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Phytoestrogen consumption and endometrial cancer risk: a population-based case–control study in New Jersey

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Abstract

Phytoestrogens have been shown to exert anti-estrogenic and estrogenic effects in some tissues, including the breast. However, only a few studies have evaluated their role in endometrial cancer risk. We evaluated this association in a population-based case–control study in New Jersey. A total of 424 cases and 398 controls completed an interview, including a food frequency questionnaire with supplemental questions for phytoestrogen foods. Risk estimates were derived using an unconditional logistic regression, adjusting for major risk factors for endometrial cancer. There was some suggestion of a decreased risk with quercetin intake (OR: 0.65; 95% CI: 0.41–1.01 for the highest compared to the lowest quartile; p for trend: 0.02). We found a limited evidence of an association with any of the lignans evaluated, total lignans, coumestrol, individual isoflavones, total isoflavones, or total phytoestrogens. However, there was some suggestion of an inverse association with total isoflavone intake limited to lean women (BMI <25; OR for the highest tertile: 0.50; 95% CI: 0.25–0.98) and those with a waist-to-hip ratio ≤0.85 (OR: 0.59; 95% CI: 0.33–1.05). There was no evidence of effect modification by HRT use. This study suggests a reduction in endometrial cancer risk with quercetin intake and with isoflavone intake in lean women.

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Abbreviations

OR:

Odds ratio

CI:

Confidence interval

FFQ:

Food frequency questionnaire

BMI:

Body mass index

WHR:

Waist-to-hip ratio

HRT:

Hormone replacement therapy

ERT:

Estrogen replacement therapy

OC:

Oral contraceptives

References

  1. American Cancer Society (2008) Cancer facts and figures 2008. American Cancer Society, Atlanta, GA. http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf

  2. Bandera EV, Kushi LH (2004) Phytoestrogens in the prevention and prognosis of female hormonal cancers. Annu Rev Food Nutr Toxic 1:63–87

    Google Scholar 

  3. Duffy C, Perez K, Partridge A (2007) Implications of phytoestrogen intake for breast cancer. CA Cancer J Clin 57:260–277. doi:10.3322/CA.57.5.260

    Article  PubMed  Google Scholar 

  4. Kaaks R, Lukanova A, Kurzer MS (2002) Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomarkers Prev 11:1531–1543

    PubMed  CAS  Google Scholar 

  5. Setchell KD (1998) Phytoestrogens: the biochemistry, physiology, and implications for human health of soy isoflavones. Am J Clin Nutr 68:1333S–1346S

    PubMed  CAS  Google Scholar 

  6. Strauss L, Santti R, Saarinen N, Streng T, Joshi S, Makela S (1998) Dietary phytoestrogens and their role in hormonally dependent disease. Toxicol Lett 102–103:349–354. doi:10.1016/S0378-4274(98)00332-4

    Article  PubMed  Google Scholar 

  7. Moutsatsou P (2007) The spectrum of phytoestrogens in nature: our knowledge is expanding. Hormones (Athens) 6:173–193

    Google Scholar 

  8. Messina MJ, Persky V, Setchell KD, Barnes S (1994) Soy intake and cancer risk: a review of the in vitro and in vivo data. Nutr Cancer 21:113–131

    Article  PubMed  CAS  Google Scholar 

  9. Horn-Ross PL, John EM, Canchola AJ, Stewart SL, Lee MM (2003) Phytoestrogen intake and endometrial cancer risk. J Natl Cancer Inst 95:1158–1164 -Erratum in: J Natl Cancer Inst. 2006 Oct 18;98(20):1501

    Google Scholar 

  10. Xu WH, Zheng W, Xiang YB et al (2004) Soya food intake and risk of endometrial cancer among Chinese women in Shanghai: population based case–control study. BMJ 328:1285. doi:10.1136/bmj.38093.646215.AE

    Article  PubMed  Google Scholar 

  11. Zeleniuch-Jacquotte A, Lundin E, Micheli A et al (2006) Circulating enterolactone and risk of endometrial cancer. Int J Cancer 119:2376–2381. doi:10.1002/ijc.22140

    Article  PubMed  CAS  Google Scholar 

  12. 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 146:294–306

    PubMed  CAS  Google Scholar 

  13. Olson SH, Orlow I, Bayuga S et al (2008) Variants in hormone biosynthesis genes and risk of endometrial cancer. Cancer Causes Control 19:955–963

    PubMed  Google Scholar 

  14. Caan B, Sternfeld B, Gunderson E, Coates A, Quesenberry C, Slattery ML (2005) Life after cancer epidemiology (LACE) study: a cohort of early stage breast cancer survivors (United States). Cancer Causes Control 16:545–556. doi:10.1007/s10552-004-8340-3

