Abstract
Epidemiological studies are inconclusive regarding the association between dietary fiber intake and endometrial cancer risk. Thus, we aimed to conduct a meta-analysis to clarify the association between dietary fiber and endometrial cancer risk. We searched the PubMed and ISI Web databases for relevant studies through March 2018. The association between dietary fiber and endometrial cancer risk was evaluated by conducting a meta-analysis including 3 cohort and 12 case–control studies. A significant negative association was observed between total dietary fiber intake and endometrial cancer risk in 11 case–control studies (odds ratios (OR) 0.76, 95% confidence interval (CI): 0.64–0.89, I2 = 35.2%, p = 0.117), but a marginal positive association was observed in three cohort studies (relative risk (RR) 1.22, 95% CI: 1.00–1.49, I2 = 0.0%, p = 0.995). Particularly, a negative association was observed in North America (OR = 0.70, 95% CI: 0.59–0.83, I2 = 8.9%, p = 0.362). In addition, a positive association was observed in cereal fiber (RR = 1.26, 95% CI: 1.03–1.52, I2 = 0.0%, p = 0.530, 3 cohort studies) and a negative association was observed in vegetable fiber (OR = 0.74, 95% CI: 0.58–0.94, I2 = 0.0%, p = 0.445, 3 case–control studies). In conclusion, negative associations with endometrial cancer risk were observed for higher total dietary fiber intake and higher vegetable fiber intake in the case–control studies. However, results from the cohort studies suggested positive relationships of higher total fiber intake and higher cereal fiber intake with endometrial cancer risk.
Highlights
Endometrial cancer, ranking the fourth in incidence of all cancers in women, is the most common gynecologic cancer, especially in economically developed countries [1]
Based on the three studies, a marginal positive association was observed between dietary fiber intake and endometrial studies, a marginal positive association was observed between dietary fiber intake and endometrial cancer risk by comparing the highest category of cancer risk by comparing the highest category of dietary intake to the lowest category
Our meta-analysis supports an inverse association between total dietary fiber intake and risk of endometrial cancer in case-control studies, in studies conducted in North America
Summary
Endometrial cancer, ranking the fourth in incidence of all cancers in women, is the most common gynecologic cancer, especially in economically developed countries [1]. Nutrients 2018, 10, 945 estrogen exposure increases the chance of development of endometrial cancer [2]. It is biologically plausible to hypothesize an inverse association of dietary fiber intake with the risk of endometrial cancer. As a recognized healthy dietary pattern, higher dietary fiber intake reduces body fatness as reflected either by body mass index (BMI), weight, or waist circumference, hip circumference, and waist-to-hip ratio [7]. These obesity indexes were convincingly associated with an increased endometrial cancer risk [8]. High dietary fiber intake was related with the risk of diabetes and hypertension, which are risk factors for several cancers, including endometrial cancer [9]
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