Low-fat dietary pattern and cancer incidence in the women's health initiative dietary modification randomized controlled trial

Ross L. Prentice, Cynthia Thomson, Bette Caan, F. Allan Hubbell, Garnet L. Anderson, Shirley A A Beresford, Mary Pettinger, Dorothy S. Lane, Lawrence Lessin, Shagufta Yasmeen, Baljinder Singh, Janardan Khandekar, James M. Shikany, Suzanne Satterfield, Rowan T. Chlebowski

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Abstract

Background: The Women's Health Initiative Dietary Modification (DM) Randomized Controlled Trial evaluated the effects of a low-fat dietary pattern on chronic disease incidence, with breast cancer and colorectal cancer as primary outcomes. The trial protocol also listed ovarian cancer and endometrial cancer as outcomes that may be favorably affected by the intervention. Methods: A total of 48835 postmenopausal women were randomly assigned during 1993-1998 to a DM intervention (n = 19541) or comparison (usual diet; n = 29294) group and followed up for an average of 8.1 years. The intervention goal was to reduce total fat intake to 20% of energy and to increase consumption of vegetables, fruits, and grains. Cancer outcomes were verified by pathology report review. We used weighted log-rank tests to compare incidence of invasive cancers of the ovary and endometrium, total invasive cancer, and invasive cancers at other sites between the groups. All statistical tests were two-sided. Results: Ovarian cancer risk was lower in the intervention than in the comparison group (P =. 03). Although the overall ovarian cancer hazard ratio (HR) was not statistically significantly less than 1.0, the hazard ratio decreased with increasing intervention duration (Ptrend =. 01). For the first 4 years, the risk for ovarian cancer was similar in the intervention and control groups (0.52 cases per 1000 person-years in the intervention group versus 0.45 per 1000 person-years in the comparison group; HR = 1.16, 95% confidence interval [CI] = 0.73 to 1.84); over the next 4.1 years, the risk was lower in the intervention group (0.38 cases per 1000 person-years in the intervention group versus 0.64 per 1000 person-years in the comparison group; HR = 0.60, 95% CI = 0.38 to 0.96). Risk of cancer of the endometrium did not differ between the groups (P =. 18). The estimated risk of total invasive cancer was slightly lower in the intervention group than in the control group (HR = 0.95, 95% CI = 0.89 to 1.01; P =. 10). Conclusions: A low-fat dietary pattern may reduce the incidence of ovarian cancer among postmenopausal women.

Original languageEnglish (US)
Pages (from-to)1534-1543
Number of pages10
JournalJournal of the National Cancer Institute
Volume99
Issue number20
DOIs
StatePublished - Oct 2007

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Diet Therapy
Dietary Fats
Women's Health
Ovarian Neoplasms
Randomized Controlled Trials
Incidence
Endometrial Neoplasms
Neoplasms
Confidence Intervals
Control Groups
Clinical Protocols
Vegetables
Colorectal Neoplasms
Fruit
Chronic Disease
Fats
Pathology
Breast Neoplasms
Diet

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Low-fat dietary pattern and cancer incidence in the women's health initiative dietary modification randomized controlled trial. / Prentice, Ross L.; Thomson, Cynthia; Caan, Bette; Hubbell, F. Allan; Anderson, Garnet L.; Beresford, Shirley A A; Pettinger, Mary; Lane, Dorothy S.; Lessin, Lawrence; Yasmeen, Shagufta; Singh, Baljinder; Khandekar, Janardan; Shikany, James M.; Satterfield, Suzanne; Chlebowski, Rowan T.

In: Journal of the National Cancer Institute, Vol. 99, No. 20, 10.2007, p. 1534-1543.

