Type I and II endometrial cancers: have they different risk factors?
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Setiawan Veronica Wendy, Yang Hannah P, Pike Malcolm C, McCann Susan E, Yu Herbert, Xiang Yong-Bing, Wolk Alicja, Wentzensen Nicolas, Weiss Noel S, Webb Penelope M, van den Brandt Piet A, van de Vijver Koen, Thompson Pamela J, Australian National Endometrial Cancer Study Group, Strom Brian L, Spurdle Amanda B, Soslow Robert A, Shu Xiao-ou, Schairer Catherine, Sacerdote Carlotta, Rohan Thomas E, Robien Kim, Risch Harvey A, Ricceri Fulvio, Rebbeck Timothy R, Rastogi Radhai, Prescott Jennifer, Polidoro Silvia, Park Yikyung, Olson Sara H, Moysich Kirsten B, Miller Anthony B, McCullough Marjorie L, Matsuno Rayna K, Magliocco Anthony M, Lurie Galina, Lu Lingeng, Lissowska Jolanta, Liang Xiaolin, Lacey James V, Kolonel Laurence N, Henderson Brian E, Hankinson Susan E, Håkansson Niclas, Goodman Marc T, Gaudet Mia M, Garcia-Closas Montserrat, Friedenreich Christine M, Freudenheim Jo L, Doherty Jennifer, De Vivo Immaculata, Courneya Kerry S, Cook Linda S, Chen Chu, Cerhan James R, Cai Hui, Brinton Louise A, Bernstein Leslie, Anderson Kristin E, Anton-Culver Hoda, Schouten Leo J, Horn-Ross Pamela L
Аннотация
PATIENTS AND METHODS: Individual-level data from 10 cohort and 14 case-control studies from the Epidemiology of Endometrial Cancer Consortium were pooled. A total of 14,069 endometrial cancer cases and 35,312 controls were included. We classified endometrioid (n = 7,246), adenocarcinoma not otherwise specified (n = 4,830), and adenocarcinoma with squamous differentiation (n = 777) as type I tumors and serous (n = 508) and mixed cell (n = 346) as type II tumors.
RESULTS: Parity, oral contraceptive use, cigarette smoking, age at menarche, and diabetes were associated with type I and type II tumors to similar extents. Body mass index, however, had a greater effect on type I tumors than on type II tumors: odds ratio (OR) per 2 kg/m(2) increase was 1.20 (95% CI, 1.19 to 1.21) for type I and 1.12 (95% CI, 1.09 to 1.14) for type II tumors (P heterogeneity < .0001). Risk factor patterns for high-grade endometrioid tumors and type II tumors were similar.
CONCLUSION: The results of this pooled analysis suggest that the two endometrial cancer types share many common etiologic factors. The etiology of type II tumors may, therefore, not be completely estrogen independent, as previously believed.