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Published in: Cancer Causes & Control 3/2014

01-03-2014 | Original paper

Body weight in early adulthood, adult weight gain, and risk of endometrial cancer in women not using postmenopausal hormones

Authors: Victoria L. Stevens, Eric J. Jacobs, Alpa V. Patel, Juzhong Sun, Susan M. Gapstur, Marjorie L. McCullough

Published in: Cancer Causes & Control | Issue 3/2014

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Abstract

Purpose

High body mass index (BMI) measured in middle age or later is an established risk factor for endometrial cancer. However, whether BMI measured in early adulthood and adult weight change are associated with endometrial cancer risk is less clear, particularly among nonusers of postmenopausal hormones (PMH).

Methods

These associations were investigated among women in the Cancer Prevention Study II Nutrition Cohort. Women taking PMH (n = 11,624, 12 % of all women) were excluded, and the analysis was limited to 33,057 postmenopausal women who did not take PMH. Between enrollment in 1992/1993 and 30 June 2009, 447 women were diagnosed with endometrial cancer. Cox proportional hazards regression was used to calculate hazard rate ratios (RR) and corresponding 95 % confidence intervals (CI) for the association of BMI at age 18, calculated from recalled weight, and weight change between age 18 and 1992, with endometrial cancer incidence.

Results

BMI at age 18 was associated with higher risk of endometrial cancer in multivariable models adjusted for other risk factors (RR 1.29, 95 % CI 1.12–1.49 per 5 BMI units). Similarly, adult weight change was associated with higher risk of endometrial cancer (RR 1.81, 95 % CI 1.66–1.98 per 5 BMI unit change) in multivariable models adjusted for other risk factors.