Research output: Contribution to journalArticle

Prentice, RL, Thomson, C, Caan, B, Hubbell, FA, Anderson, GL, Beresford, SAA, Pettinger, M, Lane, DS, Lessin, L, Yasmeen, S, Singh, B, Khandekar, J, Shikany, JM, Satterfield, S & Chlebowski, RT 2007, 'Low-fat dietary pattern and cancer incidence in the women's health initiative dietary modification randomized controlled trial', Journal of the National Cancer Institute, vol. 99, no. 20, pp. 1534-1543. https://doi.org/10.1093/jnci/djm159
Prentice, Ross L. ; Thomson, Cynthia ; Caan, Bette ; Hubbell, F. Allan ; Anderson, Garnet L. ; Beresford, Shirley A A ; Pettinger, Mary ; Lane, Dorothy S. ; Lessin, Lawrence ; Yasmeen, Shagufta ; Singh, Baljinder ; Khandekar, Janardan ; Shikany, James M. ; Satterfield, Suzanne ; Chlebowski, Rowan T. / Low-fat dietary pattern and cancer incidence in the women's health initiative dietary modification randomized controlled trial. In: Journal of the National Cancer Institute. 2007 ; Vol. 99, No. 20. pp. 1534-1543.
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abstract = "Background: The Women's Health Initiative Dietary Modification (DM) Randomized Controlled Trial evaluated the effects of a low-fat dietary pattern on chronic disease incidence, with breast cancer and colorectal cancer as primary outcomes. The trial protocol also listed ovarian cancer and endometrial cancer as outcomes that may be favorably affected by the intervention. Methods: A total of 48835 postmenopausal women were randomly assigned during 1993-1998 to a DM intervention (n = 19541) or comparison (usual diet; n = 29294) group and followed up for an average of 8.1 years. The intervention goal was to reduce total fat intake to 20{\%} of energy and to increase consumption of vegetables, fruits, and grains. Cancer outcomes were verified by pathology report review. We used weighted log-rank tests to compare incidence of invasive cancers of the ovary and endometrium, total invasive cancer, and invasive cancers at other sites between the groups. All statistical tests were two-sided. Results: Ovarian cancer risk was lower in the intervention than in the comparison group (P =. 03). Although the overall ovarian cancer hazard ratio (HR) was not statistically significantly less than 1.0, the hazard ratio decreased with increasing intervention duration (Ptrend =. 01). For the first 4 years, the risk for ovarian cancer was similar in the intervention and control groups (0.52 cases per 1000 person-years in the intervention group versus 0.45 per 1000 person-years in the comparison group; HR = 1.16, 95{\%} confidence interval [CI] = 0.73 to 1.84); over the next 4.1 years, the risk was lower in the intervention group (0.38 cases per 1000 person-years in the intervention group versus 0.64 per 1000 person-years in the comparison group; HR = 0.60, 95{\%} CI = 0.38 to 0.96). Risk of cancer of the endometrium did not differ between the groups (P =. 18). The estimated risk of total invasive cancer was slightly lower in the intervention group than in the control group (HR = 0.95, 95{\%} CI = 0.89 to 1.01; P =. 10). Conclusions: A low-fat dietary pattern may reduce the incidence of ovarian cancer among postmenopausal women.",
author = "Prentice, {Ross L.} and Cynthia Thomson and Bette Caan and Hubbell, {F. Allan} and Anderson, {Garnet L.} and Beresford, {Shirley A A} and Mary Pettinger and Lane, {Dorothy S.} and Lawrence Lessin and Shagufta Yasmeen and Baljinder Singh and Janardan Khandekar and Shikany, {James M.} and Suzanne Satterfield and Chlebowski, {Rowan T.}",
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AU - Prentice, Ross L.

AU - Thomson, Cynthia

AU - Caan, Bette

AU - Hubbell, F. Allan

AU - Anderson, Garnet L.

AU - Beresford, Shirley A A

AU - Pettinger, Mary

AU - Lane, Dorothy S.

AU - Lessin, Lawrence

AU - Yasmeen, Shagufta

AU - Singh, Baljinder

AU - Khandekar, Janardan

AU - Shikany, James M.

AU - Satterfield, Suzanne

AU - Chlebowski, Rowan T.

