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

Published online by Cambridge University Press:  02 January 2007

Stephanie AN Silvera ,
Thomas E Rohan ,
Meera Jain ,
Paul D Terry ,
Geoffrey R Howe  and
Anthony B Miller
Stephanie AN Silvera*
Affiliation:
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Room 1301, Bronx, NY 10461, USA
Thomas E Rohan
Affiliation:
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Room 1301, Bronx, NY 10461, USA
Meera Jain
Affiliation:
Department of Public Health Sciences, University of Toronto, Toronto, Canada
Paul D Terry
Affiliation:
National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Sciences, Research Triangle Park, NC, USA
Geoffrey R Howe
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
Anthony B Miller
Affiliation:
Department of Public Health Sciences, University of Toronto, Toronto, Canada
*
*Corresponding author: Email ssilvera@aecom.yu.edu
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Abstract

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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 49 613 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.

Keywords

Glycaemic indexGlycaemic loadEndometrial neoplasmsProspective cohortNational Breast Screening Study
Type
Research Article
Information
Public Health Nutrition , Volume 8 , Issue 7 , October 2005 , pp. 912 - 919
Copyright
Copyright © The Authors 2005

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