Abstract
Epidemiological studies have provided controversial evidence of the association between dietary fatty acids intake and endometrial cancer risk. The continuous update project of World Cancer Research Fund failed to focus on this issue. To address this inconsistency, we conducted this dose-response meta-analysis based on epidemiological studies published up to the end of June 2015 identified from PubMed, EMBASE and Web of Science. Two authors independently performed the eligibility evaluation and data extraction. Random-effects models were used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs). Fourteen epidemiological studies (4 cohort and 10 case-control studies) were included in this dose-response meta-analysis. The summary RR for an intake increment of 10g/day was 1.02 (95% CI = 0.97-1.08; I2 = 66.0%) for saturated fatty acids, 0.98 (95% CI = 0.96-1.001; I2 = 0%) for monounsaturated fatty acids, and 1.00 (95% CI = 0.95-1.06; I2 = 0%) for polyunsaturated fatty acids intake. Non-significant results were observed in the majority of subgroup analyses stratified by study characteristics and adjustment for potential confounders in analyses of aforementioned associations. In conclusion, results from this dose-response meta-analysis provided limited evidence that dietary saturated, monounsaturated, and polyunsaturated fatty acids consumption was associated with endometrial cancer risk. Further studies, especial prospective designed or pooled studies are warranted to confirm our findings.
Highlights
About 320,000 new cases of endometrial cancer (EC) were diagnosed and nearly 76,000 deaths from this disease occurred worldwide in 2012 [1]
In vitro and in vivo studies have indicated that dietary fat and fatty acids (FA) intake have been proposed to influence EC risk by modulating the production, metabolism, and excretion of endogenous hormones [3,4,5,6,7]
Risk measures were adjusted for body mass index (13 studies), total energy intake (13 studies), parity (12 studies), hormone replacement therapy (12 studies), oral contraceptive use (11 studies), cigarette smoking (11 studies), and menopausal status (9 studies)
Summary
About 320,000 new cases of endometrial cancer (EC) were diagnosed and nearly 76,000 deaths from this disease occurred worldwide in 2012 [1]. By comparison with Africa and South Asia, the incidence rates of this disease were higher in North America and Europe [1] This discrepancy could not be totally attributed to these well established risk factors including obesity, reproductive factors (e.g., parity, age at menarche), and use of exogenous hormones (e.g., estrogen hormonal replacement therapy, oral contraceptives) [2]. The continuous update project of World Cancer Research Fund and American Institute for Cancer Research (WCRF/AICR) including studies up to December 2012 only investigated the association between total dietary fat intake and EC risk which indicated limited evidence [8]. During the recent five years, the findings from one of the largest population-based cohort studies, the European Prospective Investigation into Cancer and Nutrition (EPIC) found non-significant result of saturated and polyunsaturated FA but suggested significant result of monounsaturated FA intake with EC risk [9]. We carried out this dose-response meta-analysis of epidemiological studies to assess the aforementioned associations
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