Understanding risk factors for endometrial cancer in young women.
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Peeri Noah Charles, Bertrand Kimberly A, Na Renhua, De Vivo Immaculata, Setiawan Veronica Wendy, Seshan Venkatraman E, Alemany Laia, Chen Yu, Clarke Megan A, Clendenen Tess, Cook Linda S, Costas Laura, Dal Maso Luigino, Freudenheim Jo L, Friedenreich Christine M, Gierach Gretchen L, Goodman Marc T, La Vecchia Carlo, Levi Fabio, Lopez-Querol Marta, Lu Lingeng, Moysich Kirsten B, Mutter George, Naduparambil Jeffin, Negri Eva, O'Connell Kelli, O'Mara Tracy, Palmer Julie R, Parazzini Fabio, Penney Kathryn Lee, Petruzella Stacey, Reynolds Peggy, Ricceri Fulvio, Risch Harvey, Rohan Thomas E, Sacerdote Carlotta, Sandin Sven, Shu Xiao-Ou, Stolzenberg-Solomon Rachael Z, Webb Penelope M, Wentzensen Nicolas, Wilkens Lynne R, Xu Wanghong, Yu Herbert, Zeleniuch-Jacquotte Anne, Zheng Wei, Guo Xingyi, Lipworth Loren, Du Mengmeng
Аннотация
METHODS: We included 13 846 incident endometrial cancer patients (1639 aged younger than 50 years) and 30 569 matched control individuals from the Epidemiology of Endometrial Cancer Consortium. We used generalized linear models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for 6 risk factors and endometrial cancer risk. We created a risk score to evaluate the combined associations and population attributable fractions for these factors.
RESULTS: In younger and older women, we observed positive associations with body mass index and diabetes and inverse associations with age at menarche, oral contraceptive use, and parity. Current smoking was associated with reduced risk only in women aged 50 years and older (Phet < .01). Body mass index was the strongest risk factor (OR≥35 vs<25 kg/m2 = 5.57, 95% CI = 4.33 to 7.16, for ages younger than 50 years; OR≥35 vs<25 kg/m2 = 4.68, 95% CI = 4.30 to 5.09, for ages 50 years and older; Phet = .14). Possessing at least 4 risk factors was associated with approximately ninefold increased risk in women aged younger than 50 years and approximately fourfold increased risk in women aged 50 years and older (Phet < .01). Together, 59.1% of endometrial cancer in women aged younger than 50 years and 55.6% in women aged 50 years and older were attributable to these factors.
CONCLUSIONS: Our data confirm younger and older women share common endometrial cancer risk factors. Early educational efforts centered on these factors may help mitigate the rising endometrial cancer burden in young women.