Dietary omega-3 fatty acids and endometrial cancer risk in the Epidemiology of Endometrial Cancer Consortium: An individual-participant meta-analysis

Theodore M. Brasky, Erinn M. Hade, David E. Cohn, Alison M. Newton, Stacey Petruzella, Kelli O'Connell, Kimberly A. Bertrand, Linda S. Cook, Immaculata De Vivo, Mengmeng Du, Jo L. Freudenheim, Christine M. Friedenreich, Marc T. Goodman, Jessica Gorzelitz, Torukiri I. Ibiebele, Vittorio Krogh, Linda M. Liao, Loren Lipworth, Lingeng Lu, Susan McCannTracy A. O'Mara, Julie R. Palmer, Jeanette Ponte, Anna Prizment, Harvey Risch, Sven Sandin, Leo J. Schouten, Veronica Wendy Setiawan, Xiao ou Shu, Britton Trabert, Piet A. van den Brandt, Penelope M. Webb, Nicolas Wentzensen, Lynne R. Wilkens, Alicja Wolk, Herbert Yu, Marian L. Neuhouser

Research output: Contribution to journalArticlepeer-review


Background: Limited data from prospective studies suggest that higher dietary intake of long-chain omega-3 polyunsaturated fatty acids (LCn3PUFA), which hold anti-inflammatory properties, may reduce endometrial cancer risk; particularly among certain subgroups characterized by body mass and tumor pathology. Materials and methods: Data from 12 prospective cohort studies participating in the Epidemiology of Endometrial Cancer Consortium were harmonized as nested case-control studies, including 7268 endometrial cancer cases and 26,133 controls. Habitual diet was assessed by food frequency questionnaire, from which fatty acid intakes were estimated. Two-stage individual-participant data mixed effects meta-analysis estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) through logistic regression for associations between study-specific energy-adjusted quartiles of LCn3PUFA and endometrial cancer risk. Results: Women with the highest versus lowest estimated dietary intakes of docosahexaenoic acid, the most abundant LCn3PUFA in diet, had a 9% increased endometrial cancer risk (Quartile 4 vs. Quartile 1: OR 1.09, 95% CI: 1.01–1.19; P trend = 0.04). Similar elevated risks were observed for the summary measure of total LCn3PUFA (OR 1.07, 95% CI: 0.99–1.16; P trend = 0.06). Stratified by body mass index, higher intakes of LCn3PUFA were associated with 12–19% increased endometrial cancer risk among overweight/obese women and no increased risk among normal-weight women. Higher associations appeared restricted to White women. The results did not differ by cancer grade. Conclusion: Higher dietary intakes of LCn3PUFA are unlikely to reduce endometrial cancer incidence; rather, they may be associated with small to moderate increases in risk in some subgroups of women, particularly overweight/obese women.

Original languageEnglish
Pages (from-to)137-146
Number of pages10
JournalGynecologic Oncology
StatePublished - Feb 2023


  • Endometrial cancer
  • Fatty acid
  • Omega-3
  • Polyunsaturated
  • Uterine cancer


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