Investigation of dietary factors and endometrial cancer risk using a nutrient-wide association study approach in the EPIC and nurses' health study (NHS) and NHSII

Melissa A. Merritt*, Ioanna Tzoulaki, Shelley S. Tworoger, Immaculata De Vivo, Susan E. Hankinson, Judy Fernandes, Konstantinos K. Tsilidis, Elisabete Weiderpass, Anne Tjønneland, Kristina E.N. Petersen, Christina C. Dahm, Kim Overvad, Laure Dossus, Marie Christine Boutron-Ruault, Guy Fagherazzi, Renée T. Fortner, Rudolf Kaaks, Krasimira Aleksandrova, Heiner Boeing, Antonia TrichopoulouChristina Bamia, Dimitrios Trichopoulos, Domenico Palli, Sara Grioni, Rosario Tumino, Carlotta Sacerdote, Amalia Mattiello, H. B. Bueno-De-Mesquita, N. Charlotte Onland-Moret, Petra H. Peeters, Inger T. Gram, Guri Skeie, J. Ramón Quirós, Eric J. Duell, María José Sánchez, D. Salmerón, Aurelio Barricarte, Saioa Chamosa, Ulrica Ericson, Emily Sonestedt, Lena Maria Nilsson, Annika Idahl, Kay Tee Khaw, Nicholas Wareham, Ruth C. Travis, Sabina Rinaldi, Isabelle Romieu, Chirag J. Patel, Elio Riboli, Marc J. Gunter

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

40 Citations (Scopus)


Data on the role of dietary factors in endometrial cancer development are limited and inconsistent. We applied a "nutrient-wide association study" approach to systematically evaluate dietary risk associations for endometrial cancer while controlling for multiple hypothesis tests using the false discovery rate (FDR) and validating the results in an independent cohort. We evaluated endometrial cancer risk associations for dietary intake of 84 foods and nutrients based on dietary questionnaires in three prospective studies, the European Prospective Investigation into Cancer and Nutrition (EPIC; N = 1,303 cases) followed by validation of nine foods/nutrients (FDR ≤ 0.10) in the Nurses' Health Studies (NHS/NHSII; N = 1,531 cases). Cox regression models were used to estimate HRs and 95% confidence intervals (CI). In multivariate adjusted comparisons of the extreme categories of intake at baseline, coffee was inversely associated with endometrial cancer risk (EPIC, median intake 750 g/day vs. 8.6; HR, 0.81; 95% CI, 0.68-0.97, Ptrend = 0.09; NHS/NHSII, median intake 1067 g/day vs. none; HR, 0.82; 95% CI, 0.70-0.96, Ptrend = 0.04). Eight other dietary factors that were associated with endometrial cancer risk in the EPIC study (total fat, monounsaturated fat, carbohydrates, phosphorus, butter, yogurt, cheese, and potatoes) were not confirmed in the NHS/NHSII. Our findings suggest that coffee intake may be inversely associated with endometrial cancer risk. Further data are needed to confirm these findings and to examine the mechanisms linking coffee intake to endometrial cancer risk to develop improved prevention strategies.

Original languageEnglish
Pages (from-to)466-471
Number of pages6
JournalCancer Epidemiology Biomarkers and Prevention
Issue number2
Publication statusPublished - 1 Feb 2015
Externally publishedYes


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