Endometrial cancer risk factors by 2 main histologic subtypes: the NIH-AARP Diet and Health Study.

TitleEndometrial cancer risk factors by 2 main histologic subtypes: the NIH-AARP Diet and Health Study.
Publication TypeJournal Article
Year of Publication2013
AuthorsYang HP, Wentzensen N, Trabert B, Gierach GL, Felix AS, Gunter MJ, Hollenbeck A, Park Y, Sherman ME, Brinton LA
JournalAm J Epidemiol
Volume177
Issue2
Pagination142-51
Date Published2013 Jan 15
ISSN1476-6256
KeywordsAdult, Aged, Aged, 80 and over, Carcinoma, Carcinoma, Endometrioid, Endometrial Neoplasms, Female, Follow-Up Studies, Health Surveys, Humans, Incidence, Logistic Models, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Prospective Studies, Risk Factors, Self Report, United States
Abstract

On the basis of clinical and pathologic criteria, endometrial carcinoma has been distinguished as types I (mainly endometrioid) and II (nonendometrioid). Limited data suggest that these subtypes have different risk factor profiles. The authors prospectively evaluated risk factors for types I (n = 1,312) and II (n = 138) incident endometrial carcinoma among 114,409 women in the National Institutes of Health (NIH)-AARP Diet and Health Study (1995-2006). For individual risk factors, relative risks were estimated with Cox regression by subtype, and P(heterogeneity) was assessed in case-case comparisons with type I as the referent. Stronger relations for type I versus Type II tumors were seen for menopausal hormone therapy use (relative risk (RR) of 1.18 vs. 0.84; P(heterogeneity) = 0.01) and body mass index of ≥30 vs. <30 kg/m2 (RR of 2.93 vs. 1.83; P(heterogeneity) = 0.001). Stronger relations for type II versus type I tumors were observed for being black versus white (RR of 2.18 vs. 0.66; P(heterogeneity) = 0.0004) and having a family history of breast cancer (RR of 1.93 vs. 0.80; P(heterogeneity) = 0.002). Other risk factor associations were similar by subtype. In conclusion, the authors noted different risk factor associations for Types I and II endometrial carcinomas, supporting the etiologic heterogeneity of these tumors. Because of the limited number of Type II cancers, additional evaluation of risk factors will benefit from consortial efforts.

DOI10.1093/aje/kws200
Alternate JournalAm. J. Epidemiol.
PubMed ID23171881