Reproductive risk factors and endometrial cancer: the European Prospective Investigation into Cancer and Nutrition
Reproductive risk factors and endometrial cancer: the European Prospective Investigation into Cancer and Nutrition
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DOI：
10.1002/ijc.25050
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发表时间：
2010-07-15
影响因子：
6.4
通讯作者：
Riboli, Elio
中科院分区：
文献类型：
--
作者：
Dossus, Laure;Allen, Naomi;Riboli, Elio
子宫内膜癌风险与生殖因素（初潮年龄、绝经年龄、产次、首次和末次生育年龄、自末次生育以来的时间和口服避孕药（OC）的使用）相关。然而，这些因素是密切相关的，它们是否独立地起作用仍然需要澄清。我们在欧洲癌症与营养前瞻性调查（EPIC）中进行了一项研究，以检查月经和生殖变量与子宫内膜癌风险的关系。在符合研究条件的302，618名妇女中，确定了1，017例子宫内膜癌病例。在月经初潮晚、绝经早、既往使用过避孕药、产次高和距最后一次足月妊娠时间较短（FTP）的妇女中观察到子宫内膜癌风险降低。在调整FTP次数或流产（自然或人工流产）后，未观察到与母乳喂养持续时间相关。在相互调整后，初潮年龄晚，绝经年龄早和OC使用时间显示出类似的风险降低7-8%，每年月经寿命，而减少的风险与FTPs的累积持续时间更强（每年22%）。总之，我们的研究结果证实了子宫内膜癌风险的降低与雌激素累积暴露量较低和/或孕激素暴露量较高相关的因素，如FTPs数量增加和月经寿命缩短，因此，支持激素机制在子宫内膜癌发生中的重要作用。
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.