Risk of endometrial cancer in relation to individual nutrients from diet and supplements

Public Health Nutrition
Q2
Jul 2011
Citations:27
Influential Citations:7
Observational Studies (Human)
81
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Methods
Population-based case-control study in Alberta, Canada (2002-2006). Cases: 506 women aged 30-79 with incident endometrial cancer; Controls: 981 women from the population, frequency-matched on age. Data collected via in-person interviews and a Diet History Questionnaire; unconditional logistic regression used to estimate risk within nutrient quartiles.
Results
Most macronutrients showed little association with endometrial cancer risk. Highest dietary cholesterol intake linked to increased EC risk (multivariable OR 1.51; 95% CI 1.08-2.11; P-trend 0.02). Calcium showed inverse associations: calcium from foods had an age-adjusted protective signal (OR 0.73; 95% CI 0.54-0.99) but was attenuated after multivariable adjustment (OR 0.82; 95% CI 0.59-1.13). When calcium from foods plus supplements was considered, highest intake yielded a 28% reduction in risk (multivariable OR 0.72; 95% CI 0.51-0.99; P-trend 0.04). Among non-supplement users, dietary calcium alone showed a stronger inverse association (OR 0.52; 95% CI 0.30-0.93). Some unexpected elevated risks at limited intakes of soluble fiber, vitamin C, thiamin, vitamin B6, lutein/zeaxanthin, and vitamin B12 with no linear trend; these may be chance findings. Cholesterol risk was higher in overweight/obese women (BMI ≥25.0 kg/m2; highest quartile OR 2.11; 95% CI 1.44-3.10) and in postmenopausal women not using hormone therapy (OR 1.79; 95% CI 1.06-3.00). Overall interpretation: dietary cholesterol may increase EC risk; calcium intake from foods and supplements may reduce risk. The results underscore the importance of accounting for supplement use in nutritional epidemiology; prospective studies are needed to confirm findings.
Limitations
Case-control design with retrospective dietary assessment; potential recall bias; misclassification of supplement exposure; low control response rate (~52%); possible selection bias; residual confounding; multiple comparisons; cannot isolate effects of individual nutrients within multivitamins.

Abstract

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 ca...