more common in black than white women. High dietary fat intake has been associated with increased endogenous concentrations of estradiol, a sex steroid hormone that is known to influence UL risk. We assessed the relation of dietary fat intake (total, subtypes, and selected food sources) with UL incidence. Data were from the Black Women's Health Study, a prospective cohort study. Over an 8-y period (2001-2009), 12,044 premenopausal women were followed for a first diagnosis of UL. Diet was assessed via a food-frequency questionnaire in 2001. Cox regression models were used to compute incidence rate ratios (IRRs) and 95% CIs with adjustment for potential confounders. During 75,687 person-years of follow-up, there were 2695 incident UL cases diagnosed by ultrasound (n = 2191) or surgery (n = 504). Intakes of total fat and fat subtypes were not appreciably associated with UL risk overall, although statistically significant associations were observed for specific saturated (inverse) and monounsaturated and polyunsaturated (positive) fatty acids. With respect to polyunsaturated fats, the IRR for the highest compared with lowest quintiles of marine fatty acid intake [the sum of omega-3 (n-3) polyunsaturated fatty acids eicosapentanoic acid, docosapentaenoic acid, and docosahexaenoic acid] was 1.18 (95% CI: 1.05, 1.34; P-trend = 0.005). The IRR for the highest compared with lowest categories of dark-meat fish consumption was 1.13 (95% CI: 1.00, 1.28). In US black women, the most consistent associations of fat intake with UL were small increases in risk associated with intakes of long-chain omega-3 fatty acids. Future studies are warranted to confirm these findings and elucidate which components of fatty foods, if any, are related to UL risk.
    American Journal of Clinical Nutrition 03/2014; 99(5). DOI:10.3945/ajcn.113.073635 · 6.92 Impact Factor