Pregnancy outcomes and risk of endometrial cancer: A pooled analysis of individual participant data in the Epidemiology of Endometrial Cancer Consortium

Jordan, Susan J.; Na, Renhua; Weiderpass, Elisabete; Adami, Hans Olov; Anderson, Kristin E.; Brandt, Piet A. van den; Brinton, Louise A.; Chen, Chu; Cook, Linda S.; Doherty, Jennifer A.; Du, Mengmeng; Friedenreich, Christine M.; Gierach, Gretchen L.; Goodman, Marc T.; Levi, Fabio; Lu, Lingeng; Miller, Anthony B.; McCann, Susan E.; Moysich, Kirsten B.; Negri, Eva; Petruzella, Stacey; Palmer, Julie R.; Parazzini, Fabio; Pike, Malcolm C.; Prizment, Anna E.; Rebbeck, Timothy R.; Reynolds, Peggy; Ricceri, Fulvio; Risch, Harvey A.; Rohan, Thomas E.; Sacerdote, Carlotta; Schouten, Leo J.; Serraino, Diego; Setiawan, Veronica Wendy; Shu, Xiao Ou; Sponholtz, Todd R.; Spurdle, Amanda B.; Trabert, Britton; Wentzensen, Nicolas; Wilkens, Lynne R.; Wise, Lauren A.; Yu, Herbert; Vecchia, Carlo La; Vivo, Immaculata De; Xu, Wanghong; Zeleniuch‐Jacquotte, Anne; Webb, Penelope M.

doi:10.1002/ijc.33360

Cited by 20 publications

(31 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the reduction of risk seen with cumulative time pregnant (>101 weeks) on cancer of the uterus was not statistically significant in this study, a recent analysis found that whilst there is a greater magnitude of reduction in risk for a full-term pregnancy than an early pregnancy loss, each additional pregnancy is associated with a further reduction in endometrial cancer risk [29].…”

Section: Discussioncontrasting

confidence: 86%

Reproductive Pattern of Parous Women and the Risk of Cancer in Later Life

Pasdar

Scott

Iversen

et al. 2021

Cancers

View full text Add to dashboard Cite

We assessed the risk of any and site-specific cancers in a case-control study of parous women living in northeast Scotland in relation to: total number of pregnancies, cumulative time pregnant, age at first delivery and interpregnancy interval. We analysed 6430 women with cancer and 6430 age-matched controls. After adjustment for confounders, women with increasing number of pregnancies had similar odds of cancer diagnosis as women with only one pregnancy. The adjusted odds of cancer diagnosis were no higher in women with cumulative pregnancy time 50–150 weeks compared to those pregnant ≤ 50 weeks. Compared with women who had their first delivery at or before 20 years of age, the adjusted odds ratio (AOR) among those aged 21–25 years was 0.81, 95% CI 0.74, 0.88; 26–30 years AOR 0.77, 95% CI 0.69, 0.86; >30 years AOR 0.63, 95% CI 0.55, 0.73. After adjustment, the odds of having any cancer were higher in women who had an inter-pregnancy interval >3 years compared to those with no subsequent pregnancy (AOR 1.17, 95% CI 1.05, 1.30). Older age at first pregnancy was associated with increased risk of breast and gastrointestinal cancer, and reduced risk of invasive cervical, carcinoma in situ of the cervix and respiratory cancer.

show abstract

Section: Discussioncontrasting

confidence: 86%

Reproductive Pattern of Parous Women and the Risk of Cancer in Later Life

Pasdar

Scott

Iversen

et al. 2021

Cancers

View full text Add to dashboard Cite

show abstract

“…This study is in line with a Danish study reporting no association between VB in pregnancy and occult cancer (21). The results of this study also indirectly support the findings of previous research showing that the risk of breast, ovarian and endometrial cancer was similar in women with a gestation history irrespective of whether the pregnancies were carried until full-term delivery (1,2,19).…”

Section: Comparison With Other Studiessupporting

confidence: 92%

Association between having a pregnancy complicated by vaginal bleeding and risk of cancer

