Noah Charles Peeri, Kimberly A Bertrand, Renhua Na, Immaculata De Vivo, Veronica Wendy Setiawan, Venkatraman E Seshan, Laia Alemany, Yu Chen, Megan A Clarke, Tess Clendenen, Linda S Cook, Laura Costas, Luigino Dal Maso, Jo L Freudenheim, Christine M Friedenreich, Gretchen L Gierach, Marc T Goodman, Carlo La Vecchia, Fabio Levi, Marta Lopez-Querol, Lingeng Lu, Kirsten B Moysich, George Mutter, Jeffin Naduparambil, Eva Negri, Kelli O'Connell, Tracy O'Mara, Julie R Palmer, Fabio Parazzini, Kathryn Lee Penney, Stacey Petruzella, Peggy Reynolds, Fulvio Ricceri, Harvey Risch, Thomas E Rohan, Carlotta Sacerdote, Sven Sandin, Xiao-Ou Shu, Rachael Z Stolzenberg-Solomon, Penelope M Webb, Nicolas Wentzensen, Lynne R Wilkens, Wanghong Xu, Herbert Yu, Anne Zeleniuch-Jacquotte, Wei Zheng, Xingyi Guo, Loren Lipworth, Mengmeng Du
{"title":"Understanding risk factors for endometrial cancer in young women.","authors":"Noah Charles Peeri, Kimberly A Bertrand, Renhua Na, Immaculata De Vivo, Veronica Wendy Setiawan, Venkatraman E Seshan, Laia Alemany, Yu Chen, Megan A Clarke, Tess Clendenen, Linda S Cook, Laura Costas, Luigino Dal Maso, Jo L Freudenheim, Christine M Friedenreich, Gretchen L Gierach, Marc T Goodman, Carlo La Vecchia, Fabio Levi, Marta Lopez-Querol, Lingeng Lu, Kirsten B Moysich, George Mutter, Jeffin Naduparambil, Eva Negri, Kelli O'Connell, Tracy O'Mara, Julie R Palmer, Fabio Parazzini, Kathryn Lee Penney, Stacey Petruzella, Peggy Reynolds, Fulvio Ricceri, Harvey Risch, Thomas E Rohan, Carlotta Sacerdote, Sven Sandin, Xiao-Ou Shu, Rachael Z Stolzenberg-Solomon, Penelope M Webb, Nicolas Wentzensen, Lynne R Wilkens, Wanghong Xu, Herbert Yu, Anne Zeleniuch-Jacquotte, Wei Zheng, Xingyi Guo, Loren Lipworth, Mengmeng Du","doi":"10.1093/jnci/djae210","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The American Cancer Society recommends physicians inform average risk women about endometrial cancer (EC) risk on reaching menopause, but new diagnoses are rising fastest in women <50 years. Educating these women about EC risks requires knowledge of risk factors. However, EC in young women is rare and challenging to study in single study populations.</p><p><strong>Methods: </strong>We included 13,846 incident EC patients (1,639 < 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 EC risk. We created a risk score to evaluate the combined associations and population attributable fractions of these factors.</p><p><strong>Results: </strong>In younger and older women, we observed positive associations with BMI and diabetes, and inverse associations with age at menarche, oral contraceptive use, and parity. Current smoking was associated with reduced risk only in women ≥50 years (PHet<0.01). BMI was the strongest risk factor [OR≥35 vs <25 kg/m2=5.57 (95% CI:4.33-7.16) for <50 years; OR≥35 vs <25 kg/m2=4.68 (95% CI : 4.30-5.09) for ≥50 years; PHet=0.14]. Possessing ≥4 risk factors was associated with ∼9-fold increased risk in women <50 years and ∼4-fold increased risk in women ≥50 years (PHet<0.01). Together, 59.1% of ECs in women <50 and 55.6% in women ≥50 were attributable to these factors.</p><p><strong>Conclusions: </strong>Our data confirm younger and older women share common EC risk factors. Early educational efforts centered on these factors may help mitigate the rising EC burden in young women.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JNCI Journal of the National Cancer Institute","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jnci/djae210","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The American Cancer Society recommends physicians inform average risk women about endometrial cancer (EC) risk on reaching menopause, but new diagnoses are rising fastest in women <50 years. Educating these women about EC risks requires knowledge of risk factors. However, EC in young women is rare and challenging to study in single study populations.
Methods: We included 13,846 incident EC patients (1,639 < 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 EC risk. We created a risk score to evaluate the combined associations and population attributable fractions of these factors.
Results: In younger and older women, we observed positive associations with BMI and diabetes, and inverse associations with age at menarche, oral contraceptive use, and parity. Current smoking was associated with reduced risk only in women ≥50 years (PHet<0.01). BMI was the strongest risk factor [OR≥35 vs <25 kg/m2=5.57 (95% CI:4.33-7.16) for <50 years; OR≥35 vs <25 kg/m2=4.68 (95% CI : 4.30-5.09) for ≥50 years; PHet=0.14]. Possessing ≥4 risk factors was associated with ∼9-fold increased risk in women <50 years and ∼4-fold increased risk in women ≥50 years (PHet<0.01). Together, 59.1% of ECs in women <50 and 55.6% in women ≥50 were attributable to these factors.
Conclusions: Our data confirm younger and older women share common EC risk factors. Early educational efforts centered on these factors may help mitigate the rising EC burden in young women.
期刊介绍:
The Journal of the National Cancer Institute is a reputable publication that undergoes a peer-review process. It is available in both print (ISSN: 0027-8874) and online (ISSN: 1460-2105) formats, with 12 issues released annually. The journal's primary aim is to disseminate innovative and important discoveries in the field of cancer research, with specific emphasis on clinical, epidemiologic, behavioral, and health outcomes studies. Authors are encouraged to submit reviews, minireviews, and commentaries. The journal ensures that submitted manuscripts undergo a rigorous and expedited review to publish scientifically and medically significant findings in a timely manner.