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Body size in different periods of life, diabetes mellitus, hypertension, and risk of postmenopausal endometrial cancer (Sweden)

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Abstract

Objective: To measure the association between endometrial cancer risk and obesity at age 18 and recently, adult weight gain, diabetes mellitus and hypertension.

Methods: We performed a population-based, nationwide case–control study among postmenopausal women aged 50–74 years in Sweden, including 709 incident cases with histopathologically verified endometrial cancer and 3368 controls.

Results: Compared to lean women (recent body mass index (BMI), i.e. kg/m2 below 22.5), overweight women (recent BMI 28–29.99) had a 50% increase in risk for endometrial cancer (OR 1.5, 95% CI 1.0–2.1). Obese women (recent BMI 30–33.99) had a 3-fold increased risk (OR 2.9, 95% CI 2.0–4.0), and markedly obese women (recent BMI ≥ 34) a 6-fold increased risk (OR 6.3, 95% CI 4.2–9.5). The OR for Type 2 diabetes mellitus was 1.5 (95% CI 1.0–2.1) and for Type 1 diabetes mellitus it was 13.3 (3.1–56.4). The effect of recent BMI was similar for tumors having different degrees of differentiation and myometrial invasion, and did not vary with age, time since menopause, smoking status, diabetes mellitus, and use of contraceptives. Hypertension increased risk only among obese women. BMI at age 18, height, and adult weight change were not independent risk factors.

Conclusions: Recent overweight/obesity and diabetes mellitus (Types 1 and 2) are associated with endometrial cancer risk. Hypertension increases risk among obese women.

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References

  1. World Cancer Research Fund and American Institute of Cancer Research. Endometrium (1997) Food, Nutrition and Prevention of Cancer: a global perspective. Washington, DC: American Institute for Cancer Research, pp. 294-300.

    Google Scholar 

  2. Hankinson SE, Willet WC, Manson JE, et al. (1995) Alcohol, height, and adiposity in relation to estrogen and prolactin levels in postmenopausal women. J Natl Cancer Inst 87: 1297-1302.

    Google Scholar 

  3. Sho. SM, Newcomb PA (1998) Diabetes, body size, and risk of endometrial cancer. Am J Epidemiol 148: 234-240.

    Google Scholar 

  4. Brinton LA, Swanson CA (1992) Height and weight at various ages and risk of breast cancer. Ann Epidemiol 2: 597-609.

    Google Scholar 

  5. Magnusson C, Baron JA, Persson I, et al. (1998) Body size in different periods of life and breast cancer risk in post-menopausal women. Int J Cancer 76: 29-34.

    Google Scholar 

  6. Cummings SR, Nevitt MC, Browner WS, et al. (1995) Risk factors for hip fracture in white women. N Engl J Med 332: 767-773.

    Google Scholar 

  7. Grady D, Ernster VL (1996) Endometrial cancer. In: Schottenfeld D, Fraumeni JFJr, eds. Cancer Epidemiology and Prevention. 2nd edn. New York: Oxford University Press, pp. 1058-1108.

    Google Scholar 

  8. Breslow NE, Day NE (1980) Statistical Methods in Cancer Research. vol. 1: The Analysis of Case-Control Studies. Lyon: International Agency for Research on Cancer pp. 192-246.

    Google Scholar 

  9. Le Marchand L, Wilkens LR, Mi M-P (1991) Early-age body size, adult weight gain, and endometrial cancer risk. Int J Cancer 48: 807-811.

    Google Scholar 

  10. Shu XO, Brinton LA, Zheng W, et al. (1992) Relation of obesity, body fat distribution to endometrial cancer in Shanghai, China. Cancer Res 52: 3865-3870.

    Google Scholar 

  11. Swanson CA, Potischman N, Wilbanks GD, et al. (1993) Relation of endometrial cancer risk to past, contemporary body size and body fat distribution. Cancer Epidemiol Biomarkers Prevention 2: 321-327.

