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Dietary patterns, Mediterranean diet, and endometrial cancer risk

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Abstract

This study examines the association between dietary patterns and endometrial cancer risk. A case–control study of endometrial cancer was conducted from 1996 to 1999 in the San Francisco Bay Area in white, African-American, and Latina women age 35–79. Dietary patterns were defined using a principal components analysis; scoring dietary intake based on correspondence to a Mediterranean-style diet; and by jointly categorizing intake of fruits/vegetables and dietary fat. Four dietary patterns were identified and labeled “plant-based,” “western,” “ethnic,” and “phytoestrogen-rich.” None of these dietary patterns nor adherence to a Mediterranean diet (to the extent consumed by this population) was associated with endometrial cancer risk. However, among non-users of supplements, greater consumption of the “western” dietary pattern was associated with a 60% increase in risk (95% CI: 0.95–2.7 per unit change; P-interaction = 0.10). A diet characterized by high fat consumption increased risk, regardless of fruit and vegetable consumption (OR = 1.4, 95% CI: 0.97–2.1 for high fat, low fruit/vegetable intake and OR = 1.4, 95% CI: 0.95–2.1 for high fat, high fruit/vegetable intake compared to low fat, high fruit/vegetable intake). Thus, while like others we found that dietary fat increases endometrial cancer risk, the evaluation of dietary patterns did not provide any additional information regarding risk.

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References

  1. Landis SH, Murray T, Bolden S, Wingo PA (1999) Cancer statistics, 1999. CA Cancer J Clin 49(1):8–31

    PubMed  CAS  Google Scholar 

  2. National Program of Cancer Registries (2001) Data Collection and Surveillance: 2001 Cancer Data by Site and Race. Atlanta, Centers for Disease Control and Prevention

  3. Parazzini F, La Vecchia C, Bocciolone L, Franceschi S (1991) The epidemiology of endometrial cancer. Gynecol Oncol 41(1):1–16

    Article  PubMed  CAS  Google Scholar 

  4. Weiss JM, Saltzman BS, Doherty JA, Voigt LF, Chen C, Beresford SA et al (2006) Risk factors for the incidence of endometrial cancer according to the aggressiveness of disease. Am J Epidemiol 164(1):56–62

    Article  PubMed  Google Scholar 

  5. Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I (2005) Endometrial cancer. Lancet 366(9484):491–505

    Article  PubMed  Google Scholar 

  6. Terry P, Vainio H, Wolk A, Weiderpass E (2002) Dietary factors in relation to endometrial cancer: a nationwide case–control study in Sweden. Nutr Cancer 42(1):25–32

    Article  PubMed  Google Scholar 

  7. McCann SE, Freudenheim JL, Marshall JR, Brasure JR, Swanson MK, Graham S (2000) Diet in the epidemiology of endometrial cancer in western New York (United States). Cancer Causes Control 11(10):965–974

    Article  PubMed  CAS  Google Scholar 

  8. Littman AJ, Beresford SA, White E (2001) The association of dietary fat and plant foods with endometrial cancer (United States). Cancer Causes Control 12(8):691–702

    Article  PubMed  CAS  Google Scholar 

  9. Zheng W, Kushi LH, Potter JD, Sellers TA, Doyle TJ, Bostick RM et al (1995) Dietary intake of energy and animal foods and endometrial cancer incidence. The Iowa women’s health study. Am J Epidemiol 142(4):388–394

    PubMed  CAS  Google Scholar 

  10. Potischman N, Swanson CA, Brinton LA, McAdams M, Barrett RJ, Berman ML et al (1993) Dietary associations in a case–control study of endometrial cancer. Cancer Causes Control 4(3):239–250

    PubMed  CAS  Google Scholar 

  11. Jain MG, Rohan TE, Howe GR, Miller AB (2000) A cohort study of nutritional factors and endometrial cancer. Eur J Epidemiol 16(10):899–905

    Article  PubMed  CAS  Google Scholar 

  12. Horn-Ross PL, John EM, Canchola AJ, Stewart SL, Lee MM (2003) Phytoestrogen intake and endometrial cancer risk. J Natl Cancer Inst 95(15):1158–1164

