Soya Food Intake and Risk of Endometrial Cancer among Chinese Women in Shanghai: populationbased control study

Introduction: Endometrial Cancer

Elisha Gay C. Hidalgo, RND

What is endometrial cancer?

Other names of this disease: Cancer of the Uterus or Uterine Cancer Cancer that forms in the tissue lining the uterus (the small, hollow, pear-shaped organ in a woman's pelvis in which a fetus develops). Most endometrial cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). Endometrial cancer is the growth of abnormal cells in the lining of the uterus. The lining is called the endometrium.. Endometrial cancer usually occurs in women older than 50. The good news is that it is usually cured when it is found early. And most of the time, the cancer is found in its earliest stage, before it has spread outside the uterus.

The lining of the uterus is called the endometrium. Sometimes there is abnormal growth of cells in this lining. This abnormal growth is called endometrial cancer. This cancer usually occurs in women older than age 50. It causes heavy or unusual vaginal bleeding.

Adenocarcinoma of the endometrium. This tumor, which occupies a small uterine cavity, grows primarily as a firm polypoid mass.

Adenocarcinoma of the endometrium. This tumor, which occupies a small uterine cavity, grows primarily as a firm polypoid mass.

What causes endometrial cancer?

The most common cause of endometrial cancer is having too much of the hormone estrogen compared to the hormone progesterone in the body. This hormone imbalance can happen if a woman: Is obese. Fat cells make extra estrogen, but the body doesn't make extra progesterone to balance it out. Takes estrogen without taking a progestin. Has polycystic ovary syndrome, which causes hormone imbalance. Starts her period before age 12 or starts menopause after age 55. Has never been pregnant or had a full-term pregnancy. Has never breast-fed.

Risk Factors:
Factors that increase levels of estrogen in the body include: Many years of menstruation. Never having been pregnant. Irregular ovulation. Obesity. A high-fat diet. Diabetes. Estrogen-only replacement therapy (ERT). Ovarian tumors. Other factors that can increase your risk of endometrial cancer include: Age. Personal history of breast cancer or ovarian cancer. Tamoxifen treatment. Race. Hereditary nonpolyposis colorectal cancer (HNPCC).

Pelvic lymph nodes are part of the lymphatic system, which carries fluid, nutrients, and waste material between the body tissues and the bloodstream. Lymph nodes are connected by a system of channels that run throughout the body. Cancer may spread through the lymph nodes to distant parts of the body.

What are the symptoms

The most common symptom of endometrial cancer is unexpected (abnormal) bleeding from the vagina after menopause. A woman with advanced endometrial cancer may have other symptoms, such as losing weight without trying.

How is it diagnosed and treated?

Endometrial cancer is usually diagnosed with a biopsy. In this test, the doctor removes a small sample of the lining of the uterus to look for cancer cells. Endometrial cancer in its early stages can be cured. The main treatment is surgery to remove the uterus plus the cervix, ovaries, and fallopian tubes. The doctor will also remove pelvic and aortic lymph nodes to see if the cancer has spread. A woman whose cancer has spread may also have: Chemotherapy to kill cancer cells. Hormone therapy to block cancer growth. Radiation therapy to kill cancer cells.

Soya Food Intake and Risk of Endometrial Cancer among Chinese Women in Shanghai: population-based control study

Results of the Study

RESULTS: Case vs. Control

No major differences between CASES and CONTROLS in terms of: marital status, family income, total energy intake, and use of hormone replacement therapy. No significant difference between fruit and vegetable intake. However, compared with control, CASES:

Attained higher education Had an earlier age at menarche Later age at menopause Longer duration of menstruation Had higher body mass index and waist:hip ratio Were less likely to have regular exercise, drink alcohol, or use oral contraceptives Were likely to have family history of cancer, have been pregnant fewer times, and have consumed more meat and fish.

Case-control comparisons for soya intake

Women with endometrial cancer have fewer soya food intake as well as total soya protein and soya isoflavones. Median intake for control: soya protein is 10.2g/day and soya isoflavone is 42.5g/day Median intake for cases: soya protein is 9.9g/day and soya isoflavone is 40.5 mg/day

 Table 3 shows that intakes of soya protein, soya fibre, and soya isoflavones were highly correlated, making it difficult to separate their independent effects.

Results of the stratified analysis for the following:

Menopausal Status: did not vary BMI: higher BMI, less intake of soya protein and higher risk of endometrial cancer Waist:Hip ratio: : higher waist:hip ratio, less intake of soya protein and higher risk of endometrial cancer

Soya Food Intake and Risk of Endometrial Cancer among Chinese Women in Shanghai: population-based control study

Discussion

Incidence rates of Endometrial Cancer vary worldwide

Incidence of endometrial cancer is higher among Caucasians compared with Asian or black women; however, mortality is higher among blacks. This is thought to be due to poor access to care and presentation at more advanced stages In our study population, the average soya isoflavone intake from soya foods is 25 times that of reported from Western population.

Review of related studies:

Soya isoflavones may play a role in the development of hormone related cancers, including endometrial cancer. An inverse association between phytoestrogen consumption and risk of endometrial cancer was reported by Goodman in a multi ethnic population and by Horn-Ross among western women. However, legume consumption was found to be associated with a slight risk for endometrial cancer among Chinese women. Previous studies were not specifically designed to investigate the role of soya food, assessment of soya food intake was incomplete.

Testing the hypothesis of this study:

This study was specifically designed to test the hypothesis that: soya food intake reduces endometrial cancer risk depending on endogenous hormone levels, indicates that usual consumption of soya foods by adults (measured as intake of either soya protein or soya isoflavone) is associated with a significantly reduced risk of endometrial cancer, particularly among women with higher BMI or waist:hip ratio.

Findings of the Study:

Shows a more pronounced inverse association between soya food intake and and risk of endometrial cancer among women with a higher BMI or waist:hip ratio Shows a similar inverse effect on both premenopausal and postmenopausal women (in contrast with a recent US study) Suggests more studies that intends to measure estrogen concentration and its joint effect on soya and endogenous estrogen and endometrial risk.