(P13-036-25) Ultra-Processed Food Intake and Risk of Incident Ovarian and Endometrial Cancer in the NIH-AARP Cohort

Objectives: To determine whether ultra-processed food (UPF) intake is associated with ovarian and endometrial cancer incidence.

Methods: Our study population included >100,000 women in the United States who participated in the NIH-AARP Diet and Health Study and were 50 to 71 (median age 62) years of age and cancer-free at baseline in 1995-1996. Participants completed a food frequency questionnaire (FFQ) at baseline and were followed for cancer incidence for >20 years. We disaggregated FFQ items into FNDDS food codes and assigned Nova classification based on database linkage. We estimated UPF intake (g/day) and created quintiles using energy-adjusted values. We used Cox proportional hazard models, adjusted for potential confounding factors, to estimate hazard ratios (HR) and 95% confidence intervals (CI) for epithelial ovarian and endometrial cancer incidence, overall and by histotype.

Results: Among 129,870 female participants, without a history of oophorectomy, 1234 epithelial ovarian cancer cases were diagnosed. Median UPF intake in the lowest and highest quintiles ranged from 358 to 1249 g/day. Those with the highest, compared to the lowest, UPF intake were more likely to have used oral contraceptives (45% vs. 37%) and less likely to be nulliparous (14% vs. 16%). UPF intake was not associated with ovarian cancer risk (HR_Q5vs.Q1=0.92; 95% CI, 0.77-1.11), overall or by histotype. Among 107,592 female participants, without a history of hysterectomy, 2249 endometrial cancer cases were diagnosed. Participants in the highest quintile of UPF intake tended to have higher BMI (median [IQR] BMI, 27.4 [23.9-31.7] kg/m²) than those in the lowest quintile (median [IQR] BMI, 24.4 [22.0-28.0] kg/m²). Higher UPF intake was associated with increased endometrial cancer risk (HR_Q5vs.Q1=1.25; 1.09-1.43). This association was attenuated to the null after adjustment for BMI (HR_Q5vs.Q1=0.96; 0.83-1.10). HR estimates were similar for Type I endometrial cancer, which is the subtype most strongly associated with BMI.

Conclusions: In this cohort of US women, we found evidence of a positive association between UPF intake and risk of endometrial, but not ovarian cancer. The positive association with endometrial cancer was not independent of BMI.

Funding Sources: NIH Intramural Research Program