    Article  PubMed  CAS  Google Scholar 

  13. Goodman MT, Wilkens LR, Hankin JH, Lyu LC, Wu AH, Kolonel LN (1997) Association of soy and fiber consumption with the risk of endometrial cancer. Am J Epidemiol 146(4):294–306

    PubMed  CAS  Google Scholar 

  14. National Research Council-Committee on Diet and Health (1989) Diet and health: implications for reducing chronic disease risk. Washington, DC

  15. Hu FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13(1):3–9

    Article  PubMed  CAS  Google Scholar 

  16. Jacques PF, Tucker KL (2001) Are dietary patterns useful for understanding the role of diet in chronic disease? Am J Clin Nutr 73(1):1–2

    PubMed  CAS  Google Scholar 

  17. Kant AK (2004) Dietary patterns and health outcomes. J Am Diet Assoc 104(4):615–635

    Article  PubMed  Google Scholar 

  18. Kleinbaum D, Kupper LL, Muller KE (1988) Chapter 24: variable reduction and factor analysis. In: Applied regression analysis and other multivariable methods. PWS-KENT Publishing Company, Boston, Massachusettes, pp 595–640

  19. Hoffman K, Schulze MB, Boeing H, Altenburg HP (2002) Dietary patterns: report of an international workshop. Public Health Nutr 5(1):89–90

    Article  PubMed  CAS  Google Scholar 

  20. Jacobs DR Jr, Steffen LM (2003) Nutrients, foods, and dietary patterns as exposures in research: a framework for food synergy. Am J Clin Nutr 78(3 Suppl):508S–513S

    PubMed  CAS  Google Scholar 

  21. Trichopoulou A, Kouris-Blazos A, Wahlqvist ML, Gnardellis C, Lagiou P, Polychronopoulos E et al (1995) Diet and overall survival in elderly people. Bmj 311(7018):1457–1460

    PubMed  CAS  Google Scholar 

  22. Trichopoulou A, Bamia C, Trichopoulos D (2005) Mediterranean diet and survival among patients with coronary heart disease in Greece. Arch Intern Med 165(8):929–935

    Article  PubMed  Google Scholar 

  23. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348(26):2599–2608

    Article  PubMed  Google Scholar 

  24. Bosetti C, Gallus S, Trichopoulou A, Talamini R, Franceschi S, Negri E et al (2003) Influence of the Mediterranean diet on the risk of cancers of the upper aerodigestive tract. Cancer Epidemiol Biomarkers Prev 12(10):1091–1094

    PubMed  Google Scholar 

  25. Trichopoulou A, Lagiou P, Kuper H, Trichopoulos D (2000) Cancer and Mediterranean dietary traditions. Cancer Epidemiol Biomarkers Prev 9(9):869–873

    PubMed  CAS  Google Scholar 

  26. Block G, Hartman AM, Dresser CM, Carroll MD, Gannon J, Gardner L (1986) A data-based approach to diet questionnaire design and testing. Am J Epidemiol 124(3):453–469

    PubMed  CAS  Google Scholar 

  27. Horn-Ross PL, Barnes S, Lee M, Coward L, Mandel JE, Koo J et al (2000) Assessing phytoestrogen exposure in epidemiologic studies: development of a database (United States). Cancer Causes Control 11(4):289–298

    Article  PubMed  CAS  Google Scholar 

  28. Horn-Ross PL (2001) Assessing phytoestrogen exposure via a food-frequency questionnaire. Cancer Causes Control 12(5):477–478

    Article  PubMed  CAS  Google Scholar 

  29. Costacou T, Bamia C, Ferrari P, Riboli E, Trichopoulos D, Trichopoulou A (2003) Tracing the Mediterranean diet through principal components and cluster analyses in the Greek population. Eur J Clin Nutr 57(11):1378–1385

    Article  PubMed  CAS  Google Scholar 

  30. Goulet J, Lamarche B, Nadeau G, Lemieux S (2003) Effect of a nutritional intervention promoting the Mediterranean food pattern on plasma lipids, lipoproteins and body weight in healthy French-Canadian women. Atherosclerosis 170(1):115–124

