Anthropometric factors and endometrial cancer risk: a systematic review and dose–response meta-analysis of prospective studies

Aune, Dagfinn; Rosenblatt, Deborah A. Navarro; Chan, Doris S. M.; Vingeliene, Snieguole; Abar, Leila; Vieira, Ana; Greenwood, Darren C.; Bandera, Elisa V.; Norat, Teresa

doi:10.1093/annonc/mdv142

Cited by 213 publications

(183 citation statements)

References 85 publications

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“…Hyperinsulinemia can increase the levels of gonadal steroids by reducing the circulating SHBG [75], although in our systematic review there were no studies with simultaneous assessment of insulin resistance and SHBG levels. The link between anthropometric variables (height and different obesity end-points) and EC has been studied [76]. It has been proposed that obesity favours a chronic systemic inflammatory status, reduces SHBG levels, and stimulates the IGF-I axis that would contribute to cancer progression [77e79].…”

Section: Discussionmentioning

confidence: 99%

Insulin resistance and endometrial cancer risk: A systematic review and meta-analysis

Hernandez

Pasupuleti

Benítes-Zapata

et al. 2015

European Journal of Cancer

132

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Aim: It has been suggested that chronic hyperinsulinemia from insulin resistance is involved in the etiology of endometrial cancer (EC). We performed a systematic review and meta-analysis to assess whether insulin resistance is associated with the risk of EC. Methods: We searched PubMed-Medline, Embase, Scopus, and Web of Science for articles published from database inception through 30th September 2014. We included all observational studies evaluating components defining insulin resistance in women with and without EC. Quality of the included studies was assessed by NewcastleeOttawa scale. Randomeffects models and inverse variance method were used to meta-analyze the association between insulin resistance components and EC. Results: Twenty-five studies satisfied our inclusion criteria. Fasting insulin levels (13 studies, n Z 4088) were higher in women with EC (mean difference [MD] 33.94 pmol/L, 95% confidence interval [CI] 15.04e52.85, p Z 0.0004). No differences were seen in postmenopausal versus pre-and postmenopausal subgroup analysis. Similarly, non-fasting/fasting C-peptide levels (five studies, n Z 1938) were also higher in women with EC (MD 0.14 nmol/L, 95% * Corresponding author: Research Center, School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Building F, Campus Villa, Avenida Alameda de San Marcos Cuadra 2 s/n, Chorrillos, Lima 9, Peru. Tel.: þ51 1 3133333x2730.E-mail addresses: adrianhernandezdiaz@gmail.com (A.V. Hernandez), lepiscean@gmail.com (V. Pasupuleti), vbeniteszapata@gmail. com (V.A. Benites-Zapata), tpriyaleela@gmail.com (P. Thota), abhishekdp@gmail.com (A. Deshpande), faustino.perez@unizar.es (F.R. Perez-Lopez).1 Contributed equally to the study.

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Section: Discussionmentioning

confidence: 99%

Insulin resistance and endometrial cancer risk: A systematic review and meta-analysis

Hernandez

Pasupuleti

Benítes-Zapata

et al. 2015

European Journal of Cancer

132

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“…Despite the findings in other cancer types, the endometrial cancer literature is divided as to whether there is an independent relationship between waist:hip ratio and endometrial cancer risk (17)(18)(19). Importantly, studies with the most discrepant results were undertaken in markedly dissimilar populations, with significantly different proportions of obese women.…”

Section: Body Fat Distributionmentioning

confidence: 99%

“…This is based on results from the meta-analysis discussed above, in which an increase in weight between the ages of 18 and 20 years and middle age was associated with a higher endometrial cancer risk, even after adjusting for current BMI (19). For each 5-kg increase in weight over this time period, the risk of endometrial cancer increased by 18% (95% CI, 15%-21%).…”

Section: Effect Of Weight Changementioning

confidence: 99%

Identifying High-Risk Women for Endometrial Cancer Prevention Strategies: Proposal of an Endometrial Cancer Risk Prediction Model