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N2 - Background: The Women's Health Initiative Dietary Modification (DM) Randomized Controlled Trial evaluated the effects of a low-fat dietary pattern on chronic disease incidence, with breast cancer and colorectal cancer as primary outcomes. The trial protocol also listed ovarian cancer and endometrial cancer as outcomes that may be favorably affected by the intervention. Methods: A total of 48835 postmenopausal women were randomly assigned during 1993-1998 to a DM intervention (n = 19541) or comparison (usual diet; n = 29294) group and followed up for an average of 8.1 years. The intervention goal was to reduce total fat intake to 20% of energy and to increase consumption of vegetables, fruits, and grains. Cancer outcomes were verified by pathology report review. We used weighted log-rank tests to compare incidence of invasive cancers of the ovary and endometrium, total invasive cancer, and invasive cancers at other sites between the groups. All statistical tests were two-sided. Results: Ovarian cancer risk was lower in the intervention than in the comparison group (P =. 03). Although the overall ovarian cancer hazard ratio (HR) was not statistically significantly less than 1.0, the hazard ratio decreased with increasing intervention duration (Ptrend =. 01). For the first 4 years, the risk for ovarian cancer was similar in the intervention and control groups (0.52 cases per 1000 person-years in the intervention group versus 0.45 per 1000 person-years in the comparison group; HR = 1.16, 95% confidence interval [CI] = 0.73 to 1.84); over the next 4.1 years, the risk was lower in the intervention group (0.38 cases per 1000 person-years in the intervention group versus 0.64 per 1000 person-years in the comparison group; HR = 0.60, 95% CI = 0.38 to 0.96). Risk of cancer of the endometrium did not differ between the groups (P =. 18). The estimated risk of total invasive cancer was slightly lower in the intervention group than in the control group (HR = 0.95, 95% CI = 0.89 to 1.01; P =. 10). Conclusions: A low-fat dietary pattern may reduce the incidence of ovarian cancer among postmenopausal women.

AB - Background: The Women's Health Initiative Dietary Modification (DM) Randomized Controlled Trial evaluated the effects of a low-fat dietary pattern on chronic disease incidence, with breast cancer and colorectal cancer as primary outcomes. The trial protocol also listed ovarian cancer and endometrial cancer as outcomes that may be favorably affected by the intervention. Methods: A total of 48835 postmenopausal women were randomly assigned during 1993-1998 to a DM intervention (n = 19541) or comparison (usual diet; n = 29294) group and followed up for an average of 8.1 years. The intervention goal was to reduce total fat intake to 20% of energy and to increase consumption of vegetables, fruits, and grains. Cancer outcomes were verified by pathology report review. We used weighted log-rank tests to compare incidence of invasive cancers of the ovary and endometrium, total invasive cancer, and invasive cancers at other sites between the groups. All statistical tests were two-sided. Results: Ovarian cancer risk was lower in the intervention than in the comparison group (P =. 03). Although the overall ovarian cancer hazard ratio (HR) was not statistically significantly less than 1.0, the hazard ratio decreased with increasing intervention duration (Ptrend =. 01). For the first 4 years, the risk for ovarian cancer was similar in the intervention and control groups (0.52 cases per 1000 person-years in the intervention group versus 0.45 per 1000 person-years in the comparison group; HR = 1.16, 95% confidence interval [CI] = 0.73 to 1.84); over the next 4.1 years, the risk was lower in the intervention group (0.38 cases per 1000 person-years in the intervention group versus 0.64 per 1000 person-years in the comparison group; HR = 0.60, 95% CI = 0.38 to 0.96). Risk of cancer of the endometrium did not differ between the groups (P =. 18). The estimated risk of total invasive cancer was slightly lower in the intervention group than in the control group (HR = 0.95, 95% CI = 0.89 to 1.01; P =. 10). Conclusions: A low-fat dietary pattern may reduce the incidence of ovarian cancer among postmenopausal women.

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