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Risk of endometrial cancer in relationship to cigarette smoking: Results from the EPIC study
Author(s) -
AlZoughool Mustafa,
Dossus Laure,
Kaaks Rudolf,
ClavelChapelon Françoise,
Tjønneland Anne,
Olsen Anja,
Overvad Kim,
BoutronRuault MarieChristine,
Gauthier Estelle,
Linseisen Jakob,
ChangClaude Jenny,
Boeing Heiner,
Schulz Mandy,
Trichopoulou Antonia,
Chryssa Travezea,
Trichopoulos Dimitrios,
Berrino Franco,
Palli Domenico,
Mattiello Amalia,
Tumino Rosario,
Sacerdote Carlotta,
BuenodeMesquita H. Bas,
Boshuizen Hendriek C.,
Peeters Petra H.M.,
Gram Inger T.,
Braaten Tonje,
Lund Eiliv,
Chirlaque MariaDolores,
Ardanaz Eva,
Agudo Antonio,
Larrañaga Nerea,
Quirós Jose Ramon,
Berglund Göran,
Manjer Jonas,
Lundin Eva,
Hallmans Göran,
Khaw KayTee,
Bingham Sheila,
Allen Naomi,
Key Tim,
Jenab Mazda,
Cust Anne E.,
Rinaldi Sabina,
Riboli Elio
Publication year - 2007
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.22990
Subject(s) - medicine , endometrial cancer , european prospective investigation into cancer and nutrition , hazard ratio , prospective cohort study , gynecology , cancer , obstetrics , cohort study , confidence interval
Current epidemiologic evidence indicates that cigarette smoking reduces the risk of endometrial cancer. We examined data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to analyze further aspects of the smoking‐endometrial cancer relationship, such as possible modifying effects of menopausal status, HRT use, BMI and parity. In a total of 249,986 women with smoking exposure and menopausal status information, 619 incident endometrial cancer cases were identified during 1.56 million person‐years of follow‐up. Among postmenopausal women, the hazard ratio (HR) for current smokers versus never smokers was 0.70 (95% CI = 0.53–0.93), while it was 1.75 (95% CI = 1.13–2.70) among premenopausal women at recruitment. After adjustment for risk factors, the HR for postmenopausal women was slightly attenuated to 0.78 (95% CI = 0.59–1.03). No heterogeneity of effect was observed with HRT use or BMI. Among premenopausal women, current smokers of more than 15 cigarettes per day or who smoked for 30 years or more at the time of recruitment had a more than 2‐fold increased risk of endometrial cancer compared to never smokers (HR = 2.54; 95% CI = 1.47–4.38 and HR = 2.23; 95% CI = 1.04–4.77, respectively). Past smoking was not associated with endometrial cancer risk, either among pre‐ or postmenopausal women. In this prospective study, we observed an increased risk of endometrial cancer with cigarette smoking in premenopausal women. The reduction of endometrial cancer risk observed among postmenopausal women does not have direct public health relevance since cigarette smoking is the main known risk factor for cancer. © 2007 Wiley‐Liss, Inc.