A pooled analysis of dietary long-chain omega-3 fatty acid intake and endometrial cancer risk

摘要 子宫内膜癌是美国最常见的妇科恶性肿瘤， 女性常见的癌症这种疾病的发病率正在上升，特别是在黑人妇女中， 倾向于被诊断患有侵袭性疾病，并且死亡率高得惊人。耦合 与其他女性癌症相比，每个病例和每个死亡病例的研究资金非常低， 很少有可改变的疾病预防风险因素，迫切需要更好地了解子宫内膜 癌症病因学，特别注意种族差异。 越来越多的证据表明，炎症是子宫内膜癌发生的重要驱动因素。长- 链ω-3多不饱和脂肪酸（LCn 3 PUFA）具有抗炎作用， 降低子宫内膜癌风险。然而，我们已经报道了这些协会的差异， 和肿瘤组织学。没有研究能够检验高血糖饮食之间的联系 LCn 3 PUFA和子宫内膜癌风险在黑人和白色女性之间存在差异。为了揭示可靠的 估计的关联，并确定妇女的亚组，立场受益最多的饮食富含 LCn 3 PUFA，需要一个非常大的研究。 我们建议检查饮食中LCn 3 PUFA与子宫内膜癌及其亚型的关系 并通过收集饮食数据， 子宫内膜癌流行病学研究联盟。本次二次分析将包括19 参与研究，10，117例子宫内膜癌病例和26，881例对照，并将提供高统计学 来检验这些研究问题。拟议的工作将对以下方面产生重大影响： 子宫内膜癌的预防，告知临床医生，患者和营养科学家， 富含LCn 3 PUFA的饮食可能有益。这项调查的结果将为NIH提供更大的资助 申请进行化学预防试验，旨在检查LCn 3 PUFA补充剂是否 增加LCn 3 PUFA浓度并导致子宫内膜炎症生物标志物减少 诊断为子宫内膜癌的妇女的组织。我们的长期目标是减少高- 风险妇女，如那些诊断为子宫内膜增生，并减少复发， 子宫内膜癌幸存者

ABSTRACT Endometrial cancer is the most common gynecologic malignancy in the United States and the fourth most common cancer diagnosed in women. Incidence of the disease is rising, especially among black women who tend to be diagnosed with aggressive disease and who have a disproportionally higher mortality rate. Coupled with very low research funding on a per case and per death basis relative to other female cancers, and with few modifiable risk factors for disease prevention, there is a critical need to better understand endometrial cancer etiology, with special attention to racial disparities. There is increasing evidence that inflammation is an important driver of endometrial carcinogenesis. Long- chain omega-3 polyunsaturated fatty acids (LCn3PUFA) are anti-inflammatory and have been shown by us to reduce endometrial cancer risk. However, we have reported differences in these associations by body mass and tumor histology. No study has been able to examine whether the association between diets high in LCn3PUFA and endometrial cancer risk differs between black and white women. In order to reveal reliable estimates of association and to identify subgroups of women that stand to benefit the most from diets rich in LCn3PUFA, a very large study is needed. We propose to examine the association of dietary LCn3PUFA with endometrial cancer and its subtypes and to examine possible heterogeneity of these associations by race and body mass, by pooling dietary data in the Epidemiology of Endometrial Cancer Consortium of studies. This secondary analysis will include 19 participating studies, 10,117 endometrial cancer cases and 26,881 controls, and will provide high statistical power and precision to examine these research questions. The proposed work will have a significant impact on endometrial cancer prevention by informing clinicians, patients, and nutrition scientists as to whether and for whom an LCn3PUFA-rich diet may be of benefit. Results from this investigation will inform a larger NIH grant application to conduct a chemoprevention trial that will aim to examine whether LCn3PUFA supplementation increases LCn3PUFA concentrations and causes a reduction in biomarkers of inflammation in endometrial tissues of women diagnosed with endometrial cancer. Our long-term goal is to reduce incidence among high- risk women, such as those diagnosed with endometrial hyperplasia, and to reduce recurrence among endometrial cancer survivors.