    Article  PubMed  CAS  Google Scholar 

  31. Steinmetz KA, Potter JD (1996) Vegetables, fruit, and cancer prevention: a review. J Am Diet Assoc 96(10):1027–1039

    Article  PubMed  CAS  Google Scholar 

  32. Jain MG, Howe GR, Rohan TE (2000) Nutritional factors and endometrial cancer in Ontario, Canada. Cancer Control 7(3):288–296

    PubMed  CAS  Google Scholar 

  33. McCann SE, Marshall JR, Brasure JR, Graham S, Freudenheim JL (2001) Analysis of patterns of food intake in nutritional epidemiology: food classification in principal components analysis and the subsequent impact on estimates for endometrial cancer. Public Health Nutr 4(5):989–997

    Article  PubMed  CAS  Google Scholar 

  34. The North American Association of Central Cancer Registries: Average-annual Registry-specific Cancer Incidence by Race and Sex 1999–2003

  35. Freudenheim JL, Marshall JR, Vena JE, Laughlin R, Brasure JR, Swanson MK et al (1996) Premenopausal breast cancer risk and intake of vegetables, fruits, and related nutrients. J Natl Cancer Inst 88(6):340–348

    Article  PubMed  CAS  Google Scholar 

  36. Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 13 Regs Public-Use, Nov 2004 Sub (1992-2002), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch

  37. Velie EM, Schairer C, Flood A, He JP, Khattree R, Schatzkin A (2005) Empirically derived dietary patterns and risk of postmenopausal breast cancer in a large prospective cohort study. Am J Clin Nutr 82(6):1308–1319

    PubMed  CAS  Google Scholar 

  38. Fung TT, Hu FB, Holmes MD, Rosner BA, Hunter DJ, Colditz GA et al (2005) Dietary patterns and the risk of postmenopausal breast cancer. Int J Cancer 116(1):116–121

    Article  PubMed  CAS  Google Scholar 

  39. Mannisto S, Dixon LB, Balder HF, Virtanen MJ, Krogh V, Khani BR et al (2005) Dietary patterns and breast cancer risk: results from three cohort studies in the DIETSCAN project. Cancer Causes Control 16(6):725–733

    Article  PubMed  Google Scholar 

  40. Terry P, Suzuki R, Hu FB, Wolk A (2001) A prospective study of major dietary patterns and the risk of breast cancer. Cancer Epidemiol Biomarkers Prev 10(12):1281–1285

    PubMed  CAS  Google Scholar 

  41. Sieri S, Krogh V, Pala V, Muti P, Micheli A, Evangelista A et al (2004) Dietary patterns and risk of breast cancer in the ORDET cohort. Cancer Epidemiol Biomarkers Prev 13(4):567–572

    PubMed  Google Scholar 

  42. Nkondjock A, Ghadirian P (2005) Associated nutritional risk of breast and colon cancers: a population-based case–control study in Montreal, Canada. Cancer Lett 223(1):85–91

    Article  PubMed  CAS  Google Scholar 

  43. Adebamowo CA, Hu FB, Cho E, Spiegelman D, Holmes MD, Willett WC (2005) Dietary patterns and the risk of breast cancer. Ann Epidemiol 15(10):789–795

    Article  PubMed  Google Scholar 

  44. La Vecchia C (2004) Mediterranean diet and cancer. Public Health Nutr 7(7):965–968

    Article  PubMed  Google Scholar 

  45. Martinez-Gonzalez MA, Estruch R (2004) Mediterranean diet, antioxidants and cancer: the need for randomized trials. Eur J Cancer Prev 13(4):327–335

    Article  PubMed  CAS  Google Scholar 

  46. Slattery ML, Boucher KM, Caan BJ, Potter JD, Ma KN (1998) Eating patterns and risk of colon cancer. Am J Epidemiol 148(1):4–16

    PubMed  CAS  Google Scholar 

  47. Osler M, Heitmann BL, Gerdes LU, Jorgensen LM, Schroll M (2001) Dietary patterns and mortality in Danish men and women: a prospective observational study. Br J Nutr 85(2):219–225

