Body mass and endometrial cancer risk by hormone replacement therapy and cancer subtype
- PMID: 18187388
- DOI: 10.1158/1055-9965.EPI-07-2567
Body mass and endometrial cancer risk by hormone replacement therapy and cancer subtype
Abstract
Epidemiologic studies unequivocally show that greater body mass increases the risk of endometrial cancer, but whether risk varies by use of postmenopausal hormone therapy (HT), location of fat deposition, or cancer subtype is still unclear. We examined these associations among 33,436 postmenopausal women in the Cancer Prevention Study II Nutrition Cohort, who completed questionnaires on diet, lifestyle, and medical history at baseline in 1992. A total of 318 cases were eligible through June 2003. Cox-proportional hazards analyses were used to estimate multivariate-adjusted rate ratios (RR). As expected, adult body mass index (BMI) was a strong predictor of risk [RR, 4.70; 95% confidence interval (CI), 3.12-7.07 for BMI 35+ versus 22.5-25.0, P trend < 0.0001]. Use of estrogen plus progestin postmenopausal HT modified the association. Among never-users, risk was significantly linear across the entire range of BMI examined (RR, 0.51; 95% CI, 0.29-0.92 for <22.5 versus 22.5-25.0; RR, 4.41; 95% CI, 2.70-7.20 for > or =35 versus 22.5-25.0, P trend < 0.0001), but among ever estrogen plus progestin users, the association was not significant (P trend = 1.0; P interaction < 0.0001). We observed no difference in risk according to tendency for central versus peripheral fat deposition. Greater BMI (> or =30 versus <25.0) increased risk of both "type I" (classic estrogen pathway, RR, 4.22; 95% CI, 3.07-5.81) and "type II" (serous, clear cell, and all other high grade) cancers (RR, 2.87; 95% CI, 1.59-5.16). The increased risk of endometrial cancer across the range of BMI in women who never used postmenopausal HT stresses the need to prevent both overweight and obesity in women.
Similar articles
-
Lifetime weight history and endometrial cancer risk by type of menopausal hormone use in the NIH-AARP diet and health study.Cancer Epidemiol Biomarkers Prev. 2007 Apr;16(4):723-30. doi: 10.1158/1055-9965.EPI-06-0675. Cancer Epidemiol Biomarkers Prev. 2007. PMID: 17416763
-
Body mass index, height, and the risk of ovarian cancer mortality in a prospective cohort of postmenopausal women.Cancer Epidemiol Biomarkers Prev. 2002 Sep;11(9):822-8. Cancer Epidemiol Biomarkers Prev. 2002. PMID: 12223425
-
Lack of evidence for effect modification by estrogen of association between body mass index and colorectal cancer risk among postmenopausal women.Cancer Causes Control. 2007 Oct;18(8):793-9. doi: 10.1007/s10552-007-9009-5. Epub 2007 Jul 6. Cancer Causes Control. 2007. PMID: 17619155
-
Breast cancer risk in the WHI study: the problem of obesity.Maturitas. 2005 May 16;51(1):83-97. doi: 10.1016/j.maturitas.2005.02.018. Maturitas. 2005. PMID: 15883113 Review.
-
Postmenopausal hormone replacement therapy: does the progestin make a difference?J S C Med Assoc. 2002 Feb;98(1):12-9. J S C Med Assoc. 2002. PMID: 11859600 Review. No abstract available.
Cited by
-
Endometrial Cancer Risk Among Germline BRCA1/2 Pathogenic Variant Carriers: Review of Our Current Understanding and Next Steps.JCO Precis Oncol. 2023 Sep;7:e2300290. doi: 10.1200/PO.23.00290. JCO Precis Oncol. 2023. PMID: 38061009 Free PMC article. Review.
-
An institutional study: Does Body Mass Index influence surgical approach, surgical morbidities, and outcomes in endometrial cancer patients?Facts Views Vis Obgyn. 2023 Sep;15(3):259-268. doi: 10.52054/FVVO.15.3.081. Facts Views Vis Obgyn. 2023. PMID: 37742203 Free PMC article.
-
The impact of adipose tissue distribution on endometrial cancer: a systematic review.Front Oncol. 2023 May 29;13:1182479. doi: 10.3389/fonc.2023.1182479. eCollection 2023. Front Oncol. 2023. PMID: 37313459 Free PMC article. Review.
-
Particles and Prejudice: Nanomedicine Approaches to Reducing Health Disparities in Endometrial Cancer.Small. 2023 Jun 13:e2300096. doi: 10.1002/smll.202300096. Online ahead of print. Small. 2023. PMID: 37312613 Review.
-
Associations of life course obesity with endometrial cancer in the Epidemiology of Endometrial Cancer Consortium (E2C2).Int J Epidemiol. 2023 Aug 2;52(4):1086-1099. doi: 10.1093/ije/dyad046. Int J Epidemiol. 2023. PMID: 37029916 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials