Sugar-sweetened beverage intake and the risk of type I and type II endometrial cancer among postmenopausal women

Cancer Epidemiol Biomarkers Prev. 2013 Dec;22(12):2384-94. doi: 10.1158/1055-9965.EPI-13-0636. Epub 2013 Nov 22.


Background: Sugar-sweetened beverage (SSB) intake has been associated with an increased risk of obesity and type II diabetes. However, its association with endometrial cancer is unclear.

Methods: We evaluated dietary intake of SSB, fruit juice, sugar-free beverages, sweets/baked goods, starch, and sugars among 23,039 postmenopausal women in the Iowa Women's Health Study. Incident estrogen-dependent type I and estrogen-independent type II endometrial cancers were identified via linkage with the Surveillance Epidemiology and End Results Registry. Risks of type I and type II endometrial cancers were separately compared by energy-adjusted dietary intake in Cox proportional hazards regression models.

Results: From 1986 to 2010, 506 type I and 89 type II incident endometrial cancers were identified. An increased risk of type I endometrial cancer was observed with increasing SSB intake after adjustment for body mass index (BMI) and other cofounders (Ptrend = 0.0005). Compared with nondrinkers of SSB, the risk was 78% higher [95% confidence intervals (CI), 1.32-2.40] among women in the highest quintile of SSB intake. The observed association was not modified by BMI, physical activity, history of diabetes, or cigarette smoking. Higher risk of type I endometrial cancer was also observed with higher intake of sugars. None of the dietary items included in the analysis was associated with type II endometrial cancer risk.

Conclusion: Higher intake of SSB and sugars was associated with an increased risk of type I, but not type II, endometrial cancer.

Impact: SSB intake may be a risk factor for type I endometrial cancer regardless of other lifestyle factors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Beverages*
  • Body Mass Index
  • Cohort Studies
  • Endometrial Neoplasms / chemically induced
  • Endometrial Neoplasms / epidemiology*
  • Female
  • Humans
  • Incidence
  • Iowa / epidemiology
  • Middle Aged
  • Obesity / chemically induced
  • Obesity / epidemiology*
  • Postmenopause
  • Proportional Hazards Models
  • Risk Factors
  • Surveys and Questionnaires
  • Sweetening Agents / administration & dosage*
  • Sweetening Agents / adverse effects


  • Sweetening Agents