title: Mediterranean diet and risk of endometrial cancer: a pooled analysis of three Italian case-control studies.
abstract: BACKGROUND
  Some components of the Mediterranean diet have favourable effects on endometrial cancer, and the Mediterranean diet as a whole has been shown to have a beneficial role on various neoplasms.
  
  
  METHODS
  We analysed this issue pooling data from three case-control studies carried out between 1983 and 2006 in various Italian areas and in the Swiss Canton of Vaud. Cases were 1411 women with incident, histologically confirmed endometrial cancer, and controls were 3668 patients in hospital for acute diseases. We measured the adherence to the Mediterranean diet using a Mediterranean Diet Score (MDS), based on the nine dietary components characteristics of this diet, that is, high intake of vegetables, fruits/nuts, cereals, legumes, fish; low intake of dairy products and meat; high monounsaturated to saturated fatty acid ratio; and moderate alcohol intake. We estimated the odds ratios (OR) and the corresponding 95% confidence intervals (CI) for increasing levels of the MDS (varying from 0, no adherence, to 9, maximum adherence) using multiple logistic regression models, adjusted for major confounding factors.
  
  
  RESULTS
  The adjusted OR for a 6-9 components of the MDS (high adherence) compared with 0-3 (low adherence) was 0.43 (95% CI 0.34-0.56). The OR for an increment of one component of MDS diet was 0.84 (95% CI 0.80-0.88). The association was consistent in strata of various covariates, although somewhat stronger in older women, in never oral contraceptive users and in hormone-replacement therapy users.
  
  
  CONCLUSIONS
  Our study provides evidence for a beneficial role of the Mediterranean diet on endometrial cancer risk, suggesting a favourable effect of a combination of foods rich in antioxidants, fibres, phytochemicals, and unsaturated fatty acids.
authors.affiliation: Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri, Via Giuseppe La Masa 19, 20156 Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Filomeno
authors.affiliation: Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri, Via Giuseppe La Masa 19, 20156 Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bosetti
authors.affiliation: S.O.C. Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, IRCCS, 33081 Aviano (PN), Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bidoli
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, 1010 Lausanne, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Levi
authors.affiliation: S.O.C. Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, IRCCS, 33081 Aviano (PN), Italy.
authors.forename: D
authors.initials: D
authors.lastname: Serraino
authors.affiliation: Unit of Epidemiology, Struttura Complessa di Statistica Medica, Biometria e Bioinformatica, Fondazione IRCCS Istituto Nazionale Tumori, 80131 Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Montella
authors.affiliation: Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133 Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
authors.affiliation: Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri, Via Giuseppe La Masa 19, 20156 Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Tavani
mesh_terms: D016022:Case-Control Studies; D038441:Diet, Mediterranean; D016889:Endometrial Neoplasms / Q000178:diet therapy* / Q000453:epidemiology* / Q000473:pathology; D005006:Ethnicity; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D012307:Risk Factors; D013557:Switzerland; D014675:Vegetables