Search tips
Search criteria 


Logo of brjcancerBJC HomepageBJC Advance online publicationBJC Current IssueSubmitting an article to BJCWeb feeds
Br J Cancer. 1996 May; 73(10): 1284–1290.
PMCID: PMC2074517

Dietary factors and the risk of endometrial cancer: a case--control study in Greece.


In a hospital-based case-control study of endometrial cancer undertaken in Athens (1992-94), 145 women residents of Greater Athens with confirmed cancer of the endometrium were compared with 298 control patients with orthopaedic diseases. Personal interviews were conducted in the hospital setting, and diet was assessed using a validated semiquantitative food frequency questionnaire. Nutrient intakes for individuals were calculated by multiplying the nutrient intake of a typical portion size for each specified food item by the frequency at which the food was consumed per month and summing these estimates for all food items. Data were modelled through logistic regression, controlling for demographic, reproductive and somatometric risk factors for endometrial cancer as well as for total energy intake. No macronutrient was significantly associated with endometrial cancer risk, but increasing intake of monounsaturated fat, mostly olive oil, by about one standard deviation was associated with a 26% risk reduction (odds ratio = 0.74; 95% confidence interval 0.54-1.3). Among micronutrients, only calcium intake was significantly inversely associated with endometrial cancer risk, whereas there was evidence against retinol and zinc imparting protection against the disease. With respect to food groups, there was weak and non-significant evidence that vegetables are protective, whereas consumption of pulses was positively associated with disease possibly because they contribute substantially in Greece to energy intake in excess of physical activity-dependent requirements.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.0M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Anderson JE, Litzow MR, Appelbaum FR, Schoch G, Fisher LD, Buckner CD, Petersen FB, Crawford SW, Press OW, Sanders JE, et al. Allogeneic, syngeneic, and autologous marrow transplantation for Hodgkin's disease: the 21-year Seattle experience. J Clin Oncol. 1993 Dec;11(12):2342–2350. [PubMed]
  • Bierman PJ, Bagin RG, Jagannath S, Vose JM, Spitzer G, Kessinger A, Dicke KA, Armitage JO. High dose chemotherapy followed by autologous hematopoietic rescue in Hodgkin's disease: long-term follow-up in 128 patients. Ann Oncol. 1993 Nov;4(9):767–773. [PubMed]
  • Carella AM, Congiu AM, Gaozza E, Mazza P, Ricci P, Visani G, Meloni G, Cimino G, Mangoni L, Coser P, et al. High-dose chemotherapy with autologous bone marrow transplantation in 50 advanced resistant Hodgkin's disease patients: an Italian study group report. J Clin Oncol. 1988 Sep;6(9):1411–1416. [PubMed]
  • Chopra R, McMillan AK, Linch DC, Yuklea S, Taghipour G, Pearce R, Patterson KG, Goldstone AH. The place of high-dose BEAM therapy and autologous bone marrow transplantation in poor-risk Hodgkin's disease. A single-center eight-year study of 155 patients. Blood. 1993 Mar 1;81(5):1137–1145. [PubMed]
  • Crump M, Smith AM, Brandwein J, Couture F, Sherret H, Sutton DM, Scott JG, McCrae J, Murray C, Pantalony D, et al. High-dose etoposide and melphalan, and autologous bone marrow transplantation for patients with advanced Hodgkin's disease: importance of disease status at transplant. J Clin Oncol. 1993 Apr;11(4):704–711. [PubMed]
  • Gianni AM, Siena S, Bregni M, Lombardi F, Gandola L, Di Nicola M, Magni M, Peccatori F, Valagussa P, Bonadonna G. High-dose sequential chemo-radiotherapy with peripheral blood progenitor cell support for relapsed or refractory Hodgkin's disease--a 6-year update. Ann Oncol. 1993 Dec;4(10):889–891. [PubMed]
  • Harding M, Selby P, Gore M, Perren T, Treleavan J, Mansi J, Zulian G, Milan S, Meldrum M, Viner C, et al. High-dose chemotherapy and autologous bone marrow transplantation for relapsed and refractory Hodgkin's disease. Eur J Cancer. 1992;28A(8-9):1396–1400. [PubMed]
  • Jagannath S, Armitage JO, Dicke KA, Tucker SL, Velasquez WS, Smith K, Vaughan WP, Kessinger A, Horwitz LJ, Hagemeister FB, et al. Prognostic factors for response and survival after high-dose cyclophosphamide, carmustine, and etoposide with autologous bone marrow transplantation for relapsed Hodgkin's disease. J Clin Oncol. 1989 Feb;7(2):179–185. [PubMed]
