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. 1983 Jun;47(6):749–756. doi: 10.1038/bjc.1983.127

The epidemiology of endometrial cancer in young women.

B E Henderson, J T Casagrande, M C Pike, T Mack, I Rosario, A Duke
PMCID: PMC2011352  PMID: 6860544

Abstract

A case-control study was conducted in Los Angeles County, California, of 127 endometrial cancer cases aged 45 years or less at diagnosis, to investigate the role of fertility, obesity and exogenous oestrogens in the development of the disease in young women. Use of sequential oral contraceptive (SOCs) or oestrogen replacement therapy (ERT) for greater than or equal to 2 years was strongly associated with increased risk of endometrial cancer. After excluding these cases, since the SOC or ERT use was probably the cause of their disease, we were left with 110 case-control pairs for further study. Among these remaining case-control pairs increasing parity was strongly associated with decreased risk (relative risk of 0.12 for women of parity 3 compared to nulliparous women, P less than 0.001). Current weight was associated with increased risk (relative risk of 17.7 for women weighing greater than or equal to 190 lbs compared to women weighing less than 130 lbs, P less than 0.001). Combination oral contraceptive (COC) use was associated with a decreased risk, which decreased with duration of COC use (relative risk of approximately 0.28 at 5 years of use, P less than 0.001), but the estimate of the protective effect was reduced and became statistically non-significant when allowance was made for weight and parity. The protective effect of COC use was only clearly evident in women who had less than 3 live-births and weighed less than 170 lbs. These results provide further support for the "unopposed" oestrogen hypothesis of the aetiology of endometrial cancer.

