Dietary omega-3 fatty acids and endometrial cancer risk in the Epidemiology of Endometrial Cancer Consortium: An individual-participant meta-analysis

Theodore M Brasky; Erinn M Hade; David E Cohn; Alison M Newton; Stacey Petruzella; Kelli O'Connell; Kimberly A Bertrand; Linda S Cook; Immaculata De Vivo; Mengmeng Du; Jo L Freudenheim; Christine M Friedenreich; Marc T Goodman; Jessica Gorzelitz; Torukiri I Ibiebele; Vittorio Krogh; Linda M Liao; Loren Lipworth; Lingeng Lu; Susan McCann; Tracy A O'Mara; Julie R Palmer; Jeanette Ponte; Anna Prizment; Harvey Risch; Sven Sandin; Leo J Schouten; Veronica Wendy Setiawan; Xiao-Ou Shu; Britton Trabert; Piet A van den Brandt; Penelope M Webb; Nicolas Wentzensen; Lynne R Wilkens; Alicja Wolk; Herbert Yu; Marian L Neuhouser

doi:10.1016/j.ygyno.2022.10.015

Dietary omega-3 fatty acids and endometrial cancer risk in the Epidemiology of Endometrial Cancer Consortium: An individual-participant meta-analysis

Theodore M Brasky^*, Erinn M Hade, David E Cohn, Alison M Newton, Stacey Petruzella, Kelli O'Connell, Kimberly A Bertrand, Linda S Cook, Immaculata De Vivo, Mengmeng Du, Jo L Freudenheim, Christine M Friedenreich, Marc T Goodman, Jessica Gorzelitz, Torukiri I Ibiebele, Vittorio Krogh, Linda M Liao, Loren Lipworth, Lingeng Lu, Susan McCannTracy A O'Mara, Julie R Palmer, Jeanette Ponte, Anna Prizment, Harvey Risch, Sven Sandin, Leo J Schouten, Veronica Wendy Setiawan, Xiao-Ou Shu, Britton Trabert, Piet A van den Brandt, Penelope M Webb, Nicolas Wentzensen, Lynne R Wilkens, Alicja Wolk, Herbert Yu, Marian L Neuhouser

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: Limited data from prospective studies suggest that higher dietary intake of long-chain omega-3 polyunsaturated fatty acids (LCn3PUFA), which hold anti-inflammatory properties, may reduce endometrial cancer risk; particularly among certain subgroups characterized by body mass and tumor pathology.

MATERIALS AND METHODS: Data from 12 prospective cohort studies participating in the Epidemiology of Endometrial Cancer Consortium were harmonized as nested case-control studies, including 7268 endometrial cancer cases and 26,133 controls. Habitual diet was assessed by food frequency questionnaire, from which fatty acid intakes were estimated. Two-stage individual-participant data mixed effects meta-analysis estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) through logistic regression for associations between study-specific energy-adjusted quartiles of LCn3PUFA and endometrial cancer risk.

RESULTS: Women with the highest versus lowest estimated dietary intakes of docosahexaenoic acid, the most abundant LCn3PUFA in diet, had a 9% increased endometrial cancer risk (Quartile 4 vs. Quartile 1: OR 1.09, 95% CI: 1.01-1.19; P trend = 0.04). Similar elevated risks were observed for the summary measure of total LCn3PUFA (OR 1.07, 95% CI: 0.99-1.16; P trend = 0.06). Stratified by body mass index, higher intakes of LCn3PUFA were associated with 12-19% increased endometrial cancer risk among overweight/obese women and no increased risk among normal-weight women. Higher associations appeared restricted to White women. The results did not differ by cancer grade.

CONCLUSION: Higher dietary intakes of LCn3PUFA are unlikely to reduce endometrial cancer incidence; rather, they may be associated with small to moderate increases in risk in some subgroups of women, particularly overweight/obese women.

Original language	English
Pages (from-to)	137-146
Number of pages	10
Journal	Gynecologic Oncology
Volume	169
Issue number	1
DOIs	https://doi.org/10.1016/j.ygyno.2022.10.015
Publication status	Published - Feb 2023

Keywords

Humans
Female
Prospective Studies
Overweight
Fatty Acids, Omega-3
Diet
Obesity/epidemiology
Endometrial Neoplasms/epidemiology
Logistic Models
Risk Factors

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Brasky, T. M., Hade, E. M., Cohn, D. E., Newton, A. M., Petruzella, S., O'Connell, K., Bertrand, K. A., Cook, L. S., De Vivo, I., Du, M., Freudenheim, J. L., Friedenreich, C. M., Goodman, M. T., Gorzelitz, J., Ibiebele, T. I., Krogh, V., Liao, L. M., Lipworth, L., Lu, L., ... Neuhouser, M. L. (2023). Dietary omega-3 fatty acids and endometrial cancer risk in the Epidemiology of Endometrial Cancer Consortium: An individual-participant meta-analysis. Gynecologic Oncology, 169(1), 137-146. https://doi.org/10.1016/j.ygyno.2022.10.015

