Omega-3 and omega-6 fatty acid intakes and endometrial cancer risk in a population-based case–control study
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.
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.
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).
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.
KeywordsEndometrial cancer Fatty acids Fish oil Fish Case–control study
HA was supported in part by NIH doctoral training grant T32 CA105666. MN was supported by P30 CA15704. The Connecticut Endometrial Cancer Study was supported by NIH research grant 5R01 CA098346 (to HY). The cooperation of 28 Connecticut hospitals, including Charlotte Hungerford Hospital, Bridgeport Hospital, Danbury Hospital, Hartford Hospital, Middlesex Hospital, New Britain General Hospital, Bradley Memorial Hospital, Yale/New Haven Hospital, St. Francis Hospital and Medical Center, St. Mary’s Hospital, Hospital of St. Raphael, St. Vincent’s Medical Center, Stamford Hospital, William W. Backus Hospital, Windham Hospital, Eastern Connecticut Health Network, Griffin Hospital, Bristol Hospital, Johnson Memorial Hospital, Day Kimball Hospital, Greenwich Hospital, Lawrence and Memorial Hospital, Milford Hospital, New Milford Hospital, Norwalk Hospital, MidState Medical Center, John Dempsey Hospital and Waterbury Hospital, in allowing patient access, is gratefully acknowledged. This study was approved by the State of Connecticut Department of Public Health Human Investigation Committee. Certain data used in this study were obtained from the Connecticut Tumor Registry in the Connecticut Department of Public Health. The authors assume full responsibility for analyses and interpretation of these data. The authors want especially to thank Rajni Mehta for her support in case identification through Rapid Case Ascertainment, Helen Sayward for her effort in conducting the study, Ellen Anderson, Donna Bowers, Renee Capasso, Kristin DeFrancesco, Anna Florczak, and Sherry Rowland for their assistance in recruiting and interviewing study participants, and Na Ni for her help in SAS programming.
- 1.American Cancer Society (2012) Cancer facts & figures 2012. American Cancer Society, AtlantaGoogle Scholar
- 7.Karmali RA, Marsh J, Fuchs C (1984) Effect of omega-3 fatty acids on growth of a rat mammary tumor. J Natl Cancer Inst 73:457–461Google Scholar
- 10.Boudreau MD, Sohn KH, Rhee SH, Lee SW, Hunt JD, Hwang DH (2001) Suppression of tumor cell growth both in nude mice and in culture by n-3 polyunsaturated fatty acids: mediation through cyclooxygenase-independent pathways. Cancer Res 61:1386Google Scholar
- 12.Larsson SC, Kumlin M, Ingelman-Sundberg M, Wolk A (2004) Dietary long-chain n-3 fatty acids for the prevention of cancer: a review of potential mechanisms. Am J Clin Nutr 79:935–945Google Scholar
- 14.Zheng W, Kushi LH, Potter JD, Sellers TA, Doyle TJ, Bostick RM, Folsom AR (1995) Dietary intake of energy and animal foods and endometrial cancer incidence. Am J Epidemiol 142:388Google Scholar
- 17.Fernandez E, Chatenoud L, La Vecchia C, Negri E, Franceschi S (1999) Fish consumption and cancer risk. Am J Clin Nutr 70:85–90Google Scholar
- 19.Goodman MT, Hankin JH, Wilkens LR, Lyu LC, McDuffie K, Liu LQ, Kolonel LN (1997) Diet, body size, physical activity, and the risk of endometrial cancer. Cancer Res 57:5077–5085Google Scholar
- 20.Levi F, La Vecchia C, Franceschi S, Negri E (1993) Dietary factors and the risk of endometrial cancer. Cancer 71:3575–3581. doi: 10.1002/1097-0142(19930601)71:11<3575:aid-cncr2820711119>3.0.co;2-0 CrossRefGoogle Scholar
- 21.Bravi F, Scotti L, Bosetti C, Zucchetto A, Talamini R, Montella M, Greggi S, Pelucchi C, Negri E, Franceschi S (2009) Food groups and endometrial cancer risk: a case-control study from Italy. Am J Obstet Gynecol 200:293. e291–293. e297Google Scholar
- 22.Jain MG, Howe GR, Rohan TE (2000) Nutritional factors and endometrial cancer in Ontario, Canada. Cancer Control 7:288–296Google Scholar
- 24.Shu XO, Zheng W, Potischman N, Brinton LA, Hatch MC, Gao Y-T, Fraumeni JF (1993) A population-based case-control study of dietary factors and endometrial cancer in Shanghai, People’s Republic of China. Am J Epidemiol 137:155–165Google Scholar
- 25.Terry P, Wolk A, Vainio H, Weiderpass E (2002) Fatty fish consumption lowers the risk of endometrial cancer: a nationwide case-control study in Sweden. Cancer Epidemiol Biomarkers Prev 11:143–145Google Scholar
- 39.Calder PC (2006) n-3 Polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr 83:S1505–1519SGoogle Scholar
- 40.Takahashi M, Przetakiewicz M, Ong A, Borek C, Lowenstein JM (1992) Effect of omega 3 and omega 6 fatty acids on transformation of cultured cells by irradiation and transfection. Cancer Res 52:154–162Google Scholar
- 45.Mori Y, Murakawa Y, Katoh S, Hata S, Yokoyama J, Tajima N, Ikeda Y, Nobukata H, Ishikawa T, Shibutani Y (1997) Influence of highly purified eicosapentaenoic acid ethyl ester on insulin resistance in the Otsuka Long-Evans Tokushima Fatty rat, a model of spontaneous non-insulin-dependent diabetes mellitus. Metabolism 46:1458–1464CrossRefGoogle Scholar
- 47.Popp-Snijders C, Schouten J, Heine R, Van der Meer J, Van der Veen E (1987) Dietary supplementation of omega-3 polyunsaturated fatty acids improves insulin sensitivity in non-insulin-dependent diabetes. Diabetes Res 4:141Google Scholar