Table 4.
Age- and multivariable-adjusted hazard ratios and 95% confidence intervals for endometrial cancer by lifetime body fatness among postmenopausal participants, stratified by HT use
| EVER USERS | NEVER USERS | |||||||
|---|---|---|---|---|---|---|---|---|
| No. cases/person-years | Age-adjusted HR | Multivariate-adjusted HR3 (95% CI) | Multivariate adjusted HR3 + recent BMI (95% CI) | No. cases/person-years | Age-adjusted HR | Multivariate-adjusted HR3 (95% CI) | Multivariate adjusted HR3 + recent BMI4 (95% CI) | |
| Body fatness1 at age 5, Level | ||||||||
| 1 | 144 / 180,840 | 1.00 | 1.00 | 1.00 | 66 / 126,607 | 1.00 | 1.00 | 1.00 |
| 2 | 88 / 127,499 | 0.99 | 0.98 (0.75-1.29) | 0.98 (0.74-1.28) | 51 / 77,264 | 1.18 | 1.23 (0.84-1.81) | 1.19 (0.80-1.76) |
| 3 | 55 / 96,848 | 0.85 | 0.85 (0.62-1.17) | 0.81 (0.59-1.12) | 41 / 61,834 | 1.21 | 1.19 (0.80-1.79) | 0.97 (0.64-1.48) |
| 4 | 36 / 56,055 | 0.89 | 0.88 (0.61-1.28) | 0.79 (0.54-1.15) | 34 / 37,613 | 1.78 | 1.78 (1.16-2.73) | 1.30 (0.83-2.02) |
| 5+ | 33 / 36,514 | 1.26 | 1.27 (0.86-1.87) | 1.12 (0.76-1.66) | 14 / 26,915 | 0.95 | 0.89 (0.49-1.61) | 0.61 (0.33-1.12) |
| P trend | 0.89 | 0.88 | 0.56 | 0.17 | 0.25 | 0.49 | ||
| P interaction5 | 0.14 | |||||||
| Body fatness1 at age 10, Level | ||||||||
| 1 | 112 / 140,185 | 1.00 | 1.00 | 1.00 | 40 / 94,813 | 1.00 | 1.00 | 1.00 |
| 2 | 93 / 137,784 | 0.93 | 0.94 (0.71-1.25) | 0.92 (0.69-1.21) | 56 / 86,585 | 1.39 | 1.42 (0.94-2.17) | 1.28 (0.84-1.96) |
| 3 | 58 / 93,847 | 0.89 | 0.90 (0.65-1.24) | 0.84 (0.60-1.16) | 40 / 62,074 | 1.36 | 1.34 (0.85-2.12) | 1.01 (0.63-1.61) |
| 4 | 37 / 66,716 | 0.80 | 0.80 (0.55-1.17) | 0.71 (0.48-1.03) | 34 / 45,490 | 1.78 | 1.69 (1.05-2.72) | 1.11 (0.67-1.82) |
| 5+ | 56 / 59,223 | 1.42 | 1.42 (1.02-1.97) | 1.21 (0.86-1.70) | 36 / 41,271 | 1.93 | 1.78 (1.11-2.85) | 1.06 (0.65-1.73) |
| P trend | 0.30 | 0.30 | 0.98 | 0.003 | 0.01 | 0.92 | ||
| P interaction5 | 0.03 | |||||||
| Body fatness1 at age 20, Level | ||||||||
| 1-2 | 151 / 198,137 | 1.00 | 1.00 | 1.00 | 57 / 127,424 | 1.00 | 1.00 | 1.00 |
| 3 | 108 / 171,336 | 0.90 | 0.91 (0.70-1.16) | 0.84 (0.65-1.09) | 68 / 110,831 | 1.35 | 1.32 (0.92-1.90) | 1.08 (0.74-1.56) |
| 4 | 63 / 86,785 | 1.05 | 1.04 (0.77-1.40) | 0.90 (0.66-1.22) | 51 / 59,369 | 1.83 | 1.67 (1.12-2.49) | 1.03 (0.67-1.58) |
| 5+ | 34 / 41,498 | 1.15 | 1.13 (0.77-1.65) | 0.89 (0.60-1.33) | 30 / 32,610 | 2.08 | 1.72 (1.08-2.75) | 0.81 (0.48-1.35) |
| P trend | 0.54 | 0.60 | 0.42 | <0.001 | 0.01 | 0.51 | ||
| P interaction5 | 0.01 | |||||||
| Average childhood body fatness (ages 5 – 10)2, Level | ||||||||
| 1-2 | 204 / 272,896 | 1.00 | 1.00 | 1.00 | 94 / 179,987 | 1.00 | 1.00 | 1.00 |
| 2.5-3 | 69 / 104,267 | 0.99 | 1.00 (0.76-1.32) | 0.95 (0.72-1.25) | 49 / 67,768 | 1.30 | 1.27 (0.89-1.82) | 1.02 (0.70-1.48) |
