title: Investigation of dietary factors and endometrial cancer risk using a nutrient-wide association study approach in the EPIC and Nurses' Health Study (NHS) and NHSII.
abstract: Data on the role of dietary factors in endometrial cancer development are limited and inconsistent. We applied a "nutrient-wide association study" approach to systematically evaluate dietary risk associations for endometrial cancer while controlling for multiple hypothesis tests using the false discovery rate (FDR) and validating the results in an independent cohort. We evaluated endometrial cancer risk associations for dietary intake of 84 foods and nutrients based on dietary questionnaires in three prospective studies, the European Prospective Investigation into Cancer and Nutrition (EPIC; N = 1,303 cases) followed by validation of nine foods/nutrients (FDR ≤ 0.10) in the Nurses' Health Studies (NHS/NHSII; N = 1,531 cases). Cox regression models were used to estimate HRs and 95% confidence intervals (CI). In multivariate adjusted comparisons of the extreme categories of intake at baseline, coffee was inversely associated with endometrial cancer risk (EPIC, median intake 750 g/day vs. 8.6; HR, 0.81; 95% CI, 0.68-0.97, Ptrend = 0.09; NHS/NHSII, median intake 1067 g/day vs. none; HR, 0.82; 95% CI, 0.70-0.96, Ptrend = 0.04). Eight other dietary factors that were associated with endometrial cancer risk in the EPIC study (total fat, monounsaturated fat, carbohydrates, phosphorus, butter, yogurt, cheese, and potatoes) were not confirmed in the NHS/NHSII. Our findings suggest that coffee intake may be inversely associated with endometrial cancer risk. Further data are needed to confirm these findings and to examine the mechanisms linking coffee intake to endometrial cancer risk to develop improved prevention strategies.
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. m.merritt@imperial.ac.uk.
authors: Melissa A
authors: MA
authors: Merritt
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
authors: Ioanna
authors: I
authors: Tzoulaki
authors: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
authors: Shelley S
authors: SS
authors: Tworoger
authors: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts. Program in Genetic Epidemiology and Statistical Genetics, Harvard School of Public Health, Boston, Massachusetts.
authors: Immaculata
authors: I
authors: De Vivo
authors: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts. Division of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts.
authors: Susan E
authors: SE
authors: Hankinson
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
authors: Judy
authors: J
authors: Fernandes
authors: Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom.
authors: Konstantinos K
authors: KK
authors: Tsilidis
authors: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. Department of Research, Cancer Registry of Norway, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Department of Genetic Epidemiology, Samfundet Folkhälsan, Helsinki, Finland.
authors: Elisabete
authors: E
authors: Weiderpass
authors: Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Anne
authors: A
authors: Tjønneland
authors: Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Kristina E N
authors: KE
authors: Petersen
authors: Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors: Christina C
authors: CC
authors: Dahm
authors: Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors: Kim
authors: K
authors: Overvad
authors: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France. University Paris Sud, Villejuif, France. IGR, Villejuif, France.
authors: Laure
authors: L
authors: Dossus
authors: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France. University Paris Sud, Villejuif, France. IGR, Villejuif, France.
authors: Marie-Christine
authors: MC
authors: Boutron-Ruault
authors: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France. University Paris Sud, Villejuif, France. IGR, Villejuif, France.
authors: Guy
authors: G
authors: Fagherazzi
authors: Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors: Renée T
authors: RT
authors: Fortner
authors: Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors: Rudolf
authors: R
authors: Kaaks
authors: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
authors: Krasimira
authors: K
authors: Aleksandrova
authors: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
authors: Heiner
authors: H
authors: Boeing
authors: Hellenic Health Foundation, Athens, Greece. Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.
authors: Antonia
authors: A
authors: Trichopoulou
authors: Department of Hygiene, Epidemiology, and Medical Statistics, University of Athens Medical School, Athens, Greece.
authors: Christina
authors: C
authors: Bamia
authors: Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts. Hellenic Health Foundation, Athens, Greece. Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.
authors: Dimitrios
authors: D
authors: Trichopoulos
authors: Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy.
authors: Domenico
authors: D
authors: Palli
authors: Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors: Sara
authors: S
authors: Grioni
authors: Cancer Registry and Histopathology Unit, "Civic-M.P. Arezzo" Hospital, ASP, Ragusa, Italy.
authors: Rosario
authors: R
authors: Tumino
authors: Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza-University of Turin and Center for Cancer Prevention (CPO-Piemonte), Turin, Italy. Human Genetics Foundation (HuGeF), Turin, Italy.
authors: Carlotta
authors: C
authors: Sacerdote
authors: Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
authors: Amalia
authors: A
authors: Mattiello
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands. Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors: H Bas
authors: HB
authors: Bueno-de-Mesquita
authors: Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.
authors: N Charlotte
authors: NC
authors: Onland-Moret
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.
authors: Petra H
authors: PH
authors: Peeters
authors: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
authors: Inger T
authors: IT
authors: Gram
authors: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
authors: Guri
authors: G
authors: Skeie
authors: Public Health Directorate, Asturias, Spain.
authors: J Ramón
authors: JR
authors: Quirós
authors: Unit of Nutrition, Environment, and Cancer, Cancer Epidemiology Research Program, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology (ICO), Barcelona, Spain.
authors: Eric J
authors: EJ
authors: Duell
authors: Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada, Spain. CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors: María-José
authors: MJ
authors: Sánchez
authors: CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain.
authors: D
authors: D
authors: Salmerón
authors: CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Navarre Public Health Institute, Pamplona, Spain.
authors: Aurelio
authors: A
authors: Barricarte
authors: Public Health Department of Gipuzkoa, Government of the Basque Country, San Sebastian, Spain. BioDonostia Research Institute, San Sebastian, Spain.
authors: Saioa
authors: S
authors: Chamosa
authors: Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
authors: Ulrica
authors: U
authors: Ericson
authors: Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
authors: Emily
authors: E
authors: Sonestedt
authors: Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden. Arcum, Arctic Research Centre at Umeå University, Umeå, Sweden.
authors: Lena Maria
authors: LM
authors: Nilsson
authors: Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.
authors: Annika
authors: A
authors: Idahl
authors: University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom.
authors: Kay-Tee
authors: KT
authors: Khaw
authors: MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
authors: Nicholas
authors: N
authors: Wareham
authors: Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
authors: Ruth C
authors: RC
authors: Travis
authors: International Agency for Research on Cancer, Lyon, France.
authors: Sabina
authors: S
authors: Rinaldi
authors: International Agency for Research on Cancer, Lyon, France.
authors: Isabelle
authors: I
authors: Romieu
authors: Center for Biomedical Informatics, Harvard Medical School, Boston, Massachusetts.
authors: Chirag J
authors: CJ
authors: Patel
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
authors: Elio
authors: E
authors: Riboli
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
authors: Marc J
authors: MJ
authors: Gunter
mesh_terms: D000328:Adult; D004032:Diet; D015930:Diet Records; D016889:Endometrial Neoplasms / Q000453:epidemiology*; D016021:Epidemiologic Studies; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D011795:Surveys and Questionnaires