    Article  PubMed  Google Scholar 

  15. Horn-Ross PL, Barnes S, Lee M et al (2000) Assessing phytoestrogen exposure in epidemiologic studies: development of a database (United States). Cancer Causes Control 11:289–298. doi:10.1023/A:1008995606699

    Article  PubMed  CAS  Google Scholar 

  16. Thompson LU, Boucher BA, Liu Z, Cotterchio M, Kreiger N (2006) Phytoestrogen content of foods consumed in Canada, including isoflavones, lignans, and coumestan. Nutr Cancer 54:184–201. doi:10.1207/s15327914nc5402_5

    Article  PubMed  CAS  Google Scholar 

  17. Willett W, Stampfer M (1998) Implications of total energy intake for epidemiologic analyses. In: Willett W (ed) Nutritional epidemiology, 2nd edn. Oxford University Press, New York, pp 273–301

    Google Scholar 

  18. Bandera EV, Kushi LH, Moore DF, Gifkins DM, McCullough ML. The association between food, nutrition, and physical activity and the risk of endometrial cancer and underlying mechanisms. In: Second Report on Food, Nutrition, Physical Activity and the Prevention of Cancer: World Cancer Research Fund International/American Institute for Cancer Research; 2007

  19. Hirose K, Tajima K, Hamajima N et al (1996) Subsite (cervix/endometrium)-specific risk and protective factors in uterus cancer. Jpn J Cancer Res 87:1001–1009

    PubMed  CAS  Google Scholar 

  20. Littman AJ, Beresford SA, White E (2001) The association of dietary fat and plant foods with endometrial cancer (United States). Cancer Causes Control 12:691–702. doi:10.1023/A:1011292003586

    Article  PubMed  CAS  Google Scholar 

  21. Zhou B, Yang L, Sun Q et al (2008) Cigarette smoking and the risk of endometrial cancer: a meta-analysis. Am J Med 121:501–508. doi:10.1016/j.amjmed.2008.01.044

    Article  PubMed  CAS  Google Scholar 

  22. Cust AE, Armstrong BK, Friedenreich CM, Slimani N, Bauman A (2007) Physical activity and endometrial cancer risk: a review of the current evidence, biologic mechanisms and the quality of physical activity assessment methods. Cancer Causes Control 18:243–258. doi:10.1007/s10552-006-0094-7

    Article  PubMed  Google Scholar 

  23. Voskuil DW, Monninkhof EM, Elias SG, Vlems FA, van Leeuwen FE (2007) Physical activity and endometrial cancer risk, a systematic review of current evidence. Cancer Epidemiol Biomarkers Prev 16:639–648. doi:10.1158/1055-9965.EPI-06-0742

    Article  PubMed  Google Scholar 

  24. Bandera EV, Kushi LH, Moore DF, Gifkins DM, McCullough ML (2007) Dietary lipids and endometrial cancer: the current epidemiologic evidence. Cancer Causes Control 18:687–703. doi:10.1007/s10552-007-9021-9

    Article  PubMed  Google Scholar 

  25. Bandera EV, Kushi LH, Olson SH, Chen WY, Muti P (2003) Alcohol consumption and endometrial cancer: some unresolved issues. Nutr Cancer 45:24–29. doi:10.1207/S15327914NC4501_3

    Article  PubMed  Google Scholar 

  26. Galea S, Tracy M (2007) Participation rates in epidemiologic studies. Ann Epidemiol 17:643–653. doi:10.1016/j.annepidem.2007.03.013

    Article  PubMed  Google Scholar 

  27. Hartge P (2006) Participation in population studies. Epidemiology 17:252–254. doi:10.1097/01.ede.0000209441.24307.92

    Article  PubMed  Google Scholar 

  28. Murray MJ, Meyer WR, Lessey BA, Oi RH, DeWire RE, Fritz MA (2003) Soy protein isolate with isoflavones does not prevent estradiol-induced endometrial hyperplasia in postmenopausal women: a pilot trial. Menopause 10:456–464. doi:10.1097/01.GME.0000063567.84134.D1

    Article  PubMed  Google Scholar 

  29. Kutuk O, Basaga H (2006) Phytoestrogens in cell signaling. In: Yildiz F (ed) Phytoestrogens in functional foods. CRC Press. Taylor and Francis Group, Florida, pp 123–151

    Google Scholar 

  30. Unfer V, Casini ML, Costabile L, Mignosa M, Gerli S, Di Renzo GC (2004) Endometrial effects of long-term treatment with phytoestrogens: a randomized, double-blind, placebo-controlled study. Fertil Steril 82:145–148. doi:10.1016/j.fertnstert.2003.11.041 quiz 265

    Article  PubMed  CAS  Google Scholar 

  31. Boots AW, Haenen GR, Bast A (2008) Health effects of quercetin: from antioxidant to nutraceutical. Eur J Pharmacol 585:325–337. doi:10.1016/j.ejphar.2008.03.008

    Article  PubMed  CAS  Google Scholar 

  32. Neuhouser ML (2004) Dietary flavonoids and cancer risk: evidence from human population studies. Nutr Cancer 50:1–7. doi:10.1207/s15327914nc5001_1

    Article  PubMed  CAS  Google Scholar 

  33. Cui Y, Morgenstern H, Greenland S et al (2008) Dietary flavonoid intake and lung cancer–a population-based case–control study. Cancer 112:2241–2248. doi:10.1002/cncr.23398

    Article  PubMed  CAS  Google Scholar 

  34. Theodoratou E, Kyle J, Cetnarskyj R et al (2007) Dietary flavonoids and the risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev 16:684–693. doi:10.1158/1055-9965.EPI-06-0785

    Article  PubMed  CAS  Google Scholar 

  35. Garcia-Closas R, Gonzalez CA, Agudo A, Riboli E (1999) Intake of specific carotenoids and flavonoids and the risk of gastric cancer in Spain. Cancer Causes Control 10:71–75. doi:10.1023/A:1008867108960

    Article  PubMed  CAS  Google Scholar 

  36. McCann SE, Ambrosone CB, Moysich KB et al (2005) Intakes of selected nutrients, foods, and phytochemicals and prostate cancer risk in western New York. Nutr Cancer 53:33–41. doi:10.1207/s15327914nc5301_4

    Article  PubMed  CAS  Google Scholar 

  37. Adebamowo CA, Cho E, Sampson L et al (2005) Dietary flavonols and flavonol-rich foods intake and the risk of breast cancer. Int J Cancer 114:628–633. doi:10.1002/ijc.20741

    Article  PubMed  CAS  Google Scholar 

  38. Gates MA, Tworoger SS, Hecht JL, De Vivo I, Rosner B, Hankinson SE (2007) A prospective study of dietary flavonoid intake and incidence of epithelial ovarian cancer. Int J Cancer 121:2225–2232. doi:10.1002/ijc.22790

    Article  PubMed  CAS  Google Scholar 

  39. Lin J, Zhang SM, Wu K, Willett WC, Fuchs CS, Giovannucci E (2006) Flavonoid intake and colorectal cancer risk in men and women. Am J Epidemiol 164:644–651. doi:10.1093/aje/kwj296

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank the interviewers and students who were involved in this study (Silvia Brendel, Dina Gifkins, Nora Geraghty, June Kittredge, Elinor Miller, Louise Salant, Mathilde Saxon, Elizabeth Ward, Doreen Wass, Kay Yoon), the New Jersey Department of Health and Senior Services personnel (Tara Blando, Joan Kay, Betsy Kohler, Kevin Masterson, and Helen Weiss), as well as all the participants who generously donated their time to the study. This work was funded by NIH-K07 CA095666 and R01CA83918.

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Authors and Affiliations

  1. The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, 195 Little Albany St., New Brunswick, NJ, 08903, USA

    Elisa V. Bandera & Melony G. Williams

  2. School of Public Health, University of Medicine and Dentistry of New Jersey, Piscataway, NJ, USA

    Elisa V. Bandera & Melony G. Williams

  3. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Camelia Sima, Sharon Bayuga, Katherine Pulick, Ann G. Zauber & Sara H. Olson

  4. Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Robert Soslow

  5. New Jersey Department of Health and Senior Services, Trenton, NJ, USA

    Homer Wilcox

Authors
  1. Elisa V. Bandera
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  2. Melony G. Williams
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  3. Camelia Sima
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  4. Sharon Bayuga
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  7. Robert Soslow
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  9. Sara H. Olson
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Corresponding author

Correspondence to Elisa V. Bandera.

Appendix

Appendix

See Table 6.

Table 6 Additional food items in the supplemental page, not included in the Block Food Frequency Questionnaire (version 98.2)
Full size table

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Bandera, E.V., Williams, M.G., Sima, C. et al. Phytoestrogen consumption and endometrial cancer risk: a population-based case–control study in New Jersey. Cancer Causes Control 20, 1117–1127 (2009). https://doi.org/10.1007/s10552-009-9336-9

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  • DOI: https://doi.org/10.1007/s10552-009-9336-9

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