Conclusions

High BMI at age 18 and greater adult weight gain were strongly associated with risk of endometrial cancer. These results underscore the importance of both avoiding overweight/obesity in young adulthood and preventing weight gain thereafter to minimize risk of this cancer.
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Literature
1.
2.
go back to reference Renehan AG, Tyson M, Egger M et al (2008) Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 371:569–578CrossRefPubMed Renehan AG, Tyson M, Egger M et al (2008) Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 371:569–578CrossRefPubMed
3.
go back to reference Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 4:579–591CrossRefPubMed Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 4:579–591CrossRefPubMed
4.
go back to reference Kaaks R, Lukanova A, Kurzer MS (2002) Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomarkers Prev 11:1531–1543PubMed Kaaks R, Lukanova A, Kurzer MS (2002) Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomarkers Prev 11:1531–1543PubMed
5.
go back to reference Pan L, Blanck HM, Sherry B et al (2012) Trends in the prevalence of extreme obesity among US preschool-aged children living in low-income families, 1998–2010. J Am Med Assoc 308:2563–2565CrossRef Pan L, Blanck HM, Sherry B et al (2012) Trends in the prevalence of extreme obesity among US preschool-aged children living in low-income families, 1998–2010. J Am Med Assoc 308:2563–2565CrossRef
6.
go back to reference Flegal KM, Carroll MD, Kit BK et al (2012) Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. J Am Med Assoc 307:491–497CrossRef Flegal KM, Carroll MD, Kit BK et al (2012) Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. J Am Med Assoc 307:491–497CrossRef
7.
go back to reference Crosbie EJ, Zwahlen M, Kitchener HC et al (2010) Body mass index, hormone replacement therapy, and endometrial cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev 19:3119–3130CrossRefPubMed Crosbie EJ, Zwahlen M, Kitchener HC et al (2010) Body mass index, hormone replacement therapy, and endometrial cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev 19:3119–3130CrossRefPubMed
8.
go back to reference Blitzer PH, Blitzer EC, Rimm AA (1976) Association between teen-age obesity and cancer in 56,711 women: all cancers and endometrial cancer. Prev Med 5:20–31CrossRefPubMed Blitzer PH, Blitzer EC, Rimm AA (1976) Association between teen-age obesity and cancer in 56,711 women: all cancers and endometrial cancer. Prev Med 5:20–31CrossRefPubMed
9.
go back to reference Le Marchand L, Wilkens LR, Mi M-P (1991) Early-age body size, adult weight gain and endometrial cancer risk. Int J Cancer 48:807–811CrossRefPubMed Le Marchand L, Wilkens LR, Mi M-P (1991) Early-age body size, adult weight gain and endometrial cancer risk. Int J Cancer 48:807–811CrossRefPubMed
10.
go back to reference Shu XO, Brinton LA, Zheng W et al (1992) Relation of obesity and body fat distribution to endometrial cancer in Shanghai, China. Cancer Res 52:3865–3870PubMed Shu XO, Brinton LA, Zheng W et al (1992) Relation of obesity and body fat distribution to endometrial cancer in Shanghai, China. Cancer Res 52:3865–3870PubMed
11.
go back to reference Levi F, La Vecchia C, Negri E et al (1992) Body mass at different ages and subsequent endometrial cancer risk. Int J Cancer 50:567–571CrossRefPubMed Levi F, La Vecchia C, Negri E et al (1992) Body mass at different ages and subsequent endometrial cancer risk. Int J Cancer 50:567–571CrossRefPubMed
12.
go back to reference Swanson CA, Potischman N, Wilbanks GD et al (1993) Relation of endometrial cancer risk to past and contemporary body size and body fat distribution. Cancer Epidemiol Biomarkers Prev 2:321–327PubMed Swanson CA, Potischman N, Wilbanks GD et al (1993) Relation of endometrial cancer risk to past and contemporary body size and body fat distribution. Cancer Epidemiol Biomarkers Prev 2:321–327PubMed
13.
go back to reference Olson SH, Trevisan M, Marshall JR et al (1995) Body mass index, weight gain, and risk of endometrial cancer. Nutr Cancer 23:141–149CrossRefPubMed Olson SH, Trevisan M, Marshall JR et al (1995) Body mass index, weight gain, and risk of endometrial cancer. Nutr Cancer 23:141–149CrossRefPubMed
14.
go back to reference Terry P, Baron JA, Weiderpass E et al (1999) Lifestyle and endometrial cancer risk: a cohort study from the Swedish Twin Registry. Int J Cancer 82:38–42CrossRefPubMed Terry P, Baron JA, Weiderpass E et al (1999) Lifestyle and endometrial cancer risk: a cohort study from the Swedish Twin Registry. Int J Cancer 82:38–42CrossRefPubMed
