Dietary cadmium exposure and risk of breast, endometrial, and ovarian cancer in the Women's Health Initiative

• Published in: Environmental health perspectives Vol. 122; no. 6; pp. 594 - 600
• Main Authors: Adams, Scott V, Quraishi, Sabah M, Shafer, Martin M, Passarelli, Michael N, Freney, Emily P, Chlebowski, Rowan T, Luo, Juhua, Meliker, Jaymie R, Mu, Lina, Neuhouser, Marian L, Newcomb, Polly A
• Format: Journal Article
• Language: English
• Published: United States National Institute of Environmental Health Sciences 01.06.2014; NLM-Export
• Subjects: Aged; Assessments; Breast; Breast cancer; Breast Neoplasms - epidemiology; Breast Neoplasms - etiology; Cadmium; Cadmium - administration & dosage; Cadmium - analysis; Cadmium - toxicity; Cancer; Creatinine; Diet - statistics & numerical data; DNA methylation; Endometrial cancer; Endometrial Neoplasms - epidemiology; Endometrial Neoplasms - etiology; Environmental Exposure - statistics & numerical data; Estrogens; FDA approval; Female; Food; Food Contamination; Foods; Hazardous Substances - administration & dosage; Hazardous Substances - analysis; Hazardous Substances - toxicity; Health; Health aspects; Health promotion; Health risks; Heavy metals; Humans; Intakes; Laboratories; Medical research; Middle Aged; Nutrition research; Observational studies; Ovarian cancer; Ovarian Neoplasms - epidemiology; Ovarian Neoplasms - etiology; Risk; Risk Factors; Studies; Tobacco; Trends; United States - epidemiology; Urine; Women's Health; Womens health; United States; United States > US
• ISSN: 0091-6765; 1552-9924
• DOI: 10.1289/ehp.1307054

In vitro and animal data suggest that cadmium, a heavy metal that contaminates some foods and tobacco plants, is an estrogenic endocrine disruptor. Elevated estrogen exposure is associated with breast, endometrial, and ovarian cancer risk. We examined the association between dietary cadmium intake and risk of these cancers in the large, well-characterized Women's Health Initiative (WHI). A total of 155,069 postmenopausal women, 50-79 years of age, who were enrolled in the WHI clinical trials or observational study, participated in this study. We estimated dietary cadmium consumption by combining baseline food frequency questionnaire responses with U.S. Food and Drug Administration data on food cadmium content. Participants reported incident invasive breast, endometrial, or ovarian cancer, and WHI centrally adjudicated all cases through August 2009. We applied Cox regression to estimate adjusted hazard ratios (HRs) and 95% CIs for each cancer, comparing quintiles of energy-adjusted dietary cadmium intake. Over an average of 10.5 years, 6,658 invasive breast cancers, 1,198 endometrial cancers, and 735 ovarian cancers were reported. We observed no statistically significant associations between dietary cadmium and risk of any of these cancers after adjustment for potential confounders including total dietary energy intake. Results did not differ in any subgroup of women examined. We found little evidence that dietary cadmium is a risk factor for breast, endometrial, or ovarian cancers in postmenopausal women. Misclassification in dietary cadmium assessment may have attenuated observed associations.