  • Jones RJ, Piantadosi S, Mann RB, Ambinder RF, Seifter EJ, Vriesendorp HM, Abeloff MD, Burns WH, May WS, Rowley SD, et al. High-dose cytotoxic therapy and bone marrow transplantation for relapsed Hodgkin's disease. J Clin Oncol. 1990 Mar;8(3):527–537. [PubMed]
  • Linch DC, Winfield D, Goldstone AH, Moir D, Hancock B, McMillan A, Chopra R, Milligan D, Hudson GV. Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin's disease: results of a BNLI randomised trial. Lancet. 1993 Apr 24;341(8852):1051–1054. [PubMed]
  • Lohri A, Barnett M, Fairey RN, O'Reilly SE, Phillips GL, Reece D, Voss N, Connors JM. Outcome of treatment of first relapse of Hodgkin's disease after primary chemotherapy: identification of risk factors from the British Columbia experience 1970 to 1988. Blood. 1991 May 15;77(10):2292–2298. [PubMed]
  • Longo DL, Duffey PL, Young RC, Hubbard SM, Ihde DC, Glatstein E, Phares JC, Jaffe ES, Urba WJ, DeVita VT., Jr Conventional-dose salvage combination chemotherapy in patients relapsing with Hodgkin's disease after combination chemotherapy: the low probability for cure. J Clin Oncol. 1992 Feb;10(2):210–218. [PubMed]
  • Miller AB, Hoogstraten B, Staquet M, Winkler A. Reporting results of cancer treatment. Cancer. 1981 Jan 1;47(1):207–214. [PubMed]
  • Philip T, Armitage JO, Spitzer G, Chauvin F, Jagannath S, Cahn JY, Colombat P, Goldstone AH, Gorin NC, Flesh M, et al. High-dose therapy and autologous bone marrow transplantation after failure of conventional chemotherapy in adults with intermediate-grade or high-grade non-Hodgkin's lymphoma. N Engl J Med. 1987 Jun 11;316(24):1493–1498. [PubMed]
  • Phillips GL, Wolff SN, Herzig RH, Lazarus HM, Fay JW, Lin HS, Shina DC, Glasgow GP, Griffith RC, Lamb CW, et al. Treatment of progressive Hodgkin's disease with intensive chemoradiotherapy and autologous bone marrow transplantation. Blood. 1989 Jun;73(8):2086–2092. [PubMed]
  • Rapoport AP, Rowe JM, Kouides PA, Duerst RA, Abboud CN, Liesveld JL, Packman CH, Eberly S, Sherman M, Tanner MA, et al. One hundred autotransplants for relapsed or refractory Hodgkin's disease and lymphoma: value of pretransplant disease status for predicting outcome. J Clin Oncol. 1993 Dec;11(12):2351–2361. [PubMed]
  • Reece DE, Barnett MJ, Connors JM, Fairey RN, Fay JW, Greer JP, Herzig GP, Herzig RH, Klingemann HG, LeMaistre CF, et al. Intensive chemotherapy with cyclophosphamide, carmustine, and etoposide followed by autologous bone marrow transplantation for relapsed Hodgkin's disease. J Clin Oncol. 1991 Oct;9(10):1871–1879. [PubMed]
  • Reece DE, Connors JM, Spinelli JJ, Barnett MJ, Fairey RN, Klingemann HG, Nantel SH, O'Reilly S, Shepherd JD, Sutherland HJ, et al. Intensive therapy with cyclophosphamide, carmustine, etoposide +/- cisplatin, and autologous bone marrow transplantation for Hodgkin's disease in first relapse after combination chemotherapy. Blood. 1994 Mar 1;83(5):1193–1199. [PubMed]
  • Tourani JM, Levy R, Colonna P, Desablens B, Leprise PY, Guilhot F, Brahimi S, Belhani M, Ifrah N, Sensebe L, et al. High-dose salvage chemotherapy without bone marrow transplantation for adult patients with refractory Hodgkin's disease. J Clin Oncol. 1992 Jul;10(7):1086–1094. [PubMed]
  • Yahalom J, Gulati SC, Toia M, Maslak P, McCarron EG, O'Brien JP, Portlock CS, Straus DJ, Phillips J, Fuks Z. Accelerated hyperfractionated total-lymphoid irradiation, high-dose chemotherapy, and autologous bone marrow transplantation for refractory and relapsing patients with Hodgkin's disease. J Clin Oncol. 1993 Jun;11(6):1062–1070. [PubMed]
  • Zulian GB, Selby P, Milan S, Nandi A, Gore M, Forgeson G, Perren TJ, McElwain TJ. High dose melphalan, BCNU and etoposide with autologous bone marrow transplantation for Hodgkin's disease. Br J Cancer. 1989 Apr;59(4):631–635. [PMC free article] [PubMed]
  • Armstrong B, Doll R. Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer. 1975 Apr 15;15(4):617–631. [PubMed]
  • Barbone F, Austin H, Partridge EE. Diet and endometrial cancer: a case-control study. Am J Epidemiol. 1993 Feb 15;137(4):393–403. [PubMed]
