Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2007 Dec;86(6):1730-7.
doi: 10.1093/ajcn/86.5.1730.

Association between dietary fiber and endometrial cancer: a dose-response meta-analysis

Elisa V Bandera  1 , Lawrence H Kushi, Dirk F Moore, Dina M Gifkins, Marjorie L McCullough
Affiliations
Meta-Analysis

Association between dietary fiber and endometrial cancer: a dose-response meta-analysis

Elisa V Bandera et al. Am J Clin Nutr. 2007 Dec.

Abstract

Background: Endometrial cancer is the most common female gynecologic cancer in the United States. Excessive and prolonged exposure of the endometrium to estrogens unopposed by progesterone and a high body mass are well-established risk factors for endometrial cancer. Although dietary fiber has been shown to beneficially reduce estrogen concentrations and prevent obesity, its role in endometrial cancer has received relatively little attention.

Objective: The objective was to summarize and quantify the current evidence of a role of dietary fiber consumption in endometrial cancer risk and to identify research gaps in this field.

Design: We conducted a systematic literature review of articles published through February 2007 to summarize the current evidence of a relation between dietary fiber consumption and endometrial cancer risk and to quantify the magnitude of the association by conducting a dose-response meta-analysis.

Results: Ten articles representing 1 case-cohort study and 9 case-control studies that evaluated several aspects of fiber consumption and endometrial cancer risk were identified through searches in various databases. On the basis of 7 case-control studies, the random-effects summary risk estimate was 0.82 (95% CI: 0.75, 0.90) per 5 g/1000 kcal dietary fiber, with no evidence of heterogeneity (I(2): 0%, P for heterogeneity: 0.55). The random-effects summary estimate was 0.71 (95% CI: 0.59, 0.85) for the comparison of the highest with the lowest dietary fiber intake in 8 case-control studies, with little evidence of heterogeneity (I(2): 20.8%, P for heterogeneity: 0.26). In contrast, the only prospective study that evaluated this association did not find an association.

Conclusions: Although the current evidence, based on data from case-control studies, supports an inverse association between dietary fiber and endometrial cancer, additional population-based studies, particularly cohort studies, are needed before definitive conclusions can be drawn.

PubMed Disclaimer

Conflict of interest statement

The authors’ responsibilities were as follows—EVB and LHK: study design and implementation; EVB: study management; DFM, LHK, and EVB: data analysis; DMG, EVB, and MLM: bibliographic searches; EVB and DMG: data extraction and tabulation; EVB, LHK, and MLM: interpretation of the evidence; and LHK, DFM, DMG, and MLM: critical revision of the article. None of the authors declared any conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Random-effects meta-analysis of studies that evaluated dietary fiber and endometrial cancer risk (per 5 g/1000 kcal). All studies excluded hysterectomies from the control group and adjusted for BMI (weight) and total energy intake [Potischman et al (11), adjusted for noncarbohydrate calories]. **Excluded studies for the following reasons: *hospital based, †<200 cases. OR, odds ratio; RR, relative risk.
FIGURE 2
FIGURE 2
Random-effects meta-analysis of studies that evaluated dietary fiber and endometrial cancer risk: highest compared with lowest category. All studies excluded hysterectomies from the control group and adjusted for BMI (weight) and total energy intake [Potischman et al (11), adjusted for noncarbohydrate calories]. **Excluded studies for the following reasons: *hospital based, †<200 cases.
See this image and copyright information in PMC

References

    1. Khan M, Mori M, Sakauchi F, et al. Risk of endometrial cancer mortality by ever-use of sex hormones and other factors in Japan. Asian Pac J Cancer Prev. 2006;7:260–6. - PubMed
    1. Kaaks R, Lukanova A, Kurzer MS. Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomarkers Prev. 2002;11:1531–43. - PubMed
    1. Sowers MR, Crawford S, McConnell DS, et al. Selected diet and lifestyle factors are associated with estrogen metabolites in a multiracial/ethnic population of women. J Nutr. 2006;136:1588–95. - PubMed
    1. Slavin JL. Dietary fiber and body weight. Nutrition. 2005;21:411–8. - PubMed
    1. Bandera EV, Kushi LH, Moore DF, Gifkins DM, McCullough ML. The association between food, nutrition, and physical activity and the risk of endometrial cancer and underlying mechanisms. Second Report on Food, Nutrition, Physical Activity and the Prevention of Cancer: World Cancer Research Fund International/American Institute for Cancer Research. 2007. [accessed 1 November 2007]. Internet: www.wcrf.org.

Publication types