Dudukina

Horváth‐Puhó

Sørensen

et al. 2022

Preprint

View full text Add to dashboard Cite

Objective: To investigate an association of vaginal bleeding-affected deliveries with the long-term risk of cancer as compared with vaginal bleeding-unaffected deliveries and pregnancies ending in a termination or miscarriage. Design: Registry-based cohort study in Denmark, 1995-2017. Setting: Danish health and administrative registries. Participants: Deliveries (N=37,085) affected by vaginal bleeding (VB) within 20 gestational weeks among 35,517 women, VB-unaffected deliveries (N=1,362,760) among 783,020 women, pregnancies ending in a termination (N=324,395) among 239,729 women or miscarriage (N=137,040) among 121,303 women. Main outcome measures: Incidence rates (IR) per 10,000 person-years and cumulative incidence of cancer at the end of up to 24 years of follow-up, hazard ratios (HR) with 95% confidence intervals (CIs) adjusted for age, calendar year, reproductive history, history of chronic conditions, medication use, and socioeconomic factors using Cox proportional hazards regression. Results: We observed 1,725 cancer events (IR=32.1, 95% CI: 30.6-33.6) following VB-affected deliveries, 52,620 events (IR=31.5, 95% CI: 31.2-31.7) following VB-unaffected deliveries, 12,925 events (IR=30.1, 95% CI: 29.6-30.6) following a termination and 6,080 events (IR=34.3, 95% CI: 33.4-35.1) following a miscarriage. We found no association between VB and any cancer in comparison with VB-unaffected deliveries (HR=0.98, 95% CI: 0.93-1.03), terminations (HR=1.00, 95% CI: 0.94-1.06) and miscarriages (HR=1.04, 95% CI: 0.94-1.14). Specifically, there was no increase in relative risk of breast (HR=0.94, 95% CI: 0.86-1.03), cervical (0.94, 0.77-1.14), ovarian and fallopian tube (1.16, 0.81-1.66), uterine cancer (0.78, 0.46-1.33) and other site-specific cancers across all comparisons and in sensitivity analyses. Conclusions: Having a VB-affected pregnancy ending in a delivery was not associated with an increased risk of cancer in women in comparison with having a VB-unaffected pregnancy ending in a delivery, termination or miscarriage.

show abstract

“…Obesity causes excessive endogenous estrogen to act on the endometrium, leading to EH and EC. Studies [3,42,43] have shown that when the insulin resistance index is greater than or equal to 2.8809, the relative risks of endometrial hyperplasia and endometrial cancer are 35.22 and 30.59, respectively. It's been found that when BMI ≥ 25 kg/m 2 , progesterone treatment is less effective and prone to recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…Endometrial cancer (EC) is one of the common malignant tumors in gynecology, and its incidence is increasing year by year, and is showing a trend of younger onset age [1]. It is generally believed that the continuous stimulation of estrogen without progesterone antagonism leads to endometrial hyperplasia and then cancerous transformation [2,3]. Endometrial hyperplasia (EH) is a common gynecological endocrine disease, which mainly manifests as irregular vaginal bleeding, infertility, and even malignant transformation [4].…”

Section: Introductionmentioning

confidence: 99%

Risk factors of endometrial cancer in patients with endometrial hyperplasia: implication for clinical treatments

Zhao¹,

Hu²,

Zhao

et al. 2021

BMC Women's Health

View full text Add to dashboard Cite

Background Endometrial hyperplasia (EH) is commonly-seen in the patients with endometrial cancer (EC), we aimed to evaluated the risk factors of EC in patients with EH, to provide evidence to the clinical prevention and treatment of EC. Methods This study was a retrospective study design. EH patients confirmed by pathological examinations and treated with hysterectomy in our hospital from June 1, 2018 to February 28, 2021 were included. The clinical characteristics of EC and no-EC patients were compared and analyzed. Logistics regression analyses were conducted to evaluate the risk factors of EC in patients with EH. Results A total of 228 EH patients were included, the incidence of EC in the EH patients was 31.58%. There were significant differences in the age, BMI, diabetes, hypertension and pathology of EH between EC and no EC groups (all P < 0.05), no significant differences in the hyperlipidemia, preoperative CA125, number of deliveries, menopause and endometrial thickness between EC and no EC groups were found (all P > 0.05). Logistic regression analyses indicated that age > 50 y (OR 3.064, 95% CI 1.945–5.931), BMI ≥ 25 kg/m2 (OR 2.705, 95% CI 1.121–3.889), diabetes (OR 3.049, 95% CI 1.781–5.114), hypertension (OR 2.725, 95% CI 1.108–3.431) and severe hyperplasia (OR 3.181, 95% CI 1.496–4.228) were the risk factors of EC in patients with EH (all P < 0.05). Conclusions The risk of EC in EH patients is high, especially for those patients with age > 50 y, BMI ≥ 25 kg/m2, diabetes, hypertension and severe hyperplasia, special attentions should be paid for occurrence of EC and early diagnosis and early treatment are needed for those patients.

show abstract

Pregnancy outcomes and risk of endometrial cancer: A pooled analysis of individual participant data in the Epidemiology of Endometrial Cancer Consortium

Cited by 20 publications

References 35 publications

Reproductive Pattern of Parous Women and the Risk of Cancer in Later Life

Reproductive Pattern of Parous Women and the Risk of Cancer in Later Life

Association between having a pregnancy complicated by vaginal bleeding and risk of cancer

Risk factors of endometrial cancer in patients with endometrial hyperplasia: implication for clinical treatments

Contact Info

Product

Resources

About