title: Legume, soy, tofu, and isoflavone intake and endometrial cancer risk in postmenopausal women in the multiethnic cohort study.
abstract: BACKGROUND
  Phytochemicals found in soy and other legumes have been speculated to reduce the risk of endometrial cancer; however, inconsistent findings have been reported in the few epidemiological studies conducted to date.
  
  
  METHODS
  We conducted a prospective analysis of 46 027 nonhysterectomized postmenopausal women who were recruited into the Multiethnic Cohort (MEC) Study between August 1993 and August 1996 and provided detailed baseline information on diet and other endometrial cancer risk factors. A total of 489 women diagnosed with incident endometrial cancer were identified through the Surveillance, Epidemiology, and End Results tumor registry linkages during a median follow-up period of 13.6 years. Cox proportional hazards models were used to estimate multivariable-adjusted relative risks (RRs) and 95% confidence intervals (CIs) for endometrial cancer associated with dietary intake of legumes, soy, and tofu, and for total isoflavones and specific isoflavones (daidzein, genistein, or glycitein). Truncated (age 50-89 years) age-adjusted incidence rates were calculated by applying age-specific rates within isoflavone quintiles to the overall MEC population eligible for endometrial cancer. To estimate the percentage of endometrial cancers that may have been prevented by consuming the highest quintile of total isoflavones, the partial population attributable risk percent was calculated.
  
  
  RESULTS
  A reduced risk of endometrial cancer was associated with total isoflavone intake (highest vs lowest quintile, ≥7.82 vs <1.59 mg per 1000 kcal/d, RR = 0.66, 95% CI = 0.47 to 0.91), daidzein intake (highest vs lowest quintile, ≥3.54 vs <0.70 mg per 1000 kcal/d, RR = 0.64, 95% CI = 0.46 to 0.90), and genistein intake (highest vs lowest quintile, ≥3.40 vs <0.69 mg per 1000 kcal/d, RR = 0.66, 95% CI = 0.47 to 0.91). No statistically significant association with endometrial cancer risk was observed for increasing intake of legumes, soy, tofu, or glycitein. Truncated age-adjusted incidence rates of endometrial cancer for the highest vs lowest quintile of total isoflavone intake were 55 vs 107 per 100 000 women per year, respectively. The partial population attributable risk percent for total isoflavone intake lower than the highest quintile was 26.7% (95% CI = 5.3% to 45.8%).
  
  
  CONCLUSIONS
  This study suggests that greater consumption of isoflavone-containing foods is associated with a reduced risk of endometrial cancer in this population of nonhysterectomized postmenopausal women.
authors.affiliation: University of Hawaii Cancer Center, Epidemiology Program, Honolulu, HI 96813, USA. nollberding@cc.hawaii.edu
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Ollberding
authors.forename: Unhee
authors.initials: U
authors.lastname: Lim
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Wilkens
authors.forename: Veronica Wendy
authors.initials: VW
authors.lastname: Setiawan
authors.forename: Yurii B
authors.initials: YB
authors.lastname: Shvetsov
authors.forename: Brian E
authors.initials: BE
authors.lastname: Henderson
authors.forename: Laurence N
authors.initials: LN
authors.lastname: Kolonel
authors.forename: Marc T
authors.initials: MT
authors.lastname: Goodman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology*; D007887:Fabaceae; D005247:Feeding Behavior; D005260:Female; D020022:Genetic Predisposition to Disease; D019833:Genistein / Q000494:pharmacology; D006131:Growth Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D015994:Incidence; D007529:Isoflavones / Q000494:pharmacology; D008019:Life Style; D008875:Middle Aged; D048789:Phytoestrogens / Q000008:administration & dosage / Q000494:pharmacology*; D017698:Postmenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018426:SEER Program; D045730:Soy Foods; D013025:Glycine max; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D006131:Growth Inhibitors; D007529:Isoflavones; D048789:Phytoestrogens; C004742:daidzein; C086566:glycitein; D019833:Genistein