Reproductive risk factors for endometrial cancer among Polish women

L A Brinton, L C Sakoda, J Lissowska, M E Sherman, N Chatterjee, B Peplonska, N Szeszenia-Dabrowska, W Zatonski, M Garcia-Closas, L A Brinton, L C Sakoda, J Lissowska, M E Sherman, N Chatterjee, B Peplonska, N Szeszenia-Dabrowska, W Zatonski, M Garcia-Closas

Abstract

We conducted a population-based case-control study of reproductive factors in Warsaw and Lódź, Poland, in 551 incident endometrial cancer cases and 1925 controls. The reproductive variable most strongly related to risk was multiparity, with subjects with three or more births having a 70% lower risk than the nulliparous women. The reduced risk was particularly strong below 55 years of age. Subjects with older ages at a first birth were also at reduced risk even after adjustment for number of births. Ages at last birth or intervals since last birth were not strongly related to risk. Spontaneous abortions were unrelated to risk, but induced abortions were associated with slight risk increases (odds ratios=1.28, 95% confidence intervals 0.8-2.1 for 3+ vs no abortions). The absence of effects on risk of later ages at, or short intervals since, a last birth fails to support the view that endometrial cancer is influenced by mechanical clearance of initiated cells. Alternative explanations for reproductive effects should be sought, including alterations in endogenous hormones.