15.
go back to reference Weiderpass E, Persson I, Adami HO et al (2000) Body size in different periods of life, diabetes mellitus, hypertension, and risk of postmenopausal endometrial cancer (Sweden). Cancer Causes Control 11:185–192CrossRefPubMed Weiderpass E, Persson I, Adami HO et al (2000) Body size in different periods of life, diabetes mellitus, hypertension, and risk of postmenopausal endometrial cancer (Sweden). Cancer Causes Control 11:185–192CrossRefPubMed
16.
go back to reference Jonsson F, Wolk A, Pedersen NL et al (2003) Obesity and hormone-dependent tumors: cohort and co-twin control studies based on the Swedish Twin Registry. Int J Cancer 106:594–599CrossRefPubMed Jonsson F, Wolk A, Pedersen NL et al (2003) Obesity and hormone-dependent tumors: cohort and co-twin control studies based on the Swedish Twin Registry. Int J Cancer 106:594–599CrossRefPubMed
17.
go back to reference Schouten LJ, Goldbohm RA, van den Brandt PA (2004) Anthropometry, physical activity, and endometrial cancer risk: results from the Netherlands Cohort Study. J Natl Cancer Inst 96:1635–1638CrossRefPubMed Schouten LJ, Goldbohm RA, van den Brandt PA (2004) Anthropometry, physical activity, and endometrial cancer risk: results from the Netherlands Cohort Study. J Natl Cancer Inst 96:1635–1638CrossRefPubMed
18.
go back to reference Trentham-Dietz A, Nichols HB, Hampton JM et al (2006) Weight change and risk of endometrial cancer. Int J Epidemiol 35:151–156CrossRefPubMed Trentham-Dietz A, Nichols HB, Hampton JM et al (2006) Weight change and risk of endometrial cancer. Int J Epidemiol 35:151–156CrossRefPubMed
19.
go back to reference Xu WH, Xiang YB, Zheng W et al (2006) Weight history and risk of endometrial cancer among Chinese women. Int J Epidemiol 35:159–166CrossRefPubMed Xu WH, Xiang YB, Zheng W et al (2006) Weight history and risk of endometrial cancer among Chinese women. Int J Epidemiol 35:159–166CrossRefPubMed
20.
go back to reference Friedenreich C, Cust A, Lahmann PH et al (2007) Anthropometric factors and risk of endometrial cancer: the European prospective investigation into cancer and nutrition. Cancer Causes Control 18:399–413CrossRefPubMed Friedenreich C, Cust A, Lahmann PH et al (2007) Anthropometric factors and risk of endometrial cancer: the European prospective investigation into cancer and nutrition. Cancer Causes Control 18:399–413CrossRefPubMed
21.
go back to reference Chang SC, Lacey JV Jr, Brinton LA et al (2007) Lifetime weight history and endometrial cancer risk by type of menopausal hormone use in the NIH-AARP diet and health study. Cancer Epidemiol Biomarkers Prev 16:723–730CrossRefPubMed Chang SC, Lacey JV Jr, Brinton LA et al (2007) Lifetime weight history and endometrial cancer risk by type of menopausal hormone use in the NIH-AARP diet and health study. Cancer Epidemiol Biomarkers Prev 16:723–730CrossRefPubMed
22.
go back to reference Thomas CC, Wingo PA, Dolan MS et al (2009) Endometrial cancer risk among younger, overweight women. Obstet Gynecol 114:22–27PubMed Thomas CC, Wingo PA, Dolan MS et al (2009) Endometrial cancer risk among younger, overweight women. Obstet Gynecol 114:22–27PubMed
23.
24.
go back to reference Hosono S, Matsuo K, Hirose K et al (2011) Weight gain during adulthood and body weight at age 20 are associated with the risk of endometrial cancer in Japanese women. J Epidemiol 21:466–473CrossRefPubMed Hosono S, Matsuo K, Hirose K et al (2011) Weight gain during adulthood and body weight at age 20 are associated with the risk of endometrial cancer in Japanese women. J Epidemiol 21:466–473CrossRefPubMed
25.
go back to reference Lu L, Risch H, Irwin ML et al (2011) Long-term overweight and weight gain in early adulthood in association with risk of endometrial cancer. Int J Cancer 129:1237–1243CrossRefPubMedCentralPubMed Lu L, Risch H, Irwin ML et al (2011) Long-term overweight and weight gain in early adulthood in association with risk of endometrial cancer. Int J Cancer 129:1237–1243CrossRefPubMedCentralPubMed
26.
go back to reference Yang TY, Cairns BJ, Allen N et al (2012) Postmenopausal endometrial cancer risk and body size in early life and middle age: prospective cohort study. Br J Cancer 107:169–175CrossRefPubMedCentralPubMed Yang TY, Cairns BJ, Allen N et al (2012) Postmenopausal endometrial cancer risk and body size in early life and middle age: prospective cohort study. Br J Cancer 107:169–175CrossRefPubMedCentralPubMed