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title = "Dietary omega-3 fatty acids and endometrial cancer risk in the Epidemiology of Endometrial Cancer Consortium: An individual-participant meta-analysis",

abstract = "BACKGROUND: Limited data from prospective studies suggest that higher dietary intake of long-chain omega-3 polyunsaturated fatty acids (LCn3PUFA), which hold anti-inflammatory properties, may reduce endometrial cancer risk; particularly among certain subgroups characterized by body mass and tumor pathology.MATERIALS AND METHODS: Data from 12 prospective cohort studies participating in the Epidemiology of Endometrial Cancer Consortium were harmonized as nested case-control studies, including 7268 endometrial cancer cases and 26,133 controls. Habitual diet was assessed by food frequency questionnaire, from which fatty acid intakes were estimated. Two-stage individual-participant data mixed effects meta-analysis estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) through logistic regression for associations between study-specific energy-adjusted quartiles of LCn3PUFA and endometrial cancer risk.RESULTS: Women with the highest versus lowest estimated dietary intakes of docosahexaenoic acid, the most abundant LCn3PUFA in diet, had a 9% increased endometrial cancer risk (Quartile 4 vs. Quartile 1: OR 1.09, 95% CI: 1.01-1.19; P trend = 0.04). Similar elevated risks were observed for the summary measure of total LCn3PUFA (OR 1.07, 95% CI: 0.99-1.16; P trend = 0.06). Stratified by body mass index, higher intakes of LCn3PUFA were associated with 12-19% increased endometrial cancer risk among overweight/obese women and no increased risk among normal-weight women. Higher associations appeared restricted to White women. The results did not differ by cancer grade.CONCLUSION: Higher dietary intakes of LCn3PUFA are unlikely to reduce endometrial cancer incidence; rather, they may be associated with small to moderate increases in risk in some subgroups of women, particularly overweight/obese women.",

keywords = "Humans, Female, Prospective Studies, Overweight, Fatty Acids, Omega-3, Diet, Obesity/epidemiology, Endometrial Neoplasms/epidemiology, Logistic Models, Risk Factors",

author = "Brasky, {Theodore M} and Hade, {Erinn M} and Cohn, {David E} and Newton, {Alison M} and Stacey Petruzella and Kelli O'Connell and Bertrand, {Kimberly A} and Cook, {Linda S} and {De Vivo}, Immaculata and Mengmeng Du and Freudenheim, {Jo L} and Friedenreich, {Christine M} and Goodman, {Marc T} and Jessica Gorzelitz and Ibiebele, {Torukiri I} and Vittorio Krogh and Liao, {Linda M} and Loren Lipworth and Lingeng Lu and Susan McCann and O'Mara, {Tracy A} and Palmer, {Julie R} and Jeanette Ponte and Anna Prizment and Harvey Risch and Sven Sandin and Schouten, {Leo J} and Setiawan, {Veronica Wendy} and Xiao-Ou Shu and Britton Trabert and {van den Brandt}, {Piet A} and Webb, {Penelope M} and Nicolas Wentzensen and Wilkens, {Lynne R} and Alicja Wolk and Herbert Yu and Neuhouser, {Marian L}",

year = "2023",

month = feb,

doi = "10.1016/j.ygyno.2022.10.015",

language = "English",

volume = "169",

pages = "137--146",

journal = "Gynecologic Oncology",

issn = "0090-8258",

publisher = "Elsevier Science",

number = "1",

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Brasky, TM, Hade, EM, Cohn, DE, Newton, AM, Petruzella, S, O'Connell, K, Bertrand, KA, Cook, LS, De Vivo, I, Du, M, Freudenheim, JL, Friedenreich, CM, Goodman, MT, Gorzelitz, J, Ibiebele, TI, Krogh, V, Liao, LM, Lipworth, L, Lu, L, McCann, S, O'Mara, TA, Palmer, JR, Ponte, J, Prizment, A, Risch, H, Sandin, S, Schouten, LJ, Setiawan, VW, Shu, X-O, Trabert, B, van den Brandt, PA, Webb, PM, Wentzensen, N, Wilkens, LR, Wolk, A, Yu, H & Neuhouser, ML 2023, 'Dietary omega-3 fatty acids and endometrial cancer risk in the Epidemiology of Endometrial Cancer Consortium: An individual-participant meta-analysis', Gynecologic Oncology, vol. 169, no. 1, pp. 137-146. https://doi.org/10.1016/j.ygyno.2022.10.015

TY - JOUR

T1 - Dietary omega-3 fatty acids and endometrial cancer risk in the Epidemiology of Endometrial Cancer Consortium

