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

Published:October 27, 2022DOI:


      • We conducted an individual-participant data meta-analysis of dietary omega-3 fatty acids and endometrial cancer risk.
      • Data were obtained from 12 prospective cohort studies.
      • Small, positive associations between dietary omega-3 fatty acids and endometrial cancer were observed overall.
      • Stronger, moderate positive associations were observed among participants with body mass indices ≥25 kg/m2.



      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.


      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.


      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.



      AA (Arachidonic acid), ALA (Alpha-linolenic acid), BWHS (Black Women's Health Study), BMI (Body mass index), CI (Confidence interval), DHA (Docosahexaenoic acid), DPA (Docosapentaenoic acid), EPA (Eicosapentaenoic acid), E2C2 (Epidemiology of Endometrial Cancer Consortium), FFQ (Food frequency questionnaire), HR (Hazard ratio), IPD (Individual-participant data), LA (Linoleic acid), LCn3 (Long-chain omega-3), OR (Odds ratio), n6 (Omega-6), PUFA (Polyunsaturated fatty acid), VITAL (Vitamins and Lifestyle cohort study), WHI (Women's Health Initiative)
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