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Selected References

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  1. Breslow N. E., Day N. E., Halvorsen K. T., Prentice R. L., Sabai C. Estimation of multiple relative risk functions in matched case-control studies. Am J Epidemiol. 1978 Oct;108(4):299–307. doi: 10.1093/oxfordjournals.aje.a112623. [DOI] [PubMed] [Google Scholar]
  2. DAMON A. Host factors in cancer of the breast and uterine cervix and corpus. J Natl Cancer Inst. 1960 Feb;24:483–516. [PubMed] [Google Scholar]
  3. DOCKERTY M. B., LOVELADY S. B., FOUST G. T., Jr Carcinoma of the corpus uteri in young women. Am J Obstet Gynecol. 1951 May;61(5):966–981. doi: 10.1016/0002-9378(51)90298-0. [DOI] [PubMed] [Google Scholar]
  4. Elwood J. M., Cole P., Rothman K. J., Kaplan S. D. Epidemiology of endometrial cancer. J Natl Cancer Inst. 1977 Oct;59(4):1055–1060. doi: 10.1093/jnci/59.4.1055. [DOI] [PubMed] [Google Scholar]
  5. Henderson B. E., Ross R. K., Pike M. C., Casagrande J. T. Endogenous hormones as a major factor in human cancer. Cancer Res. 1982 Aug;42(8):3232–3239. [PubMed] [Google Scholar]
  6. Holford T. R., White C., Kelsey J. L. Multivariate analysis for matched case-control studies. Am J Epidemiol. 1978 Mar;107(3):245–256. doi: 10.1093/oxfordjournals.aje.a112531. [DOI] [PubMed] [Google Scholar]
  7. Hsueh A. J., Peck E. J., Jr, clark J. H. Progesterone antagonism of the oestrogen receptor and oestrogen-induced uterine growth. Nature. 1975 Mar 27;254(5498):337–339. doi: 10.1038/254337a0. [DOI] [PubMed] [Google Scholar]
  8. Hulka B. S., Chambless L. E., Kaufman D. G., Fowler W. C., Jr, Greenberg B. G. Protection against endometrial carcinoma by combination-product oral contraceptives. JAMA. 1982 Jan 22;247(4):475–477. [PubMed] [Google Scholar]
  9. Kaufman D. W., Shapiro S., Slone D., Rosenberg L., Miettinen O. S., Stolley P. D., Knapp R. C., Leavitt T., Jr, Watring W. G., Rosenshein N. B. Decreased risk of endometrial cancer among oral-contraceptive users. N Engl J Med. 1980 Oct 30;303(18):1045–1047. doi: 10.1056/NEJM198010303031807. [DOI] [PubMed] [Google Scholar]
  10. Kelsey J. L., LiVolsi V. A., Holford T. R., Fischer D. B., Mostow E. D., Schwartz P. E., O'Connor T., White C. A case-control study of cancer of the endometrium. Am J Epidemiol. 1982 Aug;116(2):333–342. doi: 10.1093/oxfordjournals.aje.a113417. [DOI] [PubMed] [Google Scholar]
  11. La Vecchia C., Franceschi S., Gallus G., Decarli A., Colombo E., Mangioni C., Tognoni G. Oestrogens and obesity as risk factors for endometrial cancer in Italy. Int J Epidemiol. 1982 Jun;11(2):120–126. doi: 10.1093/ije/11.2.120. [DOI] [PubMed] [Google Scholar]
  12. Lyon F. A. The development of adenocarcinoma of the endometrium in young women receiving long-term sequential oral contraception. Am J Obstet Gynecol. 1975 Oct 1;123(3):299–301. doi: 10.1016/0002-9378(75)90202-1. [DOI] [PubMed] [Google Scholar]
  13. MEISSNER W. A., SOMMERS S. C., SHERMAN G. Endometrial hyperplasia, endometrial carcinoma, and endometriosis produced experimentally by estrogen. Cancer. 1957 May-Jun;10(3):500–509. doi: 10.1002/1097-0142(195705/06)10:3<500::aid-cncr2820100312>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  14. Mack T. M. Cancer surveillance program in Los Angeles County. Natl Cancer Inst Monogr. 1977 Dec;47:99–101. [PubMed] [Google Scholar]
  15. Mack T. M., Pike M. C., Henderson B. E., Pfeffer R. I., Gerkins V. R., Arthur M., Brown S. E. Estrogens and endometrial cancer in a retirement community. N Engl J Med. 1976 Jun 3;294(23):1262–1267. doi: 10.1056/NEJM197606032942304. [DOI] [PubMed] [Google Scholar]
  16. McDonald T. W., Annegers J. F., O'Fallon W. M., Dockerty M. B., Malkasian G. D., Jr, Kurland L. T. Exogenous estrogen and endometrial carcinoma: case-control and incidence study. Am J Obstet Gynecol. 1977 Mar 15;127(6):572–580. doi: 10.1016/0002-9378(77)90351-9. [DOI] [PubMed] [Google Scholar]
  17. Nisker J. A., Hammond G. L., Davidson B. J., Frumar A. M., Takaki N. K., Judd H. L., Siiteri P. K. Serum sex hormone-binding globulin capacity and the percentage of free estradiol in postmenopausal women with and without endometrial carcinoma. A new biochemical basis for the association between obesity and endometrial carcinoma. Am J Obstet Gynecol. 1980 Nov 15;138(6):637–642. doi: 10.1016/0002-9378(80)90080-0. [DOI] [PubMed] [Google Scholar]
  18. Peterson E. P. Endometrial carcinoma in young women. A clinical profile. Obstet Gynecol. 1968 May;31(5):702–707. doi: 10.1097/00006250-196805000-00018. [DOI] [PubMed] [Google Scholar]
  19. SOMMERS S. C., HERTIG A. T., BENGLOFF H. Genesis of endometrial carcinoma; cases 19 to 35 years old. Cancer. 1949 Nov;2(6):957-63, illust. doi: 10.1002/1097-0142(194911)2:6<957::aid-cncr2820020604>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  20. Siiteri P. K. Steroid hormones and endometrial cancer. Cancer Res. 1978 Nov;38(11 Pt 2):4360–4366. [PubMed] [Google Scholar]
  21. Silverberg S. G., Makowski E. L. Endometrial carcinoma in young women taking oral contraceptive agents. Obstet Gynecol. 1975 Nov;46(5):503–506. [PubMed] [Google Scholar]
  22. Smith D. C., Prentice R., Thompson D. J., Herrmann W. L. Association of exogenous estrogen and endometrial carcinoma. N Engl J Med. 1975 Dec 4;293(23):1164–1167. doi: 10.1056/NEJM197512042932302. [DOI] [PubMed] [Google Scholar]
  23. Tseng L., Gurpide E. Induction of human endometrial estradiol dehydrogenase by progestins. Endocrinology. 1975 Oct;97(4):825–833. doi: 10.1210/endo-97-4-825. [DOI] [PubMed] [Google Scholar]
  24. Vermeulen A., Verdonck L. Sex hormone concentrations in post-menopausal women. Clin Endocrinol (Oxf) 1978 Jul;9(1):59–66. doi: 10.1111/j.1365-2265.1978.tb03572.x. [DOI] [PubMed] [Google Scholar]
  25. Weiss N. S., Sayvetz T. A. Incidence of endometrial cancer in relation to the use of oral contraceptives. N Engl J Med. 1980 Mar 6;302(10):551–554. doi: 10.1056/NEJM198003063021004. [DOI] [PubMed] [Google Scholar]
  26. Wynder E. L., Escher G. C., Mantel N. An epidemiological investigation of cancer of the endometrium. Cancer. 1966 Apr;19(4):489–520. doi: 10.1002/1097-0142(196604)19:4<489::aid-cncr2820190406>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
  27. Ziel H. K., Finkle W. D. Increased risk of endometrial carcinoma among users of conjugated estrogens. N Engl J Med. 1975 Dec 4;293(23):1167–1170. doi: 10.1056/NEJM197512042932303. [DOI] [PubMed] [Google Scholar]

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