| 3.5-4.5 | 50 / 87,104 | 0.86 | 0.85 (0.62-1.17) | 0.77 (0.56-1.05) | 48 / 57,618 | 1.65 | 1.55 (1.08-2.23) | 1.08 (0.73-1.58) |
| 5+ | 33 / 33,488 | 1.45 | 1.45 (1.00-2.12) | 1.25 (0.85-1.84) | 15 / 24,859 | 1.12 | 1.03 (0.59-1.80) | 0.66 (0.36-1.15) |
| P trend | 0.49 | 0.50 | 0.80 | 0.05 | 0.12 | 0.41 | ||
| P interaction5 | 0.12 | |||||||
| Average adolescent body fatness (ages 10 – 20)2, Level | ||||||||
| 1-2 | 150 / 195,308 | 1.00 | 1.00 | 1.00 | 56 / 126,767 | 1.00 | 1.00 | 1.00 |
| 2.5-3 | 95 / 151,533 | 0.90 | 0.91 (0.70-1.18) | 0.85 (0.65-1.11) | 60 / 97,753 | 1.37 | 1.35 (0.93-1.97) | 1.16 (0.79-1.70) |
| 3.5-4.5 | 83 / 122,339 | 0.99 | 1.00 (0.76-1.31) | 0.87 (0.66-1.15) | 69 / 84,007 | 1.83 | 1.73 (1.19-2.50) | 1.12 (0.76-1.66) |
| 5+ | 28 / 28,575 | 1.47 | 1.42 (0.94-2.15) | 1.12 (0.73-1.72) | 21 / 21,709 | 2.14 | 1.80 (1.06-3.05) | 0.88 (0.50-1.56) |
| P trend | 0.34 | 0.37 | 0.72 | <0.001 | 0.002 | 0.95 | ||
| P interaction5 | 0.01 | |||||||
| Recent BMI, kg/m2 | ||||||||
| ≤ 24.9 | 150 / 243,398 | 1.00 | 1.00 | N/A5 | 26 / 138,819 | 1.00 | 1.00 | N/A5 |
| 25.0-29.9 | 111 / 156,920 | 1.16 | 1.16 (0.90-1.50) | 56 / 108,637 | 2.51 | 2.35 (1.46-3.78) | ||
| 30.0-34.9 | 59 / 63,369 | 1.65 | 1.64 (1.19-2.26) | 53 / 51,279 | 4.95 | 4.25 (2.65-7.13) | ||
| ≥35.0 | 36 / 34,068 | 2.35 | 2.23 (1.49-3.34) | 71 / 31,499 | 11.15 | 9.31 (5.64-15.35) | ||
| P trend | <0.001 | <0.001 | <0.001 | <0.001 | ||||
| P interaction6 | <0.001 | |||||||
Participants were asked to recall their body fatness at ages 5, 10, and 20, using a nine-level drawing (Figure 1), where Level 1 corresponds to the leanest and Level 9 the most overweight.
Average childhood and adolescent body fatness were the average of the levels at ages 5 and 10, and ages 10 and 20 respectively.
Adjusted for smoking history [never, past, current], oral contraceptive use [never, <3 years, 3-5 years, > 5years], postmenopausal hormone use (ever-users only) [past (ref), current – estrogen only, current – estrogen only, current – estrogen & progesterone / other], age at menopause [unknown, < 45, 45-< 47, 47 - <49, 49-<51, 51- <53, 53+ years], birth weight [<5.5, 5.5-<7, 7-8.4, 8.5-9.9, 10 lb], family history of colon/rectal cancer, family history of endometrial cancer, height (inches; continuous), parity and age at last birth [Nulliparous, 1-2 & <30 yrs, 1-2 & ≥ 30 yrs, 3-4 & < 30 yrs, 3-4 & ≥ 30 yrs, ≥ 5 children], physical activity [adolescent & age 20 models: <21, 21-<36, 36-<53, 54-<81, 81+ METS/week; recent BMI model: <3, 3-<9, 9-<18, 18-<27, 27+ METS/week]
BMI: body mass index
Recent BMI models not adjusted for recent BMI
Wald test for interaction between body size and postmenopausal hormone use (examined in base multivariate model).