References

    1. Albrektsen G, Heuch I, Kvale G (1999) Joint effects on cancer risk of age at childbirth, time since birth and attained age: circumventing the problem of collinearity. Stat Med 18: 1261–1277
    1. Albrektsen G, Heuch I, Tretli S, Kvale G (1995) Is the risk of cancer of the corpus uteri reduced by a recent pregnancy. A prospective study of 765 756 Norwegian women. Int J Cancer 61: 485–490
    1. Bartholomew LL, Grimes DA (1998) The alleged association between induced abortion and risk of breast cancer: biology or bias? Obstet Gynecol Surv 53: 708–714
    1. Brinton LA, Berman ML, Mortel R, Twiggs LB, Barrett RJ, Wilbanks GD, Lannom L, Hoover RN (1992) Reproductive, menstrual, and medical risk factors for endometrial cancer: results from a case–control study. Am J Obstet Gynecol 167: 1317–1325
    1. Brinton LA, Westhoff CL, Scoccia B, Lamb EJ, Althuis MD, Mabie JE, Moghissi KS (2005) Causes of infertility as predictors of subsequent cancer risk. Epidemiology 16: 500–507
    1. Chubak J, Tworoger SS, Yasui Y, Ulrich CM, Stanczyk FZ, McTiernan A (2004) Associations between reproductive and menstrual factors and postmenopausal sex hormone concentrations. Cancer Epidemiol Biomarkers Prev 13: 1296–1301
    1. Dahlgren E, Friberg LG, Johansson S, Lindstrom B, Oden A, Samsioe G, Janson PO (1991) Endometrial carcinoma; ovarian dysfunction – a risk factor in young women. Eur J Obstet Gynecol Reprod Biol 41: 143–150
    1. Escobedo LG, Lee NC, Peterson HB, Wingo PA (1991) Infertility-associated endometrial cancer risk may be limited to specific subgroups of infertile women. Obstet Gynecol 77: 124–128
    1. Henderson BE, Casagrande JT, Pike MC, Mack T, Rosario I, Duke A (1983) The epidemiology of endometrial cancer in young women. Br J Cancer 47: 749–756
    1. Heuch I, Albrektsen G, Kvale G (1999) Modeling effects of age at and time since delivery on subsequent risk of cancer. Epidemiology 10: 739–746
    1. Hinkula M, Pukkala E, Kyyronen P, Kauppila A (2002) Grand multiparity and incidence of endometrial cancer: a population-based study in Finland. Int J Cancer 98: 912–915
    1. Kaaks R, Lukanova A, Kurzer MS (2002) Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomarkers Prev 11: 1531–1543
    1. Kvale G, Heuch I, Nilssen S (1991) Reproductive factors and cancers of the breast and genital organs – are the different cancer sites similarly affected? Cancer Detect Prev 15: 369–377
    1. Kvale G, Heuch I, Ursin G (1988) Reproductive factors and risk of cancer of the uterine corpus: a prospective study. Cancer Res 48: 6217–6221
    1. Lambe M, Wuu J, Weiderpass E, Hsieh CC (1999) Childbearing at older age and endometrial cancer risk (Sweden). Cancer Causes Control 10: 43–49
    1. Lesko SM, Rosenberg L, Kaufman DW, Stolley P, Warshauer ME, Lewis Jr JL, Shapiro S (1991) Endometrial cancer and age at last delivery: evidence for an association. Am J Epidemiol 133: 554–559
    1. McPherson CP, Sellers TA, Potter JD, Bostick RM, Folsom AR (1996) Reproductive factors and risk of endometrial cancer. The Iowa Women's Health Study. Am J Epidemiol 143: 1195–1202
    1. Modan B, Ron E, Lerner-Geva L, Blumstein T, Menczer J, Rabinovici J, Oelsner G, Freedman L, Mashiach S, Lunenfeld B (1998) Cancer incidence in a cohort of infertile women. Am J Epidemiol 147: 1038–1042
    1. Newcomb PA, Trentham-Dietz A (2000) Breast feeding practices in relation to endometrial cancer risk, USA. Cancer Causes Control 11: 663–667
    1. Parazzini F, La Vecchia C, Negri E, Fedele L, Balotta F (1991) Reproductive factors and risk of endometrial cancer. Am J Obstet Gynecol 164: 522–527
    1. Parazzini F, Negri E, La Vecchia C, Benzi G, Chiaffarino F, Polatti A, Francheschi S (1998) Role of reproductive factors on the risk of endometrial cancer. Int J Cancer 76: 784–786
    1. Parslov M, Lidegaard O, Klintorp S, Pedersen B, Jonsson L, Eriksen PS, Ottesen B (2000) Risk factors among young women with endometrial cancer: a Danish case–control study. Am J Obstet Gynecol 182: 23–29
    1. Petrakis NL, Wrensch MR, Ernster VL, Miike R, Murai J, Simberg N, Siiteri PK (1987) Influence of pregnancy and lactation on serum and breast fluid estrogen levels: implications for breast cancer risk. Int J Cancer 40: 587–591
    1. Pettersson B, Adami HO, Bergstrom R, Johansson ED (1986) Menstruation span – a time-limited risk factor for endometrial carcinoma. Acta Obstet Gynecol Scand 65: 247–255
    1. Pierpoint T, McKeigue PM, Isaacs AJ, Wild SH, Jacobs HS (1998) Mortality of women with polycystic ovary syndrome at long-term follow-up. J Clin Epidemiol 51: 581–586
    1. Rookus MA, van Leeuwen FE (1996) Induced abortion and risk for breast cancer: reporting (recall) bias in a Dutch case–control study. J Natl Cancer Inst 88: 1759–1764
    1. Rosenblatt KA, Thomas DB (1995) Prolonged lactation and endometrial cancer. WHO Collaborative Study of Neoplasia and Steroid Contraceptives. Int J Epidemiol 24: 499–503
    1. Salazar-Martinez E, Lazcano-Ponce EC, Gonzalez Lira-Lira G, Escudero-De los RP, Salmeron-Castro J, Hernandez-Avila M (1999) Reproductive factors of ovarian and endometrial cancer risk in a high fertility population in Mexico. Cancer Res 59: 3658–3662
    1. Shu XO, Brinton LA, Zheng W, Gao YT, Fan J, Fraumeni Jr JF (1991) A population-based case–control study of endometrial cancer in Shanghai, China. Int J Cancer 49: 38–43
    1. Tang MT, Weiss NS, Daling JR, Malone KE (2000) Case–control differences in the reliability of reporting a history of induced abortion. Am J Epidemiol 151: 1139–1143
    1. Wernli KJ, Ray RM, Gao DL, De Roos AJ, Checkoway H, Thomas DB (2006) Menstrual and reproductive factors in relation to risk of endometrial cancer in Chinese women. Cancer Causes Control 17: 949–955
    1. Xu WH, Xiang YB, Ruan ZX, Zheng W, Cheng JR, Dai Q, Gao YT, Shu XO (2004) Menstrual and reproductive factors and endometrial cancer risk: Results from a population-based case–control study in urban Shanghai. Int J Cancer 108: 613–619

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する