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Reproductive risk factors and endometrial cancer: the European Prospective Investigation into Cancer and Nutrition
Author(s) -
Dossus Laure,
Allen Naomi,
Kaaks Rudolf,
Bakken Kjersti,
Lund Eiliv,
Tjonneland Anne,
Olsen Anja,
Overvad Kim,
ClavelChapelon Francoise,
Fournier Agnes,
ChabbertBuffet Nathalie,
Boeing Heiner,
Schütze Madlen,
Trichopoulou Antonia,
Trichopoulos Dimitrios,
Lagiou Pagona,
Palli Domenico,
Krogh Vittorio,
Tumino Rosario,
Vineis Paolo,
Mattiello Amalia,
BuenodeMesquita H. Bas,
OnlandMoret N. Charlotte,
Peeters Petra H.M.,
Dumeaux Vanessa,
Redondo MariaLuisa,
Duell Eric,
SanchezCantalejo Emilio,
Arriola Larraitz,
Chirlaque MariaDolores,
Ardanaz Eva,
Manjer Jonas,
Borgquist Signe,
Lukanova Annie,
Lundin Eva,
Khaw KayTee,
Wareham Nicholas,
Key Tim,
Chajes Veronique,
Rinaldi Sabina,
Slimani Nadia,
Mouw Traci,
Gallo Valentina,
Riboli Elio
Publication year - 2010
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.25050
Subject(s) - menarche , medicine , endometrial cancer , gynecology , menopause , obstetrics , prospective cohort study , european prospective investigation into cancer and nutrition , cancer , breast cancer
Abstract Endometrial cancer risk has been associated with reproductive factors (age at menarche, age at menopause, parity, age at first and last birth, time since last birth and use of oral contraceptives (OCs)]. However, these factors are closely interrelated and whether they act independently still requires clarification. We conducted a study to examine the association of menstrual and reproductive variables with the risk of endometrial cancer among the European Prospective Investigation into Cancer and Nutrition (EPIC). Among the 302,618 women eligible for the study, 1,017 incident endometrial cancer cases were identified. A reduction in endometrial cancer risk was observed in women with late menarche, early menopause, past OC use, high parity and a shorter time since last full‐term pregnancy (FTP). No association was observed for duration of breast feeding after adjustment for number of FTP or for abortion (spontaneous or induced). After mutual adjustment, late age at menarche, early age at menopause and duration of OC use showed similar risk reductions of 7–8% per year of menstrual life, whereas the decreased risk associated with cumulative duration of FTPs was stronger (22% per year). In conclusion, our findings confirmed a reduction in risk of endometrial cancer with factors associated with a lower cumulative exposure to estrogen and/or higher exposure to progesterone, such as increasing number of FTPs and shorter menstrual lifespan and, therefore, support an important role of hormonal mechanisms in endometrial carcinogenesis.