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Body size and the risk of endometrial cancer by hormone therapy use in postmenopausal women in the California Teachers Study cohort

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Abstract

Objective

To investigate whether hormone therapy (HT) and obesity are associated with endometrial cancer risk among postmenopausal women in the California Teachers Study cohort.

Methods

Of 28,418 postmenopausal women, 395 developed type 1 endometrial cancer between 1995 and 2006. Multivariate Cox regression was performed to estimate relative risks (RR), stratified by HT use (never used, ever estrogen alone (ET) or exclusively estrogen-plus-progestin (EPT)).

Results

Among women who never used HT, overall and abdominal adiposity were associated with increased risk; when evaluated simultaneously, abdominal adiposity was more strongly associated (RR 2.2, 95% confidence interval (CI): 1.1–4.5 for waist ≥35 vs. <35 inches). Among women who ever used ET, risk was increased in women with BMI ≥ 25 kg/m2 (RR 1.6, 95% CI: 1.1–2.3 vs. <25 kg/m2). Neither overall nor abdominal obesity was associated with risk in women who exclusively used EPT (p-interaction <0.001 for BMI by HT use).

Conclusions

Among women who never used HT, risk was strongly positively related to obesity and may have been influenced more by abdominal than by overall adiposity; however, due to small numbers, this latter finding requires replication. Among women who ever used ET, being overweight at baseline predicted higher risk, whereas use of EPT mitigated any effects of obesity.

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Acknowledgments

This research was supported by grant R01 CA77398 from the National Cancer Institute and contract 97-10500 from the California Breast Cancer Research Fund. The funding sources did not contribute to the design or conduct of the study, nor to the writing or submission of this manuscript. The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer-reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract N01-PC-35136 awarded to the Cancer Prevention Institute of California (formerly the Northern California Cancer Center), contract N01-PC-35139 awarded to the University of Southern California, and contract N02-PC-15105 awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries under agreement #U55/CCR921930-02 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the authors, and endorsement by the State of California, Department of Public Health, the National Cancer Institute and the Centers for Disease Control and Prevention or their contractors and subcontractors is not intended nor should be inferred. The authors would like to thank the CTS Steering Committee who are responsible for the formation and maintenance of the cohort within which this study was conducted but who did not directly contribute to the current paper: Hoda Anton-Culver, Christina A. Clarke, Rosemary Cress, Katherine D. Henderson, Susan L. Neuhausen, Rich Pinder, Daniel O. Stram, Dee W. West and Argyrios Ziogas.

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Correspondence to Alison J. Canchola.

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Canchola, A.J., Chang, E.T., Bernstein, L. et al. Body size and the risk of endometrial cancer by hormone therapy use in postmenopausal women in the California Teachers Study cohort. Cancer Causes Control 21, 1407–1416 (2010). https://doi.org/10.1007/s10552-010-9568-8

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  • DOI: https://doi.org/10.1007/s10552-010-9568-8

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