  • Dales LG, Friedman GD, Ury HK, Grossman S, Williams SR. A case-control study of relationships of diet and other traits to colorectal cancer in American blacks. Am J Epidemiol. 1979 Feb;109(2):132–144. [PubMed]
  • Fortes C, Forastiere F, Anatra F, Schmid G. Re: Consumption of olive oil and specific food groups in relation to breast cancer risk in Greece. J Natl Cancer Inst. 1995 Jul 5;87(13):1020–1022. [PubMed]
  • Garland CF, Garland FC, Gorham ED. Can colon cancer incidence and death rates be reduced with calcium and vitamin D? Am J Clin Nutr. 1991 Jul;54(1 Suppl):193S–201S. [PubMed]
  • Gnardellis C, Trichopoulou A, Katsouyanni K, Polychronopoulos E, Rimm EB, Trichopoulos D. Reproducibility and validity of an extensive semiquantitative food frequency questionnaire among Greek school teachers. Epidemiology. 1995 Jan;6(1):74–77. [PubMed]
  • Graham S, Dayal H, Swanson M, Mittelman A, Wilkinson G. Diet in the epidemiology of cancer of the colon and rectum. J Natl Cancer Inst. 1978 Sep;61(3):709–714. [PubMed]
  • Howe GR, Ghadirian P, Bueno de Mesquita HB, Zatonski WA, Baghurst PA, Miller AB, Simard A, Baillargeon J, de Waard F, Przewozniak K, et al. A collaborative case-control study of nutrient intake and pancreatic cancer within the search programme. Int J Cancer. 1992 May 28;51(3):365–372. [PubMed]
  • Hsieh CC, Maisonneuve P, Boyle P, Macfarlane GJ, Roberston C. Analysis of quantitative data by quantiles in epidemiologic studies: classification according to cases, noncases, or all subjects? Epidemiology. 1991 Mar;2(2):137–140. [PubMed]
  • Kelsey JL, LiVolsi VA, Holford TR, Fischer DB, Mostow ED, Schwartz PE, O'Connor T, White C. A case-control study of cancer of the endometrium. Am J Epidemiol. 1982 Aug;116(2):333–342. [PubMed]
  • Koumantaki Y, Tzonou A, Koumantakis E, Kaklamani E, Aravantinos D, Trichopoulos D. A case-control study of cancer of endometrium in Athens. Int J Cancer. 1989 May 15;43(5):795–799. [PubMed]
  • La Vecchia C, Decarli A, Fasoli M, Gentile A. Nutrition and diet in the etiology of endometrial cancer. Cancer. 1986 Mar 15;57(6):1248–1253. [PubMed]
  • Levi F, Franceschi S, Negri E, La Vecchia C. Dietary factors and the risk of endometrial cancer. Cancer. 1993 Jun 1;71(11):3575–3581. [PubMed]
  • Martin-Moreno JM, Willett WC, Gorgojo L, Banegas JR, Rodriguez-Artalejo F, Fernandez-Rodriguez JC, Maisonneuve P, Boyle P. Dietary fat, olive oil intake and breast cancer risk. Int J Cancer. 1994 Sep 15;58(6):774–780. [PubMed]
  • Parazzini F, La Vecchia C, Bocciolone L, Franceschi S. The epidemiology of endometrial cancer. Gynecol Oncol. 1991 Apr;41(1):1–16. [PubMed]
  • Potischman N, Swanson CA, Brinton LA, McAdams M, Barrett RJ, Berman ML, Mortel R, Twiggs LB, Wilbanks GD, Hoover RN. Dietary associations in a case-control study of endometrial cancer. Cancer Causes Control. 1993 May;4(3):239–250. [PubMed]
  • Shu XO, Zheng W, Potischman N, Brinton LA, Hatch MC, Gao YT, Fraumeni JF., Jr A population-based case-control study of dietary factors and endometrial cancer in Shanghai, People's Republic of China. Am J Epidemiol. 1993 Jan 15;137(2):155–165. [PubMed]
  • Trichopoulos D, Tzonou A, Katsouyanni K, Trichopoulou A. Diet and cancer: methodological complexities and case-control studies in Greece. Prog Clin Biol Res. 1990;346:45–53. [PubMed]
  • Trichopoulou A, Katsouyanni K, Stuver S, Tzala L, Gnardellis C, Rimm E, Trichopoulos D. Consumption of olive oil and specific food groups in relation to breast cancer risk in Greece. J Natl Cancer Inst. 1995 Jan 18;87(2):110–116. [PubMed]
  • Tzonou A, Hsieh CC, Polychronopoulou A, Kaprinis G, Toupadaki N, Trichopoulou A, Karakatsani A, Trichopoulos D. Diet and ovarian cancer: a case-control study in Greece. Int J Cancer. 1993 Sep 30;55(3):411–414. [PubMed]
  • Willett W, Stampfer MJ. Total energy intake: implications for epidemiologic analyses. Am J Epidemiol. 1986 Jul;124(1):17–27. [PubMed]
  • Zheng W, Kushi LH, Potter JD, Sellers TA, Doyle TJ, Bostick RM, Folsom AR. Dietary intake of energy and animal foods and endometrial cancer incidence. The Iowa women's health study. Am J Epidemiol. 1995 Aug 15;142(4):388–394. [PubMed]
  • Ziegler RG. A review of epidemiologic evidence that carotenoids reduce the risk of cancer. J Nutr. 1989 Jan;119(1):116–122. [PubMed]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK