Research
Oncology
Food groups and endometrial cancer risk: a case-control study from Italy

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Objective

Although several studies have been conducted on the relation between dietary habits and endometrial cancer risk, the evidence for specific food groups is still controversial.

Study Design

We analyzed data from an Italian case-control study including 454 women with histologically confirmed endometrial cancer and 908 controls admitted to the same hospitals for acute, nonneoplastic conditions. Multivariate odds ratios (ORs) were obtained after allowance for major potential confounding factors.

Results

A significant increase in risk was observed for red meat, with an OR of 2.07 for an increment of 1 serving per day. Inverse associations were observed for coffee (OR, 0.83), cereals (OR, 0.92), and vegetables (OR, 0.83).

Conclusion

Our results support the existence of a relation between dietary habits and endometrial cancer risk and in particular suggest that a diet rich in red meat and poor in vegetables may have an unfavorable effect.

Section snippets

Materials and Methods

A case-control study on endometrial cancer was conducted between 1992 and 2006 in 3 Italian areas, including the greater Milan area, the provinces of Udine and Pordenone in northern Italy, and the urban area of Naples in southern Italy.25 Cases were 454 women (median age, 60 years; range, 18-79 years) with incident, histologically confirmed endometrial cancer (International Classification of Diseases, ninth edition, 182.0), admitted to major teaching and general hospitals of the study areas.

Results

Table 1 shows the distribution of 454 cases of endometrial cancer and 908 controls according to selected variables. By design, cases and controls had the same age distribution. As compared with controls, cases had a higher BMI, had more frequently reported history of diabetes, had greater total energy intake, had lower age at menarche, were less frequently OC users, and were more frequently HRT users. Cases and controls were comparable in terms of education, parity, and menopausal status.

Table 2

Comment

The results of the present study, based on a large case-control investigation on endometrial cancer, provide a general overview of the dietary correlates of this cancer in a southern European population. Inverse relations were observed for vegetables, cereals, and coffee, whereas positive associations were found for red meat.

With reference to vegetables, our results confirm the inverse relation with endometrial cancer risk reported in most previous studies.6, 7, 8, 9, 10, 11, 12, 13 The

Acknowledgment

The authors thank Mrs I. Garimoldi for editorial assistance.

References (32)

  • M.T. Goodman et al.

    Diet, body size, physical activity, and the risk of endometrial cancer

    Cancer Res

    (1997)
  • M.G. Jain et al.

    Nutritional factors and endometrial cancer in Ontario, Canada

    Cancer Control

    (2000)
  • C. La Vecchia et al.

    Nutrition and diet in the etiology of endometrial cancer

    Cancer

    (1986)
  • F. Levi et al.

    Dietary factors and the risk of endometrial cancer

    Cancer

    (1993)
  • A.J. Littman et al.

    The association of dietary fat and plant foods with endometrial cancer (United States)

    Cancer Causes Control

    (2001)
  • S.E. McCann et al.

    Diet in the epidemiology of endometrial cancer in western New York (United States)

    Cancer Causes Control

    (2000)
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    Cite this article as: Bravi F, Scotti L, Bosetti C, et al. Food groups and endometrial cancer risk: a case-control study from Italy. Am J Obstet Gynecol 2009;200:293.e1-293.e7.

    This study was supported in part by the Italian Association for Cancer Research and the Italian League Against Cancer. Dr Bravi was a Fellow of the Rosario Samanin Fund. Dr La Vecchia performed the research for this paper as a Senior Fellow at the International Agency for Research on Cancer.

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