Skip to main content
Japanese Journal of Cancer Research : Gann logoLink to Japanese Journal of Cancer Research : Gann
. 1996 Sep;87(9):1001–1009. doi: 10.1111/j.1349-7006.1996.tb02132.x

Subsite (cervix/endometrium)‐specific Risk and Protective Factors in Uterus Cancer

Kaoru Hirose 1,, Kazuo Tajima 1, Nobuyuki Hamajima 1, Toshiro Takezaki 1, Manami Inoue 1, Tetsuo Kuroishi 1, Kazuo Kuzuya 2, Shigeo Nakamura 3, Shinkan Tokudome 4
PMCID: PMC5921205  PMID: 8878465

Abstract

In Japan the incidence of cervical cancer has been high, but has recently been decreasing gradually, while the incidence of endometrial cancer is running at lower levels but is gradually increasing. To clarify the common and/or specific risk and/or protective factors of cervical cancer (CC) in contrast with endometrial cancer (EC), a comparative case‐control study was conducted at the Aichi Cancer Center Hospital, Japan. In total, 556 CC cases and 145 EC cases were included and 26,751 women, confirmed as free of cancer, were chosen as the common control group. Odds ratio and its 95% confidence interval (95%CI) for each exposure variable were estimated by using an unconditional logistic regression model adjusted for age and first‐visit year. Habitual smoking and experience of pregnancy increased the risk of CC, while decreasing the risk of EC. Greater body mass index (>20), daily intake of fruit and more frequent intake of boiled or broiled fish (>1–2 times/week) decreased the risk of CC, whereas they increased the risk of EC. Daily intake of milk decreased the risk of CC. The results obtained from this study suggest that several EC‐increasing risk factors are in fact CC‐decreasing determinants. The observed risk reduction in both CC and EC by physical exercise and dietary control for health is noteworthy from the public health standpoint and warrants further investigation.

Keywords: Uterus cancer, Subsite, Case‐control study, Risk factors

Full Text

The Full Text of this article is available as a PDF (514.9 KB).