Kitson

Evans

Crosbie

2017

Cancer Prevention Research

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Already the fourth most common cancer in women in the developed world, the incidence of endometrial cancer is increasing rapidly, in line with the increasing prevalence of obesity. Relatively few studies have been undertaken of riskreducing interventions aimed at limiting the impact of the disease on both individuals and the health service. Those that have been performed have demonstrated only modest results due to their application in relatively unselected populations. A validated risk prediction model is therefore urgently required to identify individuals at particularly high risk of endometrial cancer who may benefit from targeted primary prevention strategies and to guide trial eligibility. On the basis of a systematic review of the literature, the evidence for inclusion of measures of obesity, reproduction, insulin resistance, and genetic risk in such a model is discussed, and the strength of association between these risk factors and endometrial cancer is used to guide the development of a pragmatic risk prediction scoring system that could be implemented in the general population. Provisional cutoff values are described pending refinement of the model and external validation in large prospective cohorts. Potential risk-reducing interventions are suggested, highlighting the need for future studies in this area if the increasing tide of endometrial cancer is to be stemmed.Cancer Prev Res; 10(1); 1-13. Ó2016 AACR.

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“…As mentioned earlier, obesity has been shown to be an important risk factor for certain types of cancer [2][3][4][5][6][7]. However, most researchers put more effort to examine the role of general obesity in the etiologies of these malignancies, while paying less attention to the potential detrimental effect of abdominal obesity.…”

Section: Discussionmentioning

confidence: 99%

“…There is mounting evidence that obesity increases the risk of certain types of cancers, including post-menopausal breast cancer, colorectal, endometrial, kidney, and pancreatic cancers [2][3][4][5][6][7]. Obesity may have also contributed to the recent rise in gastric cardia carcinoma and esophageal adenocarcinoma (EAC) incidence over the past decades because the prevalence of obesity has increased dramatically at an accelerating and alarming rate during approximately the same time period [8,9].…”

Section: Introductionmentioning

confidence: 99%

Abdominal Obesity and Gastroesophageal Cancer Risk: Systematic Review and Meta-Analysis of Prospective Studies

Hidayat¹,

Du²,

Shi³

2016

Preprint

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Correspondence: To systematically and quantitatively review the relation of abdominal obesity, as measured by waist circumference (WC) and waist to hip ratio (WHR), to total gastroesophageal cancer, gastric cancer (GC), and esophageal cancer. PubMed and Web of Science databases were searched for studies assessing the association between abdominal obesity and gastroesophageal cancer (GC and/or esophageal cancer) up to August 2016. A random-effect model was used to calculate the summary relative risks (RRs) and 95% confidence intervals (CIs). Seven prospective cohort studies -one publication included two separate cohorts -from six publications were included in the final analysis. A total of 2130 gastroesophageal cancer cases diagnosed amongst 913182 participants. Higher WC and WHR were significantly associated with increased risk of total gastroesophageal cancer (WC: RR 1.68, 95% CI: 1.38, 2.04; WHR: RR 1.49, 95% CI: 1.19, 1.88), GC (WC: RR 1.48, 95% CI: 1.24, 1.78; WHR: 1.33, 95% CI: 1.04, 1.70), and esophageal cancer (WC: RR 2.06, 95% CI: 1.30, 3.24; WHR: RR 1.99, 95% CI: 1.05, 3.75).Findings from our subgroup analyses showed non-significant positive associations between gastric non-cardia adenocarcinoma (GNCA) and both measures of abdominal adiposity, while gastric cardia adenocarcinoma (GCA) was positively associated with WC but not with WHR. On analysis restricted to studies that adjusted for body mass index (BMI), WC was positively associated with GC and esophageal cancer, whereas WHR was positively associated with risk of GC only. Although limited, the findings from our meta-analysis suggest the potential role of abdominal obesity in the etiology of gastric and esophageal cancers.

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Anthropometric factors and endometrial cancer risk: a systematic review and dose–response meta-analysis of prospective studies

Abstract: All measures of adiposity were associated with increased risk of endometrial cancer, and in addition increasing height was associated with increased risk.

Cited by 213 publications

References 85 publications

Insulin resistance and endometrial cancer risk: A systematic review and meta-analysis

Insulin resistance and endometrial cancer risk: A systematic review and meta-analysis

Identifying High-Risk Women for Endometrial Cancer Prevention Strategies: Proposal of an Endometrial Cancer Risk Prediction Model

Abdominal Obesity and Gastroesophageal Cancer Risk: Systematic Review and Meta-Analysis of Prospective Studies

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