27.
go back to reference Nagle CM, Marquart L, Bain CJ et al (2013) Impact of weight change and weight cycling on risk of different subtypes of endometrial cancer. Eur J Cancer 49:2717–2726CrossRefPubMed Nagle CM, Marquart L, Bain CJ et al (2013) Impact of weight change and weight cycling on risk of different subtypes of endometrial cancer. Eur J Cancer 49:2717–2726CrossRefPubMed
28.
go back to reference McCullough ML, Patel AV, Patel R et al (2008) Body mass and endometrial cancer risk by hormone replacement therapy and cancer subtype. Cancer Epidemiol Biomarkers Prev 17:73–79CrossRefPubMed McCullough ML, Patel AV, Patel R et al (2008) Body mass and endometrial cancer risk by hormone replacement therapy and cancer subtype. Cancer Epidemiol Biomarkers Prev 17:73–79CrossRefPubMed
29.
go back to reference Rossouw JE, Anderson GL, Prentice RL et al (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. J Am Med Assoc 288:321–333CrossRef Rossouw JE, Anderson GL, Prentice RL et al (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. J Am Med Assoc 288:321–333CrossRef
30.
go back to reference Sprague BL, Trentham-Dietz A, Cronin KA (2012) A sustained decline in postmenopausal hormone use: results from the National Health and Nutrition Examination Survey, 1999–2010. Obstet Gynecol 120:595–603CrossRefPubMedCentralPubMed Sprague BL, Trentham-Dietz A, Cronin KA (2012) A sustained decline in postmenopausal hormone use: results from the National Health and Nutrition Examination Survey, 1999–2010. Obstet Gynecol 120:595–603CrossRefPubMedCentralPubMed
31.
go back to reference Calle EE, Rodriguez C, Jacobs EJ et al (2002) The American Cancer Society Cancer Prevention Study II Nutrition Cohort. Cancer 94:2490–2501CrossRefPubMed Calle EE, Rodriguez C, Jacobs EJ et al (2002) The American Cancer Society Cancer Prevention Study II Nutrition Cohort. Cancer 94:2490–2501CrossRefPubMed
32.
go back to reference Bergmann MM, Calle EE, Mervis CA et al (1998) Validity of self-reported cancer in a prospective cohort study in comparison with data form state cancer registries. Am J Epidemiol 147:556–562CrossRefPubMed Bergmann MM, Calle EE, Mervis CA et al (1998) Validity of self-reported cancer in a prospective cohort study in comparison with data form state cancer registries. Am J Epidemiol 147:556–562CrossRefPubMed
34.
go back to reference Cox D (1972) Regression models and life tables. J R Stat Soc B 34:187–202 Cox D (1972) Regression models and life tables. J R Stat Soc B 34:187–202
35.
go back to reference Sherman ME (2000) Theories of endometrial carcinogenesis: a multidisciplinary approach. Mod Path 13:295–308CrossRef Sherman ME (2000) Theories of endometrial carcinogenesis: a multidisciplinary approach. Mod Path 13:295–308CrossRef
36.
go back to reference Emons G, Fleckenstein G, Hinney B et al (2000) Hormonal interactions in endometrial cancer. Endocr Relat Cancer 7:227–242CrossRefPubMed Emons G, Fleckenstein G, Hinney B et al (2000) Hormonal interactions in endometrial cancer. Endocr Relat Cancer 7:227–242CrossRefPubMed
37.
go back to reference Setiawan VW, Yang HP, Pike MC et al (2013) Type I and II endometrial cancers: have they different risk factors? J Clin Oncol 31:2607–2618CrossRefPubMed Setiawan VW, Yang HP, Pike MC et al (2013) Type I and II endometrial cancers: have they different risk factors? J Clin Oncol 31:2607–2618CrossRefPubMed
38.
go back to reference Cole SR, Platt RW, Schisterman EF et al (2010) Illustrating bias due to conditioning on a collider. Int J Epidemiol 39:417–420CrossRefPubMed Cole SR, Platt RW, Schisterman EF et al (2010) Illustrating bias due to conditioning on a collider. Int J Epidemiol 39:417–420CrossRefPubMed
39.
go back to reference Kushi LH, Doyle C, McCullough M et al (2012) American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 62:30–67CrossRefPubMed Kushi LH, Doyle C, McCullough M et al (2012) American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 62:30–67CrossRefPubMed
Metadata
Title
Body weight in early adulthood, adult weight gain, and risk of endometrial cancer in women not using postmenopausal hormones
Authors
Victoria L. Stevens
Eric J. Jacobs
Alpa V. Patel
Juzhong Sun
Susan M. Gapstur
Marjorie L. McCullough
Publication date
01-03-2014
Publisher
Springer International Publishing
Published in
Cancer Causes & Control / Issue 3/2014
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-013-0333-7

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