Endometrial and ovarian cancers are among the top ten cancers that occur in women in the US. The consumption of refined sugars has increased dramatically over the past few decades, accounting for almost 15% of total energy intake. Yet, there is limited evidence on how sugar consumption affects risk of these cancers. Our review of the published literature on sugar consumption and endometrial and ovarian cancers yielded inconsistent results. Furthermore, we found that few studies considered effect modification by insulin-related risk factors [i.e. body mass index, waist-to-hip ratio (WHR), physical activity]. Using data from two related New Jersey population-based case-control studies, we evaluated endometrial and ovarian cancer risk in relation to sugary foods and beverages, and total and added sugar intakes, while considering effect modification by insulin-related factors. In our first study, women in the highest quartile of added sugar intake had significantly higher endometrial cancer risk (OR=1.84, 95% CI:1.16-2.92). Sugary drink intake moderately increased endometrial cancer risk with each unit increase (OR=1.61, 95% CI:1.09-2.40 per serving/1000 kcal). Among women with WHR >0.85, risk was significantly higher for the highest vs. lowest tertile of added sugar intakes (OR=2.50, 95% CI:1.38-4.52). The association with added sugar also became stronger when analyses were restricted to never users of hormone replacement therapy (OR: 2.03; 95% CI: 1.27-3.26 for highest vs. lowest tertile). For ovarian cancer, we did not find evidence of an association between consumption of sugary foods and beverages and risk. In conclusion, we performed a comprehensive assessment of sugar intake and endometrial and ovarian cancer risk, with consideration of insulin-modifiers. Endometrial cancer risk was adversely related to sugary drink and added sugar intakes, after adjusting for several major risk factors. Also, there was evidence that insulin-related risk factors, mainly central obesity, modified these relationships. However, there was little indication that sugar intake influenced ovarian cancer risk. Our study is the first to evaluate endometrial and ovarian cancer risk in relation to added sugar consumption from all food sources, while considering effect modification by several insulin-related factors. Given the high prevalence of intake of sugary foods and drinks in Western populations, additional research is warranted to confirm our findings on endometrial cancer and to further elucidate the role of sugar intake on ovarian cancer risk.
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Public Health
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Rutgers University Electronic Theses and Dissertations
Rutgers University. Graduate School - New Brunswick
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