American Journal of Epidemiology Vol. 146, No. 4: 294-306
Copyright © 1997 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
Association of Soy and Fiber Consumption with the Risk of Endometrial Cancer
1Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii Honolulu, HI
2Department of Preventive Medicine, University of Southern California Norris Comprehensive Cancer Center Los Angeles, CA
Reprint requests to Dr. Marc T. Goodman, Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, 1236 Lauhala Street, Honolulu, HI 96813
The authors conducted a case-control study among the multi-ethnic population of Hawaii to examine the role of dietary soy, fiber, and related foods and nutrients on the risk of endometrial cancer. Endometrial cancer cases (n = 332) diagnosed between 1985 and 1993 were identified from the five main ethnic groups in the state (Japanese, Caucasian, Native Hawaiian, Filipino, and Chinese) through the rapid-reporting system of the Hawaii Tumor Registry. Population controls (n = 511) were selected randomly from lists of female Oahu residents and matched to cases on age (±2.5 years) and ethnicity. All subjects were interviewed using a diet history questionnaire that included over 250 food items. Non-dietary risk factors for endometrial cancer included nulliparity, never using oral contraceptives, fertility drug use, use of unopposed estrogens, a history of diabetes mellitus or hypertension, and a high Quetelet's index (kg/m2). Energy intake from fat, but not from other sources, was positively associated with the risk of endometrial cancer. The authors also found a positive, monotonic relation of fat intake with the odds ratios for endometrial cancer after adjustment for energy intake. The consumption of fiber, but not starch, was inversely related to risk after adjustment for energy intake and other confounders. Similar inverse gradients in the odds ratios were obtained for crude fiber, non-starch polysaccharide, and dietary fiber. Sources of fiber, including cereal and vegetable and fruit fiber, were associated with a 29–46% reduction in risk for women in the highest quartiles of consumption. Vitamin A and possibly vitamin C, but not vitamin E, were also inversely associated with endometrial cancer, although trends were not strong. High consumption of soy products and other legumes was associated with a decreased risk of endometrial cancer (p for trend = 0.01; odds ratio = 0.46, 95% confidence interval 0.26–0.83) for the highest compared with the lowest quartile of soy intake. Similar reductions in risk were found for increased consumption of other sources of phytoestrogens such as whole grains, vegetables, fruits, and seaweeds. Ethnic-specific analyses were generally consistent with these results. The observed dietary associations appeared to be largely independent of other risk factors, although the effects of soy and legumes on risk were limited to women who were never pregnant or who had never used unopposed estrogens. These data suggest that plant-based diets low in calories from fat, high in fiber, and rich in legumes (especially soybeans), whole grain foods, vegetables, and fruits reduce the risk of endometrial cancer. These dietary associations may explain in part the reduced rates of uterine cancer in Asian countries compared with those in the United States. Am J Epidemiol 1997;146:294–306.
case-control studies; diet; dietary fiber; energy metabolism; fats; soybeans; uterine neoplasms
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Caserta, L. Maranghi, A. Mantovani, R. Marci, F. Maranghi, and M. Moscarini Impact of endocrine disruptor chemicals in gynaecology Hum. Reprod. Update, January 1, 2008; 14(1): 59 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. H. Xu, Q. Dai, Y. B. Xiang, J. R. Long, Z. X. Ruan, J. R. Cheng, W. Zheng, and X. O. Shu Interaction of Soy Food and Tea Consumption with CYP19A1 Genetic Polymorphisms in the Development of Endometrial Cancer Am. J. Epidemiol., December 15, 2007; 166(12): 1420 - 1430. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. V Bandera, L. H Kushi, D. F Moore, D. M Gifkins, and M. L McCullough Association between dietary fiber and endometrial cancer: a dose-response meta-analysis Am. J. Clinical Nutrition, December 1, 2007; 86(6): 1730 - 1737. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Cust, N. Slimani, R. Kaaks, M. van Bakel, C. Biessy, P. Ferrari, M. Laville, A. Tjonneland, A. Olsen, K. Overvad, et al. Dietary Carbohydrates, Glycemic Index, Glycemic Load, and Endometrial Cancer Risk within the European Prospective Investigation into Cancer and Nutrition Cohort Am. J. Epidemiol., October 15, 2007; 166(8): 912 - 923. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. McCullough, E. V. Bandera, R. Patel, A. V. Patel, T. Gansler, L. H. Kushi, M. J. Thun, and E. E. Calle A Prospective Study of Fruits, Vegetables, and Risk of Endometrial Cancer Am. J. Epidemiol., October 15, 2007; 166(8): 902 - 911. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. B. Michaud, J. P. Karpinski, K. L. Jones, and J. Espirito Dietary supplements in patients with cancer: Risks and key concepts, part 2 Am. J. Health Syst. Pharm., March 1, 2007; 64(5): 467 - 480. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. W. Setiawan, M. C. Pike, L. N. Kolonel, A. M. Nomura, M. T. Goodman, and B. E. Henderson Racial/Ethnic Differences in Endometrial Cancer Risk: The Multiethnic Cohort Study Am. J. Epidemiol., February 1, 2007; 165(3): 262 - 270. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Al-Nakkash, L. L. Clarke, G. E. Rottinghaus, Y. J. Chen, K. Cooper, and L. J. Rubin Dietary Genistein Stimulates Anion Secretion Across Female Murine Intestine J. Nutr., November 1, 2006; 136(11): 2785 - 2790. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. E. Wood, S. E. Appt, T. B. Clarkson, A. A. Franke, C. J. Lees, D. R. Doerge, and J. M. Cline Effects of High-Dose Soy Isoflavones and Equol on Reproductive Tissues in Female Cynomolgus Monkeys Biol Reprod, September 1, 2006; 75(3): 477 - 486. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Wang, Y. Zhang, Y. Li, S. Banerjee, J. Liao, and F. H. Sarkar Down-regulation of Notch-1 contributes to cell growth inhibition and apoptosis in pancreatic cancer cells. Mol. Cancer Ther., March 1, 2006; 5(3): 483 - 493. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. M. Sacks, A. Lichtenstein, L. Van Horn, W. Harris, P. Kris-Etherton, M. Winston, and for the American Heart Association Nutrition Commi Soy Protein, Isoflavones, and Cardiovascular Health: An American Heart Association Science Advisory for Professionals From the Nutrition Committee Circulation, February 21, 2006; 113(7): 1034 - 1044. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. M. Zhang, M. K. Cheung, K. Osann, M. M. Lee, S. S. Lin Gomez, A. S. Whittemore, A. Husain, N. N. Teng, and J. K. Chan Improved Survival of Asians With Corpus Cancer Compared With Whites: An Analysis of Underlying Factors Obstet. Gynecol., February 1, 2006; 107(2): 329 - 335. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. B. Schabath, L. M. Hernandez, X. Wu, P. C. Pillow, and M. R. Spitz Dietary Phytoestrogens and Lung Cancer Risk JAMA, September 28, 2005; 294(12): 1493 - 1504. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. E. Wood, T. C. Register, M. S. Anthony, N. D. Kock, and J. M. Cline Breast and Uterine Effects of Soy Isoflavones and Conjugated Equine Estrogens in Postmenopausal Female Monkeys J. Clin. Endocrinol. Metab., July 1, 2004; 89(7): 3462 - 3468. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. H. Xu, W. Zheng, Y. B. Xiang, Z. X. Ruan, J. R. Cheng, Q. Dai, Y. T. Gao, and X. O. Shu Soya food intake and risk of endometrial cancer among Chinese women in Shanghai: population based case-control study BMJ, May 29, 2004; 328(7451): 1285. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.-I. Katsuda, M. Yoshida, N. Saarinen, A. Smeds, D. Nakae, R. Santti, and A. Maekawa Chemopreventive Effects of Hydroxymatairesinol on Uterine Carcinogenesis in Donryu Rats Experimental Biology and Medicine, May 1, 2004; 229(5): 417 - 424. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. L. Horn-Ross, E. M. John, A. J. Canchola, S. L. Stewart, and M. M. Lee Phytoestrogen Intake and Endometrial Cancer Risk J Natl Cancer Inst, August 6, 2003; 95(15): 1158 - 1164. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Tsuda, A. Naito, C. K. Kim, K. Fukamachi, H. Nomoto, and M. A. Moore Carcinogenesis and Its Modification by Environmental Endocrine Disruptors: In Vivo Experimental and Epidemiological Findings Jpn. J. Clin. Oncol., June 1, 2003; 33(6): 259 - 270. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Greenwald Cancer Prevention Clinical Trials J. Clin. Oncol., September 15, 2002; 20(90001): 14s - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Balk, D. A. Whiteside, G. Naus, E. DeFerrari, and J. M. Roberts A Pilot Study of the Effects of Phytoestrogen Supplementation on Postmenopausal Endometrium Reproductive Sciences, July 1, 2002; 9(4): 238 - 242. [Abstract] [PDF]
