Dietary patterns and risk of cervical cancer: a case-control study in Uruguay

Eduardo De Stefani, Gisele Acosta, Hugo Deneo-Pellegrini, Alvaro L. Ronco, María Mendilaharsu, Gabriel Landó, María E. Luaces, Cecilia Silva

.

DOI: 10.4236/ojog.2011.12006                

Abstract

In the time period 1996-2004, a case-control study on diet and cervical cancer was conducted at the National Cancer Institute in Uruguay. The study included 268 cases and 536 controls with non-neoplastic diseases. The foods and beverages in the food-frequency questionnaire were included in a factor analytic model. This method retained three factors which were labeled as the drinker, red meat, and prudent patterns. The model explained 60% of the variance. Whereas the red meat and drinker patterns were directly associated with the risk of cervical cancer (OR for red meat pattern 1.79, 95% CI 1.12-2.86), on the other hand, the prudent pattern was inversely associated with cervical cancer (OR 0.60, 95% CI 0.38-0.93). To our knowledge, this study was the first one using factor analysis in order to elucidate the role of the diet in relation with cervical cancer.

Keywords

Dietary Patterns; Cervical Cancer

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Barrios, E., Vassallo, J.A., Alonso, R., Garau, M. and Musetti, C. (2010) III Atlas de Incidencia del Cáncer en el Uruguay. Registro Nacional de Cáncer. Comisión Honoraria de Lucha contra el Cáncer, 87-88 (In Spanish).
[2]	De Stefani, E., Fierro, L., Barrios, E. and Ronco, A. (1994) Cancer mortality trends in Uruguay 1953-1991. International Journal of Cancer, 56, 634-639. doi:10.1002/ijc.2910560505
[3]	Schiffman, M.H., Brinton, L.A., Devesa, S.S. and Fraumeni, J.F. (1996) Cervical cancer. In: Schottenfeld, D. and Fraumeni, J.F. Eds. Cancer Epidemiology and Prevention. Second Edition. Oxford University Press, New York, 1090-1116.
[4]	IARC Monographs on the evaluation of carcinogenic risks to humans. (2004) Tobacco smoke and involuntary smoking, 83, Lyon, France, 743-792.
[5]	World Cancer Research Fund/American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: A global perspective. AICR, Washington DC, 302-304.
[6]	Mulaik, S.A. (2010) Foundations of Factor Analysis. Second Edition, CRC Press, Boca Raton, 276-279.
[7]	De Stefani, E., Deneo-Pellegrini, H., Boffetta, P., et al. (2009) Dietary patterns and risk of cancer: A factor analysis in Uruguay. International Journal of Cancer, 124, 1391-1397. doi:10.1002/ijc.24035
[8]	Ronco, A.L., De Stefani, E., Boffetta, P., et al. (2006) Food patterns and risk of breast cancer: A factor analysis study in Uruguay. International Journal of Cancer, 119, 1672-1678. doi:10.1002/ijc.22021
[9]	Dixon, L.B., Balder, H.B., Virtannen, M.J., et al. (2004) Dietary patterns associated with colon and rectum cancer: Results from the Dietary Patterns and Cancer (DIETSCAN) Project. The American Journal of Clinical Nutrition, 80, 1003-1011.
[10]	Slattery, M.L., Boucher, K.M., Cann, B.J., et al. (1998) Eating patterns and risk of colon cancer. American Journal of Epidemiology, 148, 4-16.
[11]	Gorsuch, R.L. (2008) Factor Analysis. Second Edition. Psychology Press, Taylor & Francis Group, London, 234-236.
[12]	Thomson, G.H. (1951) The factorial analysis of human ability. University of London Press, London.
[13]	Rothman, K.J., Greenland, S. and Lash, T. (2008) Modern epidemiology. Third Edition. Lippincott Williams & Wilkins, Philadelphia, 303-327.
[14]	StataCorp. (2007) Stata Statistical Software. Release 10. College Station, StataCorp LP, Texas.
[15]	Thurstone, L.L. (1947) Multiple factor analysis: A development and expansion of vectors of the mind. University of Chicago Press, Chicago.
[16]	Kline, P. (2002) An easy guide to factor analysis. Routlege, New York.
[17]	Brinton, L.A., Reeves, W.C., Brenes, M.M., et al. (1989) The male factor in the etiology of cervical cancer among sexually monogamous women. International Journal of Cancer, 44, 199-203. doi:10.1002/ijc.2910440202
[18]	Mu?oz, N., Bosch, F.X., Shah, K.V., Meheus, A. (Editors) (1992) The epidemiology of human papillomavirus and cervical cancer. IARC Scientific Publications, Lyon.
[19]	Bosch, F.X., Manos, M.M., Mu?oz, N., et al. (1995) Prevalence of human papillomavirus in cervical cancer: A worldwide perspective. Journal of the National Cancer Institute, 87, 796-802. doi:10.1093/jnci/87.11.796
[20]	Herrero, R., Potischman, N., Brinton, L.A., et al. (1991) A case-control study of nutrient status and invasive cervical cancer: I. dietary indicators. American Journal of Epidemiology, 134, 1335-1346.
[21]	Castellsagué, X., Bosch, F.X., Mu?oz, N., et al. (2002) Male circumsion, penile human papillomavirus infection, and cervical cancer in female partners. The New England Journal of Medicine, 346, 1105-1112. doi:10.1056/NEJMoa011688
[22]	Carámbula, J.A., Ronco, A.L. and Niedworok, N.T. (1995) Investigación sociolaboral del tabaquismo en el Uruguay urbano. Programa Nacional de Prevencion del Cáncer de Pulmón. Dirección General de Salud. Ministerio de Salud Pública, Academia Nacional de Medicina, Uruguay, (In Spanish).
[23]	Gunnell, A.S., Tran, T.N., Torrang, A., et al. (2006) Synergy between cigarette smoking and human papillomavirus type 16 in cervical cancer in situ development. Cancer Epidemiology, Biomarkers & Prevention, 15, 2141-2147. doi:10.1158/1055-9965.EPI-06-0399
[24]	Sinha, R. (2002) An epidemiologic approach to studying heterocyclic amines. Mutation Research, 506-507, 197-204. doi:10.1016/S0027-5107(02)00166-5
[25]	Weisburger, J.H. (2002) Comments on the history and importance of aromatic and heterocyclic amines in public health. Mutation Research, 506-507, 9-20. doi:10.1016/S0027-5107(02)00147-1
[26]	IARC Handbooks of Cancer Prevention. (2003) Fruit and Vegetables. IARC Press, Lyon, 8, 89-92.