(P13-010-23) A Dietary Pattern Derived To Correlate With Estrogens and Risk of Endometrial Cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC) Study

Objectives: Endometrial cancer (EC) is the female malignancy most highly related to excess body weight, and is considered a model of hormonal carcinogenesis. Diet may play a role in altering estrogen metabolism and subsequently EC risk. Our objectives are to identify a dietary pattern related to circulating estrogens and to assess its association with EC risk.

Methods: The study has been conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. After 15 years of follow-up, 2023 incident EC cases have been reported out of 285440 women included. Food frequency questionnaires (FFQ) are available at baseline. Circulating plasma concentrations of estrone and estradiol are available for a subset (N=1621; EC cases N=103). Reduced rank regression (RRR) has been used to identify food groups that correlate with biomarkers to create an estrogenic dietary pattern (EDP). Hazard ratios (HR) and 95% confidence intervals (CI) using Cox regression have been calculated to estimate the prospective association between pre-diagnostic EDP and EC risk.

Results: The RRR pattern was negatively correlated with estradiol (r=-0.55) and estrone (r=-0.57) and explained 6.32% of variation in sex hormone levels. Stepwise linear regression retained a simplified pattern (EDP) characterized by high intake of legumes, high-fat dairy, poultry, fish, wine and beer and low intake of cereals, sugars and vegetable oils. Preliminary multivariable analysis showed a weak association between the EDP and EC risk (HR=1.12; 95%CI=1.00-1.25). The association is stronger in postmenopausal women and in women with overweight and obesity.

Conclusions: This is the first study that derived a dietary pattern specifically correlated with estrogen levels in European population and to evaluate its association with EC. Our results support the promotion of specific habits and could impact dietary recommendations to reduce EC incidence. If confirmed, these processes could be targeted by prevention strategies targeted in obesity-related cancers.

Funding Sources: EPIC's coordination is financially supported by International Agency for Research on Cancer (IARC) and by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London.