Glycaemic index, glycaemic load and risk of endometrial cancer: a prospective cohort study

Silvera, Stephanie A. Navarro; Rohan, Thomas E.; Jain, Meera; Terry, Paul; Howe, Geoffrey R.; Miller, Anthony B.

doi:10.1079/phn2005741

Cited by 49 publications

(58 citation statements)

References 34 publications

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“…Risk factors for endometrial cancer are relatively common and include conditions such as obesity, unfavorable glycemic index, diabetes, hypertension and unovulation [18][19][20][21][22]. Although only a small percentage of those women will develop endometrial cancer, the prevalence of risk factors and symptoms such as irregular uterine bleeding and the greater awareness for the risk factors have created a demand by women and caregivers for screening and early detection of endometrial cancer.…”

Section: Discussionmentioning

confidence: 99%

Decreased expression of P2X7 in endometrial epithelial pre-cancerous and cancer cells

Zhou

et al. 2007

Gynecologic Oncology

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Objectives-To understand the potential role of P2X 7 as biomarker of endometrial cancer, and the molecular mechanisms by which cancerous epithelial cells maintain low expression of P2X 7 .Methods-Feasibility clinical experimental study. Normal (28), simple or complex hyperplasia (7), complex hyperplasia with atypia (6) and cancer endometrial discarded tissues (40) were obtained from a total of 81 women, ages 25-75. Endpoint for P2X 7 protein was average pixel signal density of tissue immunoreactivity with anti-P2X 7 antibody. Endpoint for P2X 7 mRNA was one-step quantitative Real-Time PCR. Experiments in-vitro included normal (hEVEC) and cancerous cervical epithelial cells (HeLa) transfected with reporter plasmid containing luciferase-3′ untranslated region (3′UTR)-P2X 7 cDNA, using as endpoint steady-state luciferase mRNA levels.Results-Levels of P2X 7 protein and mRNA were significantly lower in vivo, in tissues of complex hyperplasia with atypia or endometrial adenocarcinoma, than in tissues of normal endometrium, simple hyperplasia or complex hyperplasia tissues (sensitivity and specificity of 89-100%, p<0.0001-0.01). Steady-state levels of luciferase mRNA increased over a 6 h incubation period in hEVEC cells transfected with the 3′ UTR-P2X 7 -luciferase vector, but decreased in HeLa cells transfected with the reporter plasmid.Conclusions-Tissue levels of P2X 7 protein and mRNA can differentiate effectively and accurately between normal and benign hyperplastic endometrial tissues from pre-cancerous and cancer tissues. Cancerous epithelial cells degrade P2X 7 mRNA by activation of instability domains located at the 3′UTR of the P2X 7 .

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Section: Discussionmentioning

confidence: 99%

Decreased expression of P2X7 in endometrial epithelial pre-cancerous and cancer cells

Zhou

et al. 2007

Gynecologic Oncology

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“…Five articles that were identified investigated endometrial cancer (Folsom et al, 2003;Augustin et al, 2003a;Silvera et al, 2005;Larsson et al, 2007;Cust et al, 2007a) and two that investigated ovarian cancer (Augustin et al, 2003b;Silvera et al, 2007); the characteristics of these studies are described in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…It should be noted that some individual studies had a relatively narrow range of GI and GL intakes, which could explain the lack of statistically significant results observed in these studies. In the cohort studies, comparing the highest versus the lowest category of GL intake corresponded to an approximate difference of 50 GL units (Folsom et al, 2003;Silvera et al, 2005Silvera et al, , 2007Cust et al, 2007a;Larsson et al, 2007), whereas in the case -control studies this observed difference was approximately 100 units (Augustin et al, 2003a, b). This could partly explain the stronger association observed in the meta-analysis of endometrial cancer risk and GL when the case -control study was included.…”

Section: Discussionmentioning

confidence: 99%

“…Conflicting results indicated that the association between GL and endometrial cancer risk may be influenced by menopausal status (Silvera et al, 2005;Cust et al, 2007a), hormone replacement therapy (HRT) use (Augustin et al, 2003a;Folsom et al, 2003;Silvera et al, 2005), physical activity levels (Silvera et al, 2005;Larsson et al, 2007) or diabetes history (Folsom et al, 2003).…”

Section: Gi Gl and Endometrial And Ovarian Cancermentioning

confidence: 99%

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Dietary glycaemic index, glycaemic load and endometrial and ovarian cancer risk: a systematic review and meta-analysis

Mulholland¹,

Murray²,

Cardwell³

et al. 2008

Br J Cancer

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Long-term consumption of a high glycaemic index (GI) or glycaemic load (GL) diet may lead to chronic hyperinsulinaemia, which is a potential risk factor for cancer. To date, many studies have examined the association between GI, GL and cancer risk, although results have been inconsistent, therefore our objective was to conduct a systematic review of the literature. Medline and Embase were systematically searched using terms for GI, GL and cancer to identify studies published before December 2007. Random effects metaanalyses were performed for endometrial cancer, combining maximally adjusted results that compared risk for those in the highest versus the lowest category of intake. Separate analysis examined risk by body mass index categories. Five studies examining GI and/or GL intake and endometrial cancer risk were identified. Pooled effect estimates for endometrial cancer showed an increased risk for high GL consumers (RR 1.20; 95% CI: 1.06 -1.37), further elevated in obese women (RR 1.54; 95% CI: 1.18 -2.03). No significant associations were observed for GI. Only two studies examined ovarian cancer and therefore no meta-analysis was performed, but results indicate positive associations for GL also. A high GL, but not a high GI, diet is positively associated with the risk of endometrial cancer, particularly among obese women.

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“…Body mass index and duration of hormone replacement use showed dose -response relationships with endometrial cancer risk, and parity and duration of oral contraceptive use were inversely associated with risk (data not shown; see Silvera et al, 2005: Table 1). Cases and non-cases were similar in terms of age at first live birth, smoking status (as well as intensity and duration of smoking), and alcohol consumption.…”

Section: Resultsmentioning

confidence: 99%

Dietary iron and haem iron intake and risk of endometrial cancer: a prospective cohort study

et al. 2007

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We used data from a large cohort study of Canadian women to assess the association of meat intake and dietary intake of iron and haem iron with risk of endometrial cancer. Among 34 148 women with an intact uterus at baseline and followed for a mean of 16.4 years, we identified 426 incident endometrial cancer cases. Data from a food frequency questionnaire administered at baseline were used to calculate intake of all meats, red meat, total dietary iron, iron from meat, haem iron, and non-haem iron. Analyses were carried out using Cox proportional hazards models with adjustment for known risk factors and covariates. We found no association of intake of meat or any of the dietary iron-related variables with risk of endometrial cancer. British Journal of Cancer (2008) 98, 194 -198. doi Endometrial cancer is largely a malady of affluent, developed societies, showing a more than 10-fold variation between high-and low-incidence countries (Parkin et al, 1999). Major risk factors include obesity and oestrogen replacement therapy (Grady et al, 1995;Kaaks et al, 2002;Persson and Adami, 2002), and recent work suggests that insulin resistance, hyperinsulinemia, and diabetes may also play a role in the disease (Soliman et al, 2006;Cust et al, 2007;Friberg et al, 2007). There is limited evidence that a high intake of red meat may increase risk (Terry et al, 2002a;Bandera et al, 2007).A possible association of red meat intake with endometrial cancer risk may reflect a role of haem iron, which derives mainly from red meat and which has greater bioavailability than inorganic iron (Huang, 2003). Free iron is a pro-oxidant and can catalyse lipid peroxidation and DNA damage (McCord, 1998;Huang, 2003). The association of the interrelated conditions of insulin resistance, hyperinsulinemia, and diabetes with endometrial cancer risk also suggests a possible role of excess iron intake or elevated iron stores with endometrial cancer, as these conditions have been linked to excess body iron stores (Tuomainen et al, 1997;Fernandez-Real et al, 1998;Fernandez-Real et al, 2002;Jehn et al, 2004). Furthermore, elevated iron stores are associated with increased risk of type II diabetes in healthy women, independent of known risk factors (Jiang et al, 2004).Given that few cohort studies have examined the association of meat intake with risk of endometrial cancer (Zheng et al, 1995), and no studies have examined the effects of dietary iron or haem iron intake, we used data from a large cohort study of Canadian women to assess intake of meat, red meat, total iron, and haem iron in relation to endometrial cancer risk. In addition, we explored potential joint effects of iron intake with known risk factors for endometrial cancer. MATERIALS AND METHODS Study populationThe present analysis was conducted in the Canadian National Breast Screening Study (NBSS), a randomised controlled trial of screening for breast cancer, which has been described in detail elsewhere (Miller et al, 1992;Terry et al, 2002b). In brief, 89 835 women aged 40 -59 were recruited f...

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Glycaemic index, glycaemic load and risk of endometrial cancer: a prospective cohort study

Cited by 49 publications

References 34 publications

Decreased expression of P2X7 in endometrial epithelial pre-cancerous and cancer cells

Decreased expression of P2X7 in endometrial epithelial pre-cancerous and cancer cells

Dietary glycaemic index, glycaemic load and endometrial and ovarian cancer risk: a systematic review and meta-analysis

Dietary iron and haem iron intake and risk of endometrial cancer: a prospective cohort study

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