Glycaemic index, glycaemic load and risk of endometrial cancer

A prospective cohort study

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

Research output: Contribution to journalArticleResearchpeer-review

42 Citations (Scopus)

Abstract

Objective: High-glycaemic-load diets may increase endometrial cancer risk by increasing circulating insulin levels and, as a consequence, circulating oestrogen levels. Given the paucity of epidemiological data regarding the relationship between dietary glycaemic index and glycaemic load and endometrial cancer risk, we sought to examine these associations using data from a prospective cohort study. Design, setting and subjects: We examined the association between dietary glycaemic load and endometrial cancer risk in a cohort of 49613 Canadian women aged between 40 and 59 years at baseline who completed self-administered food-frequency questionnaires between 1982 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000. Results: During a mean of 16.4 years of follow-up, we observed 426 incident cases of endometrial cancer. Hazard ratios for the highest versus the lowest quartile level of overall glycaemic index and glycaemic load were 1.47 (95% confidence interval (CI) = 0.90-2.41; P for trend = 0.14) and 1.36 (95% CI = 1.01-1.84; P for trend = 0.21), respectively. No association was observed between total carbohydrate or total sugar consumption and endometrial cancer risk. Among obese women (body mass index >30 kg m-2) the hazard ratio for the highest versus the lowest quartile level of glycaemic load was 1.88 (95% CI = 1.08-3.29; P for trend = 0.54) and there was a 55% increased risk for the highest versus the lowest quartile level of glycaemic load among premenopausal women. There was also evidence to support a positive association between glycaemic load and endometrial cancer risk among postmenopausal women who had used hormone replacement therapy. Conclusions: Our data suggest that diets with high glycaemic index or high glycaemic load may be associated with endometrial cancer risk overall, and particularly among obese women, premenopausal women and postmenopausal women who use hormone replacement therapy.

Original languageEnglish
Pages (from-to)912-919
Number of pages8
JournalPublic Health Nutrition
Volume8
Issue number7
DOIs
StatePublished - 1 Oct 2005

Fingerprint

Glycemic Index
Endometrial Neoplasms
Cohort Studies
Prospective Studies
Hormone Replacement Therapy
Confidence Intervals
Diet
Glycemic Load
Neoplasms
Estrogens
Body Mass Index
Carbohydrates
Databases
Insulin
Food
Mortality
Incidence

Keywords

  • Endometrial neoplasms
  • Glycaemic index
  • Glycaemic load
  • National Breast Screening Study
  • Prospective cohort

Cite this

Silvera, Stephanie ; Rohan, Thomas E. ; Jain, Meera ; Terry, Paul D. ; Howe, Geoffrey R. ; Miller, Anthony B. / Glycaemic index, glycaemic load and risk of endometrial cancer : A prospective cohort study. In: Public Health Nutrition. 2005 ; Vol. 8, No. 7. pp. 912-919.
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abstract = "Objective: High-glycaemic-load diets may increase endometrial cancer risk by increasing circulating insulin levels and, as a consequence, circulating oestrogen levels. Given the paucity of epidemiological data regarding the relationship between dietary glycaemic index and glycaemic load and endometrial cancer risk, we sought to examine these associations using data from a prospective cohort study. Design, setting and subjects: We examined the association between dietary glycaemic load and endometrial cancer risk in a cohort of 49613 Canadian women aged between 40 and 59 years at baseline who completed self-administered food-frequency questionnaires between 1982 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000. Results: During a mean of 16.4 years of follow-up, we observed 426 incident cases of endometrial cancer. Hazard ratios for the highest versus the lowest quartile level of overall glycaemic index and glycaemic load were 1.47 (95{\%} confidence interval (CI) = 0.90-2.41; P for trend = 0.14) and 1.36 (95{\%} CI = 1.01-1.84; P for trend = 0.21), respectively. No association was observed between total carbohydrate or total sugar consumption and endometrial cancer risk. Among obese women (body mass index >30 kg m-2) the hazard ratio for the highest versus the lowest quartile level of glycaemic load was 1.88 (95{\%} CI = 1.08-3.29; P for trend = 0.54) and there was a 55{\%} increased risk for the highest versus the lowest quartile level of glycaemic load among premenopausal women. There was also evidence to support a positive association between glycaemic load and endometrial cancer risk among postmenopausal women who had used hormone replacement therapy. Conclusions: Our data suggest that diets with high glycaemic index or high glycaemic load may be associated with endometrial cancer risk overall, and particularly among obese women, premenopausal women and postmenopausal women who use hormone replacement therapy.",
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Glycaemic index, glycaemic load and risk of endometrial cancer : A prospective cohort study. / Silvera, Stephanie; Rohan, Thomas E.; Jain, Meera; Terry, Paul D.; Howe, Geoffrey R.; Miller, Anthony B.

