Dietary fatty acids and endometrial cancer risk within the European Prospective Investigation into Cancer and Nutrition

BackgroundDiet may impact important risk factors for endometrial cancer such as obesity and inflammation. However, evidence on the role of specific dietary factors is limited. We investigated associations between dietary fatty acids and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).MethodsThis analysis includes 1,886 incident endometrial cancer cases and 297,432 non-cases. All participants were followed up for a mean of 8.8 years. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of endometrial cancer across quintiles of individual fatty acids estimated from various food sources quantified through food frequency questionnaires in the entire EPIC cohort. The false discovery rate (q-values) was computed to control for multiple comparisons.ResultsConsumption of n-6 gamma-linolenic acid was inversely associated with endometrial cancer risk (HR comparing 5th with 1st quintile(Q5-Q1)=0.77, 95% CI = 0.64; 0.92, p(trend)=0.01, q-value = 0.15). This association was mainly driven by gamma-linolenic acid derived from plant sources (HRper unit increment=0.94, 95%CI= (0.90;0.98), p = 0.01) but not from animal sources (HRper unit increment= 1.00, 95%CI = (0.92; 1.07), p = 0.92). In addition, an inverse association was found between consumption of n-3 alpha-linolenic acid from vegetable sources and endometrial cancer risk (HRper unit increment= 0.93, 95%CI = (0.87; 0.99), p = 0.04). No significant association was found between any other fatty acids (individual or grouped) and endometrial cancer risk.ConclusionOur results suggest that higher consumption of gamma-linolenic acid and alpha-linoleic acid from plant sources may be associated with lower risk of endometrial cancer.