    Google Scholar 

  12. Olson SH, Trevisan M, Marshall JR, et al. (1995) Body mass index, weight gain, and risk of endometrial cancer. Nutr Cancer 23: 141-149.

    Google Scholar 

  13. Levi F, La Vecchia C, Negri E, Parazzini F, Francheschi S (1992) Body mass at different ages and subsequent endometrial cancer risk. Int J Cancer 50: 567-571.

    Google Scholar 

  14. Tornberg SA, Carstensen JM (1994) Relationship between Quetelet's index, cancer of the breast and female genital tract in 47,000 women followed for 25 years. Br J Cancer 69: 358-361.

    Google Scholar 

  15. La Vecchia FC, Parazzini F, Negri E, Fasoli M, Gentile A, Franceschi S (1991) Anthropometric indicators of endometrial cancer risk. Eur J Cancer 27: 487-490.

    Google Scholar 

  16. Huang Z, Hankinson SE, Colditz GA, et al. (1997) Dual ffeeffects of weight and weight gain on breast cancer risk. JAMA 278: 1407- 1411.

    Google Scholar 

  17. Stoll BA, Vatten LJ, Kvinnsland S (1994) Does early physical maturity in¯uence breast cancer risk? Acta Oncol 33: 171-176.

    Google Scholar 

  18. Levi F, Francheschi S, Negri E, La Vecchia C (1993) Dietary factors and the risk of endometrial cancer. Cancer 71: 3575-3581.

    Google Scholar 

  19. Henderson BE, Ross RK, Pike MC (1993) Hormonal chemoprevention of cancer in women. Science 259: 633-638.

    Google Scholar 

  20. Tretli S (1989) Height and weight in relation to breast cancer morbidity and mortality. A prospective study of 570,000 women in Norway. Int J Cancer 44: 23-30.

    Google Scholar 

  21. Ziegler RG, Hoover RN, Nomura AMY et al. (1996) Relative weight, weight change, height and breast cancer risk in Asian-American Women. J Natl Cancer Inst 88: 650-660.

    Google Scholar 

  22. De Stavola BL, Wang DY, Allen DS, et al. (1993) The association of height, weight, menstrual and reproductive events with breast cancer: results from two prospective studies form the island of Guernsey (United Kingdom). Cancer Causes Control 4: 331-340.

    Google Scholar 

  23. Vatten LJ, Kvikstad A, Nymoen EH (1992) Incidence and mortality of breast cancer related to body height and living during childhood and adolescence. Eur J Cancer 28: 128-131.

    Google Scholar 

  24. Pike MC, Spicer DV, Dahmoush L, Press MF (1993) Estrogens, progesterones, normal breast proliferation and breast cancer risk. Epidemiol Rev 15: 17-35.

    Google Scholar 

  25. Kaaks R (1996) Nutrition, hormones, and breast cancer: is insulin the missing link? Cancer Causes Control 7: 605-625.

    Google Scholar 

  26. Rutanen EM (1998) Insulin-like growth factors in endometrial function. Gynecol Endocrinol 12: 399-406.

    Google Scholar 

  27. Elwood JM, Cole P, Rothman KJ, Kaplan SD (1977) Epidemiology of endometrial cancer. J Natl Cancer Inst 59: 1055-1060.

    Google Scholar 

  28. Hoogerland DL, Buchler DA, Crowley JJ, Carr WF (1978) Estrogen use - risk of endometrial carcinoma. Gynecol Oncol 6: 451-458.

    Google Scholar 

  29. Hulka BS, Fowler WC Jr, Kaufman DG, et al. (1980) Estrogen and endometrial cancer: cases and two control groups from North Carolina. Am J Obstet Gynecol 137: 92-101.

    Google Scholar 

  30. Kelsey JL, Li Volsi VA, Holford TR, et al. (1982) A case-control study of cancer of the endometrium. Am J Epidemiol 116: 333-342.

    Google Scholar 

  31. O'Mara BA, Byers T, Schoenfeld E (1985) Diabetes mellitus and cancer risk: a multisite case-control study. J Chronic Dis 38: 435- 441.

