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Cancer Epidemiol Biomarkers Prev. 2015 Feb;24(2):466-71. doi: 10.1158/1055-9965.EPI-14-0970.

Investigation of dietary factors and endometrial cancer risk using a nutrient-wide association study approach in the EPIC and Nurses' Health Study (NHS) and NHSII.

Author information

1
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. m.merritt@imperial.ac.uk.
2
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
3
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
4
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts. Program in Genetic Epidemiology and Statistical Genetics, Harvard School of Public Health, Boston, Massachusetts.
5
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts. Division of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts.
6
Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom.
7
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. Department of Research, Cancer Registry of Norway, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Department of Genetic Epidemiology, Samfundet Folkhälsan, Helsinki, Finland.
8
Danish Cancer Society Research Center, Copenhagen, Denmark.
9
Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
10
Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France. University Paris Sud, Villejuif, France. IGR, Villejuif, France.
11
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
12
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
13
Hellenic Health Foundation, Athens, Greece. Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.
14
Department of Hygiene, Epidemiology, and Medical Statistics, University of Athens Medical School, Athens, Greece.
15
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts. Hellenic Health Foundation, Athens, Greece. Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.
16
Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy.
17
Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
18
Cancer Registry and Histopathology Unit, "Civic-M.P. Arezzo" Hospital, ASP, Ragusa, Italy.
19
Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza-University of Turin and Center for Cancer Prevention (CPO-Piemonte), Turin, Italy. Human Genetics Foundation (HuGeF), Turin, Italy.
20
Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
21
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands. Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
22
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.
23
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.
24
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
25
Public Health Directorate, Asturias, Spain.
26
Unit of Nutrition, Environment, and Cancer, Cancer Epidemiology Research Program, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology (ICO), Barcelona, Spain.
27
Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada, Spain. CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
28
CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain.
29
CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Navarre Public Health Institute, Pamplona, Spain.
30
Public Health Department of Gipuzkoa, Government of the Basque Country, San Sebastian, Spain. BioDonostia Research Institute, San Sebastian, Spain.
31
Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
32
Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden. Arcum, Arctic Research Centre at Umeå University, Umeå, Sweden.
33
Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.
34
University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom.
35
MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
36
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
37
International Agency for Research on Cancer, Lyon, France.
38
Center for Biomedical Informatics, Harvard Medical School, Boston, Massachusetts.

Abstract

Data on the role of dietary factors in endometrial cancer development are limited and inconsistent. We applied a "nutrient-wide association study" approach to systematically evaluate dietary risk associations for endometrial cancer while controlling for multiple hypothesis tests using the false discovery rate (FDR) and validating the results in an independent cohort. We evaluated endometrial cancer risk associations for dietary intake of 84 foods and nutrients based on dietary questionnaires in three prospective studies, the European Prospective Investigation into Cancer and Nutrition (EPIC; N = 1,303 cases) followed by validation of nine foods/nutrients (FDR ≤ 0.10) in the Nurses' Health Studies (NHS/NHSII; N = 1,531 cases). Cox regression models were used to estimate HRs and 95% confidence intervals (CI). In multivariate adjusted comparisons of the extreme categories of intake at baseline, coffee was inversely associated with endometrial cancer risk (EPIC, median intake 750 g/day vs. 8.6; HR, 0.81; 95% CI, 0.68-0.97, Ptrend = 0.09; NHS/NHSII, median intake 1067 g/day vs. none; HR, 0.82; 95% CI, 0.70-0.96, Ptrend = 0.04). Eight other dietary factors that were associated with endometrial cancer risk in the EPIC study (total fat, monounsaturated fat, carbohydrates, phosphorus, butter, yogurt, cheese, and potatoes) were not confirmed in the NHS/NHSII. Our findings suggest that coffee intake may be inversely associated with endometrial cancer risk. Further data are needed to confirm these findings and to examine the mechanisms linking coffee intake to endometrial cancer risk to develop improved prevention strategies.

PMID:
25662427
PMCID:
PMC4324546
DOI:
10.1158/1055-9965.EPI-14-0970
[Indexed for MEDLINE]
Free PMC Article

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