REFERENCE

  • 1.Parkin , D. M. , Muir , C. , Whelan , S. L. , Gao , Y.‐T. , Ferlay , J. and Powell , J. “ Cancer Incidence in Five Continents , Vol. VI ,” IARC Scientific Publication Series, No.120 ( 1992. ). IARC; , Lyon . [Google Scholar]
  • 2.Pao , C. C. , Kao , S. M. , Tang , G. C. , Lee , K. , Si , J. and Ruan , S.Human papillomavirus and cervical carcinoma in China and Taiwan . Lancet , 342 , 937 ( 1993. ). [DOI] [PubMed] [Google Scholar]
  • 3.Yoo , K. Y. , Tajima , K. , Kuroishi , T. , Hirose , K. , Yoshida , M. , Miura , S. and Murai , H.Independent protective effect of lactation against breast cancer: a case‐control study in Japan . Am. J. Epidemiol ., 135 , 726 – 733 ( 1992. ). [DOI] [PubMed] [Google Scholar]
  • 4.Inoue , M. , Tajima , K. , Hirose , K. , Kuroishi , T. , Gao , C. M. and Kito , T.Life‐style and subsite of gastric cancer — joint effect of smoking and drinking habits . Int. J. Cancer , 56 , 494 – 499 ( 1994. ). [DOI] [PubMed] [Google Scholar]
  • 5.Inoue , M. , Tajima , K. , Hirose , K. , Hamajima , N. , Takezaki , T. , Hirai , T. , Kato , T. and Ohono , Y.Subsite‐specific risk factors for colorectal cancer: a hospital‐based case‐control study in Japan . Cancer Cause Control , 6 , 14 – 22 ( 1995. ). [DOI] [PubMed] [Google Scholar]
  • 6.“Patients and Medical Institutions in Japan — Graphical Review of Health Statistics — 1992” ( 1992. ). Health and Welfare Statistics Association; , Tokyo . [Google Scholar]
  • 7.Hamajima , N. , Hirose , K. , Inoue , M. , Takezaki , T. , Kuroishi , T. and Tajima , K.Age specific risk factors of breast cancer estimated by a case‐control study in Japan . J. Epidemiol ., 5 , 99 – 105 ( 1995. ). [Google Scholar]
  • 8.Hamajima , N. , Hirose , K. , Inoue , M. , Takezaki , T. , Kuroishi , T. and Tajima , K.Case‐control studies: matched controls or all available controls ? J. Clin. Epidemiol ., 47 , 971 – 975 ( 1994. ). [DOI] [PubMed] [Google Scholar]
  • 9.Elwood , J. M. , Cole , P. , Rothman , K. J. and Kaplan , S. D.Epidemiology of endometrial cancer . J. Natl. Cancer Inst ., 59 , 1055 – 1060 ( 1977. ). [DOI] [PubMed] [Google Scholar]
  • 10.Kelsey , J. L. , LiVolst , V. A. , Holford , T. R. , Fischer , D. B. , Mostow , E. D. , Schwartz , P. E. , O'Connor , T. and White , C.A case‐control study of cancer of the endometrium . Am. J. Epidemiol ., 116 , 333 – 342 ( 1982. ). [DOI] [PubMed] [Google Scholar]
  • 11.Miller , A. B. , Barclay , T. H. C. , Choi , N. W. , Grace , M. G. , Wall , C. , Plante , M. , Howe , G. R. , Cinder , B. and Davis , F. G.A study of cancer, parity and age at first pregnancy . J. Chron. Dis ., 33 , 595 – 604 ( 1980. ). [DOI] [PubMed] [Google Scholar]
  • 12.Stewart , H. L. , Dunham , L. J. , Casper , J. , Dorn , H. F. , Thomas , L. B. , Edgcomb , J. H. and Symeonidis , A.Epidemiology of cancers of uterine cervix and corpus, breast and ovary in Israel and New York City . J. Natl. Cancer Inst ., 37 , 1 – 95 ( 1966. ). [PubMed] [Google Scholar]
  • 13.Austin , H. , Austin , J. M. , Jr. , Partridge , E. E. , Hatch , K. D. and Shingleton , H. M.Endometrial cancer, obesity, and body fat distribution . Cancer Res ., 51 , 568 – 572 ( 1991. ). [PubMed] [Google Scholar]
  • 14.Brinton , L. A. and Hoover , R. N.Epidemiology of gynecologic cancers . In “Principles and Practice of Gynecologic Oncology ,” ed. Hoskins W. J. , Perez C. A. and Young R. C. , pp. 3 – 26 ( 1992. ). J. B. Lippincott Co. , Philadelphia . [Google Scholar]
  • 15.La Vecchia , C. , Decarli , A. , Fasoli , M. and Gentile , A.Nutrition and diet in the etiology of endometrial cancer . Cancer , 57 , 1248 – 1253 ( 1986. ). [DOI] [PubMed] [Google Scholar]
  • 16.Forney , J. P. , Milewich , L. , Chen , G. T. , Garlock , J. L. , Schwarz , B. E. , Edman , C. D. and MacDonald , P. C.Aromatization of androstenedione to estrone by human adipose tissue in vitro. Correlation with adipose tissue mass, age, and endometrial neoplasia . J. Clin. Endocrinol. Metab ., 53 , 192 – 199 ( 1981. ). [DOI] [PubMed] [Google Scholar]
