Long-chain ω-3 fatty acid intake and endometrial cancer risk in the Women’s Health Initiative

Brasky, Theodore M.; Rodabough, Rebecca J.; Liu, Jingmin; Kurta, Michelle L.; Wise, Lauren A.; Orchard, Tonya; Cohn, David E.; Belury, Martha A.; White, Emily; Manson, JoAnn E.; Neuhouser, Marian L.

doi:10.3945/ajcn.114.098988

Cited by 17 publications

(23 citation statements)

References 51 publications

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“…Inverse associations are not supported by previous studies, which have found no associations between intakes of these fatty acids and risk of endometrial cancer (16,17,29).…”

Section: Discussioncontrasting

confidence: 45%

“…However, in the VITAL Study, we reported 175% linear increases in endometrial cancer risk among overweight/obese women (16) which were not subsequently replicated in the much larger WHI (17). In each study, associations reported for fish intake (especially baked or broiled fish) were similar to those reported for the LC ω-3 PUFAs.…”

supporting

confidence: 64%

“…Researchers in 2 prospective cohort studies (16,17) and 1 population-based case-control study (29) have reported on associations between LC ω-3 PUFAs and endometrial cancer risk in predominantly white study populations. Findings are somewhat inconsistent.…”

Section: Discussionmentioning

confidence: 99%

“…In the largest study of this topic to date (to our knowledge), we recently examined these associations in the WHI (n = 5,745 African Americans (<7%)) (17). Relative to women who consumed the lowest amount of LC ω-3 PUFAs (EPA + DPA + DHA), women who consumed the most had a 19% reduced risk (HR = 0.81, 95% CI: 0.66, 1.00; P-trend = 0.04) of endometrial cancer.…”

Section: Discussionmentioning

confidence: 99%

“…200 Brasky et al (17). However, in the VITAL Study, we reported 175% linear increases in endometrial cancer risk among overweight/obese women (16) which were not subsequently replicated in the much larger WHI (17).…”

mentioning

confidence: 96%

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Associations of Dietary Long-Chain ω-3 Polyunsaturated Fatty Acids and Fish Consumption With Endometrial Cancer Risk in the Black Women's Health Study

Brasky¹,

Sponholtz²,

Palmer³

et al. 2016

Am. J. Epidemiol.

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Dietary long-chain (LC) ω-3 polyunsaturated fatty acids (PUFAs), which derive primarily from intakes of fatty fish, are thought to inhibit inflammation and de novo estrogen synthesis. This study prospectively examined the associations of dietary LC ω-3 PUFAs and fish with endometrial cancer risk in 47,602 African-American women living in the United States, aged 21-69 years at baseline in 1995, and followed them until 2013 (n = 282 cases). Multivariable-adjusted Cox regression models estimated hazard ratios and 95% confidence intervals for associations of LC ω-3 PUFA (quintiled) and fish (quartiled) intake with endometrial cancer risk, overall and by body mass index (BMI; weight (kg)/height (m) 2 ). The hazard ratio for quintile 5 of total dietary LC ω-3 PUFAs versus quintile 1 was 0.79 (95% confidence interval (CI): 0.51, 1.24); there was no linear trend. Hazard ratios for the association were smaller among normal-weight women (BMI <25: hazard ratio (HR) = 0.53, 95% CI: 0.18, 1.58) than among overweight/ obese women (BMI ≥25: HR = 0.88, 95% CI: 0.54, 1.43), but these differences were not statistically significant. Fish intake was also not associated with risk (quartile 4 vs. quartile 1: HR = 0.86, 95% CI: 0.56, 1.31). Again hazard ratios were smaller among normal-weight women (HR = 0.65) than among overweight/obese women (HR = 0.94). While compatible with no association, the hazard ratios observed among leaner African-American women are similar to those from recent prospective studies conducted in predominantly white populations.African-American women; docosahexaenoic acid; eicosapentaenoic acid; endometrial cancer; fish; uterine cancer; women's reproductive health Abbreviations: BMI, body mass index; BWHS, Black Women's Health Study; CI, confidence interval; DHA, docosahexaenoic acid; DPA, docosapentaenoic acid; EPA, eicosapentaenoic acid; FFQ, food frequency questionnaire; HR, hazard ratio; LC, long-chain; PUFA, polyunsaturated fatty acid; VITAL, Vitamins and Lifestyle; WHI, Women's Health Initiative.Endometrial cancer is the fourth most common cancer and the leading gynecological malignancy diagnosed in US women (1). Incidence rates are about 9% lower for African-American women relative to white women (2), but a recent study of Surveillance, Epidemiology, and End Results data that corrected for hysterectomy prevalence indicated a higher incidence in black women (3).

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“…Inverse associations are not supported by previous studies, which have found no associations between intakes of these fatty acids and risk of endometrial cancer (16,17,29).…”

Section: Discussioncontrasting

confidence: 45%

supporting

confidence: 64%