Sugar-sweetened beverage intake and the risk of type I and type II endometrial cancer among postmenopausal women.
Level 3 - non-randomized controlled study
Prospective cohort study with longitudinal follow-up
PubMed 24273064 · doi:10.1158/1055-9965.EPI-13-0636
What was done
Researchers evaluated dietary intake of sugar-sweetened beverages (SSB), fruit juice, sugar-free beverages, sweets/baked goods, starch, and sugars among 23,039 postmenopausal women in the Iowa Women's Health Study followed from 1986 to 2010. Incident estrogen-dependent (type I) and estrogen-independent (type II) endometrial cancers were identified through Surveillance, Epidemiology, and End Results (SEER) registry linkage. Cox proportional hazards regression models estimated cancer risk by energy-adjusted dietary intake while controlling for body mass index (BMI) and other confounders.
What was found
Over the follow-up period, 506 type I and 89 type II incident endometrial cancer cases were identified. Higher SSB intake showed a dose-dependent association with increased type I endometrial cancer risk after adjustment for BMI and other confounders (P_trend = 0.0005). Compared with non-drinkers, women in the highest quintile of SSB intake had a 78% higher risk of type I cancer (95% CI, 1.32–2.40). This association was not modified by BMI, physical activity, diabetes history, or smoking. Higher total sugar intake was also linked to higher type I risk. No dietary items were significantly associated with type II endometrial cancer.
Why it matters
These findings suggest that high sugar-sweetened beverage consumption may be an independent risk factor for estrogen-dependent endometrial cancer in postmenopausal women, operating via mechanisms beyond simply promoting obesity.
Limits
The observational design cannot establish causality and may be subject to residual confounding. Dietary intake relied on self-report and was not continuously updated over the 24-year follow-up. Statistical power for type II endometrial cancer was limited due to the small number of cases (n = 89). The cohort was restricted to postmenopausal women in Iowa, limiting generalizability to younger or more diverse populations.
Cited by
- supports High intake of sugar-sweetened beverages is associated with a 78% higher risk of estrogen-dependent endometrial cancer in women.