|
|
|
|
 |
|
 J L Burton and M Wells The effect of phytoestrogens on the female genital tract J. Clin. Pathol., June 1, 2002; 55(6): 401 - 407. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G L Mutter Diagnosis of premalignant endometrial disease J. Clin. Pathol., May 1, 2002; 55(5): 326 - 331. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. I. Block, A. Constantinou, L. Hilakivi-Clarke, C. Hughes, D. Tripathy, J. A. Tice, K. Block, and K. Block Point-Counterpoint: Soy Intake for Breast Cancer Patients Integr Cancer Ther, March 1, 2002; 1(1): 90 - 100. [PDF]
|
|
|
|
|
|
M. J. J. de Kleijn, Y. T. van der Schouw, P. W. F. Wilson, D. E. Grobbee, and P. F. Jacques Dietary Intake of Phytoestrogens Is Associated with a Favorable Metabolic Cardiovascular Risk Profile in Postmenopausal U.S. Women: The Framingham Study J. Nutr., February 1, 2002; 132(2): 276 - 282. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. E. Hale, C. L. Hughes, and J. M. Cline Endometrial Cancer: Hormonal Factors, the Perimenopausal ""Window of Risk,"" and Isoflavones J. Clin. Endocrinol. Metab., January 1, 2002; 87(1): 3 - 15. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. B. Johnson, M. G. Muto, E. H. Yanushpolsky, and G. L. Mutter Phytoestrogen Supplementation and Endometrial Cancer Obstet. Gynecol., November 1, 2001; 98(5): 947 - 950. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. H. Kushi, J. E. Cunningham, J. R. Hebert, R. H. Lerman, E. V. Bandera, and J. Teas The Macrobiotic Diet in Cancer J. Nutr., November 1, 2001; 131(11): 3056S - 3064. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. J. de Kleijn, Y. T. van der Schouw, P. W. F. Wilson, H. Adlercreutz, W. Mazur, D. E. Grobbee, and P. F. Jacques Intake of Dietary Phytoestrogens Is Low in Postmenopausal Women in the United States: The Framingham Study1-4 J. Nutr., June 1, 2001; 131(6): 1826 - 1832. [Abstract] [Full Text]
|
|
|
|
 |
|
 Z. Weihua, S. Makela, L. C. Andersson, S. Salmi, S. Saji, J. I. Webster, E. V. Jensen, S. Nilsson, M. Warner, and J.-A. Gustafsson A role for estrogen receptor beta in the regulation of growth of the ventral prostate PNAS, May 22, 2001; 98(11): 6330 - 6335. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Diel, K. Smolnikar, T. Schulz, U. Laudenbach-Leschowski, H. Michna, and G. Vollmer Phytoestrogens and carcinogenesis--differential effects of genistein in experimental models of normal and malignant rat endometrium Hum. Reprod., May 1, 2001; 16(5): 997 - 1006. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L.-J. W. Lu, K. E. Anderson, J. J. Grady, F. Kohen, and M. Nagamani Decreased Ovarian Hormones during a Soya Diet: Implications for Breast Cancer Prevention Cancer Res., August 1, 2000; 60(15): 4112 - 4121. [Abstract] [Full Text]
|
|
|
|
 |
|
 N. M. Brown and C. A. Lamartiniere Genistein Regulation of Transforming Growth Factor-{{alpha}}, Epidermal Growth Factor (EGF), and EGF Receptor Expression in the Rat Uterus and Vagina Cell Growth Differ., May 1, 2000; 11(5): 255 - 260. [Abstract] [Full Text]
|
|
|
|
|
|
L.-J. W. Lu, M. Cree, S. Josyula, M. Nagamani, J. J. Grady, and K. E. Anderson Increased Urinary Excretion of 2-Hydroxyestrone but not 16{{alpha}}-Hydroxyestrone in Premenopausal Women during a Soya Diet Containing Isoflavones Cancer Res., March 1, 2000; 60(5): 1299 - 1305. [Abstract] [Full Text]
|
|
|
|
|
|
Poster Presentation Abstracts J. Nutr., March 1, 2000; 130(3): 680 - 680. [Full Text]
|
|
|
|
|
|
J. W Anderson, B. M Smith, and C. S Washnock Cardiovascular and renal benefits of dry bean and soybean intake Am. J. Clinical Nutrition, September 1, 1999; 70(3): 464S - 474. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Li, J. A. Yee, M. H. McGuire, P. A. Murphy, and L. Yan Soybean Isoflavones Reduce Experimental Metastasis in Mice J. Nutr., May 1, 1999; 129(5): 1075 - 1078. [Abstract] [Full Text]
|
|
|
|
|
|
D. M. Tham, C. D. Gardner, and W. L. Haskell Potential Health Benefits of Dietary Phytoestrogens: A Review of the Clinical, Epidemiological, and Mechanistic Evidence J. Clin. Endocrinol. Metab., July 1, 1998; 83(7): 2223 - 2235. [Abstract] [Full Text]
|
|
|
|
 |
|
 J. An, C. Tzagarakis-Foster, T. C. Scharschmidt, N. Lomri, and D. C. Leitman Estrogen Receptor beta -Selective Transcriptional Activity and Recruitment of Coregulators by Phytoestrogens J. Biol. Chem., May 18, 2001; 276(21): 17808 - 17814. [Abstract] [Full Text] [PDF]
|
|