T2 - An individual-participant meta-analysis

AU - Brasky, Theodore M

AU - Hade, Erinn M

AU - Cohn, David E

AU - Newton, Alison M

AU - Petruzella, Stacey

AU - O'Connell, Kelli

AU - Bertrand, Kimberly A

AU - Cook, Linda S

AU - De Vivo, Immaculata

AU - Du, Mengmeng

AU - Freudenheim, Jo L

AU - Friedenreich, Christine M

AU - Goodman, Marc T

AU - Gorzelitz, Jessica

AU - Ibiebele, Torukiri I

AU - Krogh, Vittorio

AU - Liao, Linda M

AU - Lipworth, Loren

AU - Lu, Lingeng

AU - McCann, Susan

AU - O'Mara, Tracy A

AU - Palmer, Julie R

AU - Ponte, Jeanette

AU - Prizment, Anna

AU - Risch, Harvey

AU - Sandin, Sven

AU - Schouten, Leo J

AU - Setiawan, Veronica Wendy

AU - Shu, Xiao-Ou

AU - Trabert, Britton

AU - van den Brandt, Piet A

AU - Webb, Penelope M

AU - Wentzensen, Nicolas

AU - Wilkens, Lynne R

AU - Wolk, Alicja

AU - Yu, Herbert

AU - Neuhouser, Marian L

PY - 2023/2

Y1 - 2023/2

N2 - BACKGROUND: Limited data from prospective studies suggest that higher dietary intake of long-chain omega-3 polyunsaturated fatty acids (LCn3PUFA), which hold anti-inflammatory properties, may reduce endometrial cancer risk; particularly among certain subgroups characterized by body mass and tumor pathology.MATERIALS AND METHODS: Data from 12 prospective cohort studies participating in the Epidemiology of Endometrial Cancer Consortium were harmonized as nested case-control studies, including 7268 endometrial cancer cases and 26,133 controls. Habitual diet was assessed by food frequency questionnaire, from which fatty acid intakes were estimated. Two-stage individual-participant data mixed effects meta-analysis estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) through logistic regression for associations between study-specific energy-adjusted quartiles of LCn3PUFA and endometrial cancer risk.RESULTS: Women with the highest versus lowest estimated dietary intakes of docosahexaenoic acid, the most abundant LCn3PUFA in diet, had a 9% increased endometrial cancer risk (Quartile 4 vs. Quartile 1: OR 1.09, 95% CI: 1.01-1.19; P trend = 0.04). Similar elevated risks were observed for the summary measure of total LCn3PUFA (OR 1.07, 95% CI: 0.99-1.16; P trend = 0.06). Stratified by body mass index, higher intakes of LCn3PUFA were associated with 12-19% increased endometrial cancer risk among overweight/obese women and no increased risk among normal-weight women. Higher associations appeared restricted to White women. The results did not differ by cancer grade.CONCLUSION: Higher dietary intakes of LCn3PUFA are unlikely to reduce endometrial cancer incidence; rather, they may be associated with small to moderate increases in risk in some subgroups of women, particularly overweight/obese women.

AB - BACKGROUND: Limited data from prospective studies suggest that higher dietary intake of long-chain omega-3 polyunsaturated fatty acids (LCn3PUFA), which hold anti-inflammatory properties, may reduce endometrial cancer risk; particularly among certain subgroups characterized by body mass and tumor pathology.MATERIALS AND METHODS: Data from 12 prospective cohort studies participating in the Epidemiology of Endometrial Cancer Consortium were harmonized as nested case-control studies, including 7268 endometrial cancer cases and 26,133 controls. Habitual diet was assessed by food frequency questionnaire, from which fatty acid intakes were estimated. Two-stage individual-participant data mixed effects meta-analysis estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) through logistic regression for associations between study-specific energy-adjusted quartiles of LCn3PUFA and endometrial cancer risk.RESULTS: Women with the highest versus lowest estimated dietary intakes of docosahexaenoic acid, the most abundant LCn3PUFA in diet, had a 9% increased endometrial cancer risk (Quartile 4 vs. Quartile 1: OR 1.09, 95% CI: 1.01-1.19; P trend = 0.04). Similar elevated risks were observed for the summary measure of total LCn3PUFA (OR 1.07, 95% CI: 0.99-1.16; P trend = 0.06). Stratified by body mass index, higher intakes of LCn3PUFA were associated with 12-19% increased endometrial cancer risk among overweight/obese women and no increased risk among normal-weight women. Higher associations appeared restricted to White women. The results did not differ by cancer grade.CONCLUSION: Higher dietary intakes of LCn3PUFA are unlikely to reduce endometrial cancer incidence; rather, they may be associated with small to moderate increases in risk in some subgroups of women, particularly overweight/obese women.

KW - Humans

KW - Female

KW - Prospective Studies

KW - Overweight

KW - Fatty Acids, Omega-3

KW - Diet

KW - Obesity/epidemiology

KW - Endometrial Neoplasms/epidemiology

KW - Logistic Models

KW - Risk Factors

U2 - 10.1016/j.ygyno.2022.10.015

DO - 10.1016/j.ygyno.2022.10.015

M3 - Article

C2 - 36934308

SN - 0090-8258

VL - 169

SP - 137

EP - 146

JO - Gynecologic Oncology

JF - Gynecologic Oncology

IS - 1

ER -