  • 17.Grodin , J. M. , Siiteri , P. K. and MacDonald , P. C.Source of estrogen production in postmenopausal women . J. Clin. Endocrinol. Metab ., 36 , 207 – 214 ( 1973. ). [DOI] [PubMed] [Google Scholar]
  • 18.Siiteri , P. K.Extraglandular oestrogen formation and serum binding of estradiol: relationship to cancer . J. Endocrinol ., 89 , 119 – 129 ( 1981. ). [PubMed] [Google Scholar]
  • 19.Winkelstein , W.Jr.Smoking and cervical cancer — current status: a review . Am. J. Epidemiol ., 131 , 945 – 957 ( 1990. ). [DOI] [PubMed] [Google Scholar]
  • 20.Simons , A. M. , Phillips , D. H. and Coleman , D. V.Damage to DNA in cervical epithelium related to smoking tobacco . Br. Med. J ., 306 , 1444 – 1448 ( 1993. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.MacMahon , B. , Trichopoulos , D. , Cole , P. and Brown , J.Cigarette smoking and urinary estrogen . N. Engl. J. Med ., 307 , 1062 – 1065 ( 1982. ). [DOI] [PubMed] [Google Scholar]
  • 22.Michnovicz , J. J. , Hershcopf , R. J. , Nagunuma , H. , Bradlow , H. L. and Fishman , J.Increased 2‐hydroxylation of estradiol as a possible mechanism for the antiestrogenic effect of cigarette smoking . N. Engl. J. Med ., 315 , 1305 – 1309 ( 1986. ). [DOI] [PubMed] [Google Scholar]
  • 23.Gapstur , S. M. , Potter , J. D. , Sellers , T. A. , Kushi , L. H. and Folsom , A. R.Alcohol consumption and postmenopausal endometrial cancer: results from the Iowa Women's Health Study . Cancer Causes Control , 4 , 323 – 329 ( 1993. ). [DOI] [PubMed] [Google Scholar]
  • 24.Parazzini , F. , La Vecchia , C. , D'Avanzo , B. , Moroni , S. , Chatenoud , L. and Ricci , E.Alcohol and endometrial cancer risk: findings from an Italian case‐control study . Nutr. Cancer , 23 , 55 – 62 ( 1995. ). [DOI] [PubMed] [Google Scholar]
  • 25.Webster , L. A. and Weiss , N. S.The Cancer Steroid Hormone Study Group. Alcoholic beverage consumption and the risk of endometrial cancer . Int. J. Epidemiol ., 18 , 786 – 791 ( 1989. ). [DOI] [PubMed] [Google Scholar]
  • 26.Williams , R. R. and Horm , J. W.Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the Third National Cancer Survey . J. Natl. Cancer Inst ., 58 , 525 – 547 ( 1977. ). [DOI] [PubMed] [Google Scholar]
  • 27.Frisch , R. E. , Wyshak , G. , Albright , N. L. , Albright , T. E. , Schiff , I. , Jones , K. P. , Witshchi , J. , Shiang , E. , Koff , E. and Marguglio , M.Lower prevalence of breast cancer and cancers of the reproductive system among former college athletes compared to non‐athletes . Br. J. Cancer , 52 , 885 – 891 ( 1985. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 28.Brock , K. E. , Berry , G. , Mock , P. A. , MacLennan , R. , Truswell , A. S. and Brinton , L. A.Nutrients in diet and plasma and risk of in situ cervical cancer . J. Natl. Cancer Inst ., 80 , 580 – 585 ( 1988. ). [DOI] [PubMed] [Google Scholar]
  • 29.Henrica , C. W. de Vet , Knipschild , P. G. , Grol , M. E. C. , Schouten , H. J. A. and Sturmans , F.The role of betacarotene and other dietary factors in the aetiology of cervical dysplasia: results of a case‐control study . Int. J. Epidemiol ., 20 , 603 – 610 ( 1991. ). [DOI] [PubMed] [Google Scholar]
  • 30.Ziegler , R. G. , Brinton , L. A. , Hamman , R. F. , Lehman , H. F. , Levine , R. S. , Mallin , K. , Norman , S. A. , Rosenthal , J. F. , Trumble , A. C. and Hoover , R. N.Diet and the risk of invasive cervical cancer among white women in the United States . Am. J. Epidemiol ., 132 , 432 – 445 ( 1990. ). [DOI] [PubMed] [Google Scholar]
  • 31.Potischman , N.Nutritional epidemiology of cervical neoplasia . J. Nutr ., 123 , 424 – 429 ( 1993. ). [DOI] [PubMed] [Google Scholar]

Articles from Japanese Journal of Cancer Research : Gann are provided here courtesy of Wiley

RESOURCES