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American Journal of Epidemiology Advance Access published online on August 9, 2007
American Journal of Epidemiology, doi:10.1093/aje/kwm156
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTION

A Prospective Study of Fruits, Vegetables, and Risk of Endometrial Cancer

Marjorie L. McCullough1, Elisa V. Bandera2,3, Roshni Patel1, Alpa V. Patel1, Ted Gansler1, Lawrence H. Kushi4, Michael J. Thun1 and Eugenia E. Calle1

1 Epidemiology and Surveillance Research Department, American Cancer Society, Atlanta, GA
2 Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ
3 School of Public Health, University of Medicine and Dentistry of New Jersey, Piscataway, NJ
4 Division of Research, Kaiser Permanente, Oakland, CA

Correspondence to Dr. Marjorie McCullough, Epidemiology and Surveillance Research Department, American Cancer Society, 250 Williams Street, Atlanta, GA 30303-1002 (e-mail: marji-mccullough{at}cancer.org).

Received for publication December 15, 2006. Accepted for publication April 23, 2007.

Case-control studies support a lower risk of endometrial cancer associated with greater vegetable consumption but not fruit consumption. One prospective study suggested an inverse association with fruits and vegetables combined. The authors examined associations for vegetables and fruits separately among women in the American Cancer Society's Cancer Prevention Study II Nutrition Cohort. After exclusions, 41,400 postmenopausal women completed a questionnaire on diet, lifestyle, and medical history at baseline in 1992–1993. Information on diet was updated in 1999; historical dietary information from 1982 was also available. The authors identified 435 eligible cases of endometrial cancer through 2003. In multivariate models, neither fruit consumption (top quintile vs. bottom: rate ratio (RR) = 1.24, 95% confidence interval (CI): 0.90, 1.70; p-trend = 0.30) nor vegetable consumption (RR = 1.21, 95% CI: 0.89, 1.65; p-trend = 0.24) at baseline was associated with risk. Results were similar when diet was cumulatively updated. Only among women who had never used hormone replacement therapy was the risk of endometrial cancer lower in the highest (vs. lowest) tertile of fruit (RR = 0.75, 95% CI: 0.52, 1.07; p-interaction = 0.03, p-trend = 0.11) or vegetable (RR = 0.80, 95% CI: 0.57, 1.13; p-interaction = 0.01, p-trend = 0.29) consumption. This prospective study does not support an association between vegetable or fruit consumption and endometrial cancer.

cohort studies; endometrial neoplasms; fruit; vegetables

Abbreviations: CI, confidence interval; CPS-II, Cancer Prevention Study II; ERT, estrogen replacement therapy; FFQ, food frequency questionnaire; HRT, hormone replacement therapy; RR, rate ratio


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