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(Abstracted from Gynecol Oncol2020;158(2):407–414)Individuals diagnosed with endometrial cancer (EC) and presenting with early-stage disease have favorable outcomes and a high probability of cure compared with those presenting with advanced disease. Aggressive early interventions including surgery that contribute to good outcomes may be less available for those with various barriers to screening and health care access, including lacking insurance coverage.

Objective To determine the inherited factors associated with the ability to smell asparagus metabolites in urine.Design Genome wide association study.Setting Nurses’ Health Study and Health Professionals Follow-up Study cohorts.Participants 6909 men and women of European-American descent with available genetic data from genome wide association studies.Main outcome measure Participants were characterized as asparagus smellers if they strongly agreed with the prompt “after eating asparagus, you notice a strong characteristic odor in your urine,” and anosmic if otherwise. We calculated per-allele estimates of asparagus anosmia for about nine million single nucleotide polymorphisms using logistic regression. P values <5×10-8were considered as genome wide significant.Results 58.0% of men (n=1449/2500) and 61.5% of women (n=2712/4409) had anosmia. 871 single nucleotide polymorphisms reached genome wide significance for asparagus anosmia, all in a region on chromosome 1 (1q44: 248139851-248595299) containing multiple genes in the olfactory receptor 2 (OR2) family. Conditional analyses revealed three independent markers associated with asparagus anosmia: rs13373863, rs71538191, and rs6689553.Conclusion A large proportion of people have asparagus anosmia. Genetic variation near multiple olfactory receptor genes is associated with the ability of an individual to smell the metabolites of asparagus in urine. Future replication studies are necessary before considering targeted therapies to help anosmic people discover what they are missing.