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Healthy Eating Index-2020 and Risk of Endometrial Cancer: A Case-Control Study Among Iranian Women
Elahe Etesami1,2, Ali Nikparast3,4, Matin Ghanavati4
1Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nutrition and Cancer
|February 7, 2026
Summary
High-quality diets significantly reduce endometrial cancer (EC) risk. Adhering to the Healthy Eating Index-2020 (HEI-2020) was linked to an 83% lower odds of developing EC in Iranian women.
Area of Science:
- Gynecologic Oncology
- Nutritional Epidemiology
- Cancer Prevention
Background:
- Endometrial cancer (EC) incidence is rising globally, especially in regions undergoing nutritional shifts.
- Limited data exists on diet quality and EC risk in non-Western populations.
- Dietary patterns are increasingly recognized as crucial factors in cancer development.
Purpose of the Study:
- To investigate the association between diet quality, assessed by the Healthy Eating Index-2020 (HEI-2020), and endometrial cancer risk.
- To evaluate the role of specific dietary components in endometrial cancer risk among Iranian women.
Main Methods:
- A hospital-based case-control study was conducted in Tehran, Iran, including 136 EC cases and 272 matched controls.
- Dietary intake was assessed using a 168-item food frequency questionnaire.
- Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for potential confounders.
Main Results:
- Women in the highest tertile of HEI-2020 adherence had significantly lower odds of EC (OR = 0.17; 95% CI: 0.09-0.30) compared to the lowest tertile (P < 0.001).
- This inverse association was consistent across different BMI categories and menopausal statuses.
- Key beneficial dietary factors included higher intake of vegetables, legumes, and plant proteins, while reduced intake of saturated fats, added sugars, and refined grains was also noted.
Conclusions:
- Greater adherence to the HEI-2020 is independently associated with a reduced risk of endometrial cancer in Iranian women.
- These findings highlight the importance of high-quality dietary patterns for cancer prevention.
- Further prospective studies in diverse populations are warranted to confirm these results.
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