Low-fat diet and skin cancer risk: The women's health initiative randomized controlled dietary modification trial

Christina S. Gamba, Marcia L. Stefanick, James M. Shikany, Joseph Larson, Eleni Linos, Stacy T. Sims, James Marshall, Linda Van Horn, Nathalie Zeitouni, Jean Y. Tang*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Large cohort studies have reported no relationship between dietary fat and nonmelanoma skin cancer (NMSC), although a low-fat diet intervention reduced NMSC risk in a small clinical trial. In animal studies, skin tumor development has been reduced by low-fat diet. We evaluated the effect of a low-fat dietary pattern on NMSC and melanoma in the Women's Health Initiative Dietary Modification trial. Methods: Postmenopausal women aged 50 to 79 years (n = 48,835) were randomly assigned to the low-fat dietary pattern intervention (n = 19,541) or comparison group (n = 29,294). The intervention goals included decreasing fat intake to 20% or less of calories, increasing vegetable and fruit intake, and increasing grain intake. Self-reported incident NMSC (n = 4,907) and physician-adjudicated incident melanoma (n = 279) were ascertained every 6 months. Results: Over 8.1 years of follow-up, the low-fat diet intervention did not affect overall incidence of NMSC [HR 0.98; 95% confidence interval (CI), 0.92-1.04] or melanoma (HR, 1.04; 95% CI, 0.82-1.32). In subgroup analyses of melanoma risk, baseline fat intake interacted significantly with group assignment (Pinteraction = 0.006). Amongwomen with higher baseline fat intake, the dietary intervention significantly increased risk (HR, 1.48; 95% CI, 1.06-2.07), whereas, among women with lower baseline fat intake, the intervention tended to reduce melanoma risk (HR, 0.72; 95% CI, 0.50-1.02). Conclusions: In this large randomized trial, a low-fat dietary pattern did not affect overall incidence of NMSC or melanoma. Impact: A low-fat diet does not reduce incidence of NMSC, but an interaction between baseline fat intake and dietary intervention on melanoma risk warrants further investigation.

Original languageEnglish (US)
Pages (from-to)1509-1519
Number of pages11
JournalCancer Epidemiology Biomarkers and Prevention
Issue number9
StatePublished - Sep 2013

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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