Risk factors for endometrial cancer in black and white women: a pooled analysis from the epidemiology of endometrial cancer consortium (E2C2)

Coté, Michele L.; Alhajj, Tala; Ruterbusch, Julie J.; Bernstein, Leslie; Brinton, Louise A.; Blot, William J.; Chen, Chu; Gass, Margery; Gaussoin, Sarah A.; Henderson, Brian E.; Lee, Eunjung; Horn‐Ross, Pamela L.; Kolonel, Laurence N.; Kaunitz, Andrew M.; Liang, Xiaolin; Nicholson, Wanda K; B., Park, Amy; Petruzella, Stacey; Rebbeck, Timothy R.; Setiawan, Veronica Wendy; Signorello, Lisa B.; Simon, Michael S.; Weiss, Noel S.; Wentzensen, Nicolas; Yang, Hannah; Zeleniuch‐Jacquotte, Anne; Olson, Sara H.

doi:10.1007/s10552-014-0510-3

Cited by 42 publications

(35 citation statements)

References 43 publications

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“…1,44,45 In addition, far less is known about their etiology. In a 2013 report from the Gynecologic Oncology Group trial, which included 2,244 type I endometrial cancers and 581 type II endometrial cancers from 62 U.S. institutions, type II endometrial cancer was positively associated with multiparity and smoking, and inversely associated with obesity.…”

Section: Discussionmentioning

confidence: 99%

History of uterine leiomyoma and risk of endometrial cancer in black women

Wise

Sponholtz

Rosenberg

et al. 2016

Cancer Causes Control

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Background Previous studies have found an association between uterine leiomyomata (UL) and uterine malignancies. This relation has not been studied in black women, who are disproportionately affected by UL. Methods We investigated prospectively the association between self-reported physician-diagnosed UL and endometrial cancer in the Black Women’s Health Study. During 1995–2013, 47,267 participants with intact uteri completed biennial health questionnaires. Reports of endometrial cancer were confirmed by pathology data from medical records and cancer registries. Cox regression was used to derive incidence rate ratios (IRR) and 95% confidence intervals (CI). Results There were 300 incident endometrial cancer cases during 689,546 person-years of follow-up. In multivariable models, UL history was associated with a 42% greater incidence of endometrial cancer compared with no such history (95% CI: 1.12–1.80). IRRs for cancer diagnosed 0–2, 3–9, and ≥10 years after UL diagnosis were 3.20 (95% CI: 2.06–4.98), 0.95 (95% CI: 0.60–1.52), and 1.35 (95% CI: 1.03–1.77), respectively. Stronger overall associations between UL history and endometrial cancer were observed for later stages at cancer diagnosis (IRR=2.25, 95% CI: 1.09–4.63) and type II/III cancers (IRR=3.13, 95% CI: 1.64–5.99). Conclusions In this large cohort of black women, a history of UL was positively associated with endometrial cancer, particularly type II/III tumors. The strongest association was observed for cancer diagnosed within two years of UL diagnosis, a finding that might be explained by greater surveillance of women with UL or misdiagnosis of cancer as UL. However, an association was also observed for cancer reported ≥10 years after UL diagnosis.

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Section: Discussionmentioning

confidence: 99%

History of uterine leiomyoma and risk of endometrial cancer in black women

Wise

Sponholtz

Rosenberg

et al. 2016

Cancer Causes Control

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“…The majority of studies of reproductive history and endometrial cancer have been conducted among white women [20]. The generalizability of these findings to other racial and ethnic groups is unclear.…”

Section: Introductionmentioning

confidence: 99%

Reproductive factors and incidence of endometrial cancer in U.S. black women

Sponholtz

Palmer

Rosenberg

et al. 2017

Cancer Causes Control

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Purpose Previous studies have shown that reproductive history is a strong determinant of endometrial cancer risk among white women. Less is known about how reproductive history affects endometrial cancer risk among black women, whose incidence and mortality differ from white women. We investigated the associations of age at menarche, parity, timing of births, and menopausal age with endometrial cancer in the Black Women’s Health Study, a prospective cohort study. Methods Every 2 years from 1995 to 2013, 47,555 participants with intact uteri at baseline in 1995 completed questionnaires on reproductive and medical history, and lifestyle factors. Self-reported cases of endometrial cancer were confirmed by medical record, cancer registry, or death certificate when available. Cox proportional hazards regression was used to estimate multivariable incidence rate ratios (IRR) and 95% confidence intervals (CI). Results During 689,501 person-years of follow-up, we identified 300 incident cases of endometrial cancer. The strongest associations with endometrial cancer were found for early age at menarche (<11 vs. 12–13 years: IRR: 1.82, 95% CI: 1.31, 2.52), and later age at first birth (≥30 vs. <20 years: IRR: 0.26, 95% CI: 0.13, 0.50). Parous women were less likely than nulliparous women to develop endometrial cancer (IRR: 0.77, 95% CI: 0.57, 1.05), but there was little evidence of a dose-response relation for number of births. Conclusion Associations between reproductive factors and endometrial cancer among black women were generally consistent with those in studies of white women.

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“…Recent SEER data show increases in incidence in black women, for serous, clear cell, and endometrioid subtypes. Pooled data from E2C2 have shown that risk factors for endometrial cancer are similar in both racial groups [17]; although this is the largest study to date of risk factors in black women, data were still too sparse to evaluate some important variables. Even within GOG protocols with uniform eligibility requirements, outcomes are more favorable for white patients [18].…”

Section: Racial Disparitiesmentioning

confidence: 99%