    PubMed  CAS  Google Scholar 

  48. Dixon LB, Balder HF, Virtanen MJ, Rashidkhani B, Mannisto S, Krogh V et al (2004) Dietary patterns associated with colon and rectal cancer: results from the Dietary Patterns and Cancer (DIETSCAN) Project. Am J Clin Nutr 80(4):1003–1011

    PubMed  CAS  Google Scholar 

  49. Willett W (1990) Nutritional epidemiology. Oxford University Press, New York

    Google Scholar 

  50. Hu FB, Rimm E, Smith-Warner SA, Feskanich D, Stampfer MJ, Ascherio A et al (1999) Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. Am J Clin Nutr 69(2):243–249

    PubMed  CAS  Google Scholar 

  51. Munger RG, Folsom AR, Kushi LH, Kaye SA, Sellers TA (1992) Dietary assessment of older Iowa women with a food frequency questionnaire: nutrient intake, reproducibility, and comparison with 24-hour dietary recall interviews. Am J Epidemiol 136(2):192–200

    PubMed  CAS  Google Scholar 

  52. Stram DO, Hankin JH, Wilkens LR, Pike MC, Monroe KR, Park S et al (2000) Calibration of the dietary questionnaire for a multiethnic cohort in Hawaii and Los Angeles. Am J Epidemiol 151(4):358–370

    PubMed  CAS  Google Scholar 

  53. Smith-Warner SA, Spiegelman D, Ritz J, Albanes D, Beeson WL, Bernstein L et al (2006) Methods for pooling results of epidemiologic studies: the Pooling Project of Prospective Studies of Diet and Cancer. Am J Epidemiol 163(11):1053–1064

    Article  PubMed  Google Scholar 

  54. Willett WC, Sampson L, Browne ML, Stampfer MJ, Rosner B, Hennekens CH et al (1988) The use of a self-administered questionnaire to assess diet four years in the past. Am J Epidemiol 27(1):188–199

    Google Scholar 

  55. Bazzarre TL, Myers MP (1979) The collection of food intake data in cancer epidemiology studies. Nutr Cancer 1:22–45

    Article  CAS  Google Scholar 

  56. Chu SY, Kolonel LN, Hankin JH, Lee J (1984) A comparison of frequency and quantitative dietary methods for epidemiologic studies of diet and disease. Am J Epidemiol 119(3):323–334

    PubMed  CAS  Google Scholar 

  57. Thompson FE, Lamphiear DE, Metzner HL, Hawthorne VM, Oh MS (1987) Reproducibility of reports of frequency of food use in the Tecumseh Diet Methodology Study. Am J Epidemiol 125(4):658–671

    PubMed  CAS  Google Scholar 

  58. Wilkens LR, Hankin JH, Yoshizawa CN, Kolonel LN, Lee J (1992) Comparison of long-term dietary recall between cancer cases and noncases. Am J Epidemiol 136(7):825–835

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors wish to thank to Dr. Gladys Block for her review and comments on this article. This research was supported by grants R03 CA110929 and R01 CA74877 from the National Cancer Institute. The funding sources did not contribute to the design or conduct of the study, nor to the writing or submission of this manuscript. The collection of cancer incidence data used in this study was supported by the California Department of Health Services (as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885) and the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract N01-PC-35136 awarded to the Northern California Cancer Center. The ideas and opinions expressed herein are those of the authors and endorsement by the State of California Department of Health Services and the National Cancer Institute is not intended nor should be inferred.

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Authors and Affiliations

  1. Northern California Cancer Center, 2201 Walnut Avenue, Fremont, CA, 94538, USA

    Tapashi B. Dalvi, Alison J. Canchola & Pamela L. Horn-Ross

  2. Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, USA

    Tapashi B. Dalvi

  3. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, USA

    Pamela L. Horn-Ross

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  1. Tapashi B. Dalvi
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  2. Alison J. Canchola
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Correspondence to Pamela L. Horn-Ross.

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Dalvi, T.B., Canchola, A.J. & Horn-Ross, P.L. Dietary patterns, Mediterranean diet, and endometrial cancer risk. Cancer Causes Control 18, 957–966 (2007). https://doi.org/10.1007/s10552-007-9037-1

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  • DOI: https://doi.org/10.1007/s10552-007-9037-1

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