    Google Scholar 

  32. Adami H-O, McLaughlin J, Ekbom A, et al. (1991) Cancer risk in patients with diabetes mellitus. Cancer Causes Control 2: 307-314.

    Google Scholar 

  33. La Vecchia C, Negri E, Franceschi S, D'Avanzo B, Boyle P (1994) A case-control study of diabetes mellitus and cancer risk. Br J Cancer 70: 950-953.

    Google Scholar 

  34. Maatela J, Aromaa A, Salmi T, Pohja M, Vuento M, Gronroos M (1994) The risk of endometrial cancer in diabetic and hypertensive patients: a nationwide record-linkage study in Finland. Ann Chir Gynaecol Suppl 208: 20-24.

    Google Scholar 

  35. Weiderpass E, Gridley G, Persson I, Nyren O, Ekbom A, Adami H-O (1997) Risk of endometrial and breast cancer in patients with diabetes mellitus. Int J Cancer 71: 360-363.

    Google Scholar 

  36. Troisi R, Potischman N, Hoover RN, Siiteri P, Brinton LA (1997) Insulin and endometrial cancer. Am J Epidemiol 146: 476-482.

    Google Scholar 

  37. International Agency for Research on Cancer (1999) Some Hormones, Postmenopausal Hormone Therapy, and Hormonal Contraception (2-9 June 1998). Monograph no. 72. Lyon: International Agency for Research on Cancer.

    Google Scholar 

  38. Gray LA Sr, Christopherson WM, Hoover RN (1977) Estrogens and endometrial carcinoma. Obstet Gynecol 49: 385-389.

    Google Scholar 

  39. Weiss NS, Farewell VT, Szekely DR, English DR, Kiviat N (1980) Oestrogen and endometrial cancer: ffeeffects of otehr risk factors in the association. Maturitas 2: 185-190.

    Google Scholar 

  40. Jelovsek FR, Hammond CB, Woodard BH, et al. (1980) Risk of exogenous estrogen therapy and endometrial cancer. Am J Obstet Gynecol 137: 85-91.

    Google Scholar 

  41. La Vecchia C, Decarli A, Fasoli M, Gentile A (1986) Nutrition and diet in the etiology of endometrial cancer. Cancer 57: 1248-1253.

    Google Scholar 

  42. Mack TM, Pike MC, Henderson BE, et al. (1976) Estrogens and endometrial cancer in a retirement community. N Engl J Med 294: 1262-1267.

    Google Scholar 

  43. Horwitz RI, Feinstein AR (1978) Alternative analytic methods for case-control studies of estrogens and endometrial cancer. N Engl J Med 299: 1089-1094.

    Google Scholar 

  44. Spengler RF, Clarke EA, Woolever CA, Newman AM, Osborn RW (1981) Exogenous estrogens and endometrial cancer: a case-control study and assessment of potential biases. Am J Epidemiol 114: 497-506.

    Google Scholar 

  45. Ewertz M, Schou G, Boice JD Jr (1988) The joint ffeeffect of risk factors on endometrial cancer. Eur J Cancer 24: 189-194.

    Google Scholar 

  46. Must A, Willett WC, Dietz WH (1993) Remote recall of childhood height, weight and body build by elderly subjects. Am J Epidemiol 143: 56-64.

    Google Scholar 

  47. Breslow NE, Day NE (1987) Statistical Methods in Cancer Research. vol. 2: The Design and Analysis of Cohort Studies. Lyon: International Agency for Research on Cancer, pp. 41-42.

    Google Scholar 

  48. Kuskowska-Wolk A, Karlsson P, Stolt M, Rössner S (1989) The predictive validity of body mass index based on self-reported weight and height. Int J Obesity 13: 441-453.

    Google Scholar 

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Weiderpass, E., Persson, I., Adami, HO. et al. Body size in different periods of life, diabetes mellitus, hypertension, and risk of postmenopausal endometrial cancer (Sweden). Cancer Causes Control 11, 185–192 (2000). https://doi.org/10.1023/A:1008946825313

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