In: Public Health Nutrition, Vol. 8, No. 7, 01.10.2005, p. 912-919.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Glycaemic index, glycaemic load and risk of endometrial cancer

T2 - A prospective cohort study

AU - Silvera, Stephanie

AU - Rohan, Thomas E.

AU - Jain, Meera

AU - Terry, Paul D.

AU - Howe, Geoffrey R.

AU - Miller, Anthony B.

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N2 - Objective: High-glycaemic-load diets may increase endometrial cancer risk by increasing circulating insulin levels and, as a consequence, circulating oestrogen levels. Given the paucity of epidemiological data regarding the relationship between dietary glycaemic index and glycaemic load and endometrial cancer risk, we sought to examine these associations using data from a prospective cohort study. Design, setting and subjects: We examined the association between dietary glycaemic load and endometrial cancer risk in a cohort of 49613 Canadian women aged between 40 and 59 years at baseline who completed self-administered food-frequency questionnaires between 1982 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000. Results: During a mean of 16.4 years of follow-up, we observed 426 incident cases of endometrial cancer. Hazard ratios for the highest versus the lowest quartile level of overall glycaemic index and glycaemic load were 1.47 (95% confidence interval (CI) = 0.90-2.41; P for trend = 0.14) and 1.36 (95% CI = 1.01-1.84; P for trend = 0.21), respectively. No association was observed between total carbohydrate or total sugar consumption and endometrial cancer risk. Among obese women (body mass index >30 kg m-2) the hazard ratio for the highest versus the lowest quartile level of glycaemic load was 1.88 (95% CI = 1.08-3.29; P for trend = 0.54) and there was a 55% increased risk for the highest versus the lowest quartile level of glycaemic load among premenopausal women. There was also evidence to support a positive association between glycaemic load and endometrial cancer risk among postmenopausal women who had used hormone replacement therapy. Conclusions: Our data suggest that diets with high glycaemic index or high glycaemic load may be associated with endometrial cancer risk overall, and particularly among obese women, premenopausal women and postmenopausal women who use hormone replacement therapy.

AB - Objective: High-glycaemic-load diets may increase endometrial cancer risk by increasing circulating insulin levels and, as a consequence, circulating oestrogen levels. Given the paucity of epidemiological data regarding the relationship between dietary glycaemic index and glycaemic load and endometrial cancer risk, we sought to examine these associations using data from a prospective cohort study. Design, setting and subjects: We examined the association between dietary glycaemic load and endometrial cancer risk in a cohort of 49613 Canadian women aged between 40 and 59 years at baseline who completed self-administered food-frequency questionnaires between 1982 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000. Results: During a mean of 16.4 years of follow-up, we observed 426 incident cases of endometrial cancer. Hazard ratios for the highest versus the lowest quartile level of overall glycaemic index and glycaemic load were 1.47 (95% confidence interval (CI) = 0.90-2.41; P for trend = 0.14) and 1.36 (95% CI = 1.01-1.84; P for trend = 0.21), respectively. No association was observed between total carbohydrate or total sugar consumption and endometrial cancer risk. Among obese women (body mass index >30 kg m-2) the hazard ratio for the highest versus the lowest quartile level of glycaemic load was 1.88 (95% CI = 1.08-3.29; P for trend = 0.54) and there was a 55% increased risk for the highest versus the lowest quartile level of glycaemic load among premenopausal women. There was also evidence to support a positive association between glycaemic load and endometrial cancer risk among postmenopausal women who had used hormone replacement therapy. Conclusions: Our data suggest that diets with high glycaemic index or high glycaemic load may be associated with endometrial cancer risk overall, and particularly among obese women, premenopausal women and postmenopausal women who use hormone replacement therapy.

KW - Endometrial neoplasms

KW - Glycaemic index

KW - Glycaemic load

KW - National Breast Screening Study

KW - Prospective cohort

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