Reproductive Factors and Endometrial Cancer Risk Among Women

被引：47

作者：

Katagiri, Ryoko ^{[2
,3
,4
]}

Iwasaki, Motoki ^{[1
,2
,5
]}

Abe, Sarah Krull ^{[6
]}

Islam, Md. Rashedul ^{[6
,7
]}

Rahman, Md. Shafiur ^{[6
,8
]}

Saito, Eiko ^{[9
]}

Merritt, Melissa A. ^{[10
]}

Choi, Ji-Yeob ^{[11
]}

Shin, Aesun ^{[12
,13
]}

Sawada, Norie ^{[2
]}

Tamakoshi, Akiko ^{[14
]}

Koh, Woon-Puay ^{[15
,16
]}

Sakata, Ritsu ^{[17
]}

Tsuji, Ichiro ^{[18
]}

Kim, Jeongseon ^{[19
]}

Nagata, Chisato ^{[20
]}

Park, Sue K. ^{[13
]}

Kweon, Sun-Seog ^{[21
]}

Shu, Xiao-Ou ^{[22
]}

Gao, Yu-Tang ^{[23
]}

Tsugane, Shoichiro ^{[2
]}

Kimura, Takashi ^{[14
]}

Yuan, Jian-Min ^{[24
,25
]}

Kanemura, Seiki ^{[18
]}

Lu, Yukai ^{[18
]}

Sugawara, Yumi ^{[18
]}

Wada, Keiko ^{[20
]}

Shin, Min-Ho ^{[21
]}

Ahsan, Habibul ^{[26
]}

Boffetta, Paolo ^{[27
,28
]}

Chia, Kee Seng ^{[29
]}

Matsuo, Keitaro ^{[30
,31
]}

Qiao, You-Lin ^{[32
]}

Rothman, Nathaniel ^{[33
]}

Zheng, Wei ^{[22
]}

Inoue, Manami ^{[6
]}

Kang, Daehee ^{[34
]}

机构：

[1] Natl Canc Ctr, Inst Canc Control, 5-1-1 Tsukiji,Chuo Ku, Tokyo 1040045, Japan

[2] Natl Canc Ctr, Inst Canc Control, Div Cohort Res, Tokyo, Japan

[3] Natl Inst Hlth & Nutr, Natl Inst Biomed Innovat, Tokyo, Japan

[4] Natl Inst Hlth & Nutr, Tokyo, Japan

[5] Natl Canc Ctr, Inst Canc Control, Div Epidemiol, Tokyo, Japan

[6] Natl Canc Ctr, Inst Canc Control, Div Prevent, Tokyo, Japan

[7] Hitotsubashi Univ, Hitotsubashi Inst Adv Study, Tokyo, Japan

[8] Hamamatsu Univ, Res Ctr Child Mental Dev, Sch Med, Shizuoka, Japan

[9] Natl Ctr Global Hlth & Med, Inst Global Hlth Policy Res, Tokyo, Japan

[10] Univ Sydney, Daffodil Ctr, Joint venture Canc Council NSW, Sydney, NSW, Australia

[11] Seoul Natl Univ, Grad Sch, Dept Biomed Sci, Seoul, South Korea

[12] Seoul Natl Univ, Canc Res Inst, Seoul, South Korea

[13] Seoul Natl Univ, Coll Med, Dept Prevent Med, Seoul, South Korea

[14] Hokkaido Univ, Fac Med, Dept Publ Hlth, Sapporo, Japan

[15] Natl Univ Singapore, Yong Loo Lin Sch Med, Hlth Longev Translat Res Programme, Singapore, Singapore

[16] Singapore Inst Clin Sci, Agcy Sci Technol & Res, Singapore, Singapore

[17] Radiat Effects Res Fdn, Hiroshima, Japan

[18] Tohoku Univ, Grad Sch Med, Sendai, Miyagi, Japan

[19] Natl Canc Ctr, Grad Sch Canc Sci & Policy, Goyang, South Korea

[20] Gifu Univ, Grad Sch Med, Dept Epidemiol & Prevent Med, Gifu, Japan

[21] Chonnam Natl Univ, Med Sch, Dept Prevent Med, Gwangju, South Korea

[22] Vanderbilt Univ, Vanderbilt Ingram Canc Ctr, Vanderbilt Epidemiol Ctr, Med Ctr,Div Epidemiol, Nashville, TN USA

[23] Shanghai Canc Inst, Dept Epidemiol, Shanghai, Peoples R China

[24] Univ Pittsburgh, UPMC Hillman Canc Ctr, Div Canc Control & Populat Sci, Pittsburgh, PA USA

[25] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA USA

[26] Univ Chicago, Dept Publ Hlth Sci, Chicago, IL USA

[27] SUNY Stony Brook, Stony Brook Canc Ctr, Stony Brook, NY USA

[28] Univ Bologna, Dept Med & Surg Sci, Bologna, Italy

[29] Natl Univ Singapore, Saw Swee Hock Sch Publ Hlth, Singapore, Singapore

[30] Aichi Canc Ctr Res Inst, Div Canc Epidemiol & Prevent, Nagoya, Japan

[31] Nagoya Univ, Grad Sch Med, Dept Canc Epidemiol, Nagoya, Japan

[32] Chinese Acad Med Sci & Peking Union Med Coll, Sch Populat Med & Publ Hlth, Beijing, Peoples R China

[33] NCI, Div Canc Epidemiol & Genet, Occupat & Environm Epidemiol Branch, Bethesda, MD USA

[34] Seoul Natl Univ, Coll Med, Seoul, South Korea

来源：

JAMA NETWORK OPEN | 2023年 / 6卷 / 09期

基金：

新加坡国家研究基金会;

关键词：

BODY-MASS INDEX; DOSE-RESPONSE METAANALYSIS; POOLED ANALYSIS; ENDOGENOUS HORMONES; COHORT PROFILE; EPIDEMIOLOGY; ASSOCIATION; DESIGN; HEALTH; BREAST;

D O I：

10.1001/jamanetworkopen.2023.32296

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Importance Despite evidence of an association between reproductive factors and endometrial cancer risk, prospective studies have been conducted mainly in non-Asian countries.Objective To assess the association between reproductive factors, such as number of deliveries, age at menarche, or menopause, and endometrial cancer risk.Design, Setting, and Participants This cohort study used pooled individual data from 13 prospective cohort studies conducted between 1963 and 2014 in the Asia Cohort Consortium. Participants were Asian women. Data analysis was conducted from September 2019 to April 2023.Exposures Reproductive factors were assessed using a questionnaire in each cohort.Main Outcomes and Measures The main outcome was time to incidence of endometrial cancer. A Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% CIs.Results A total of 1005 endometrial cancer cases were detected among 332 625 women (mean [SD] age, 54.3 [10.4] years) during a mean (SD) of 16.5 (6.4) years of follow-up. Increasing number of deliveries was associated with a decreased endometrial cancer risk in a dose-response manner (=5 deliveries vs nulliparous [reference]: HR, 0.37; 95% CI, 0.26-0.53; P for trend < .001). Compared with menarche at younger than 13 years, menarche at 17 years or older had an HR of 0.64 (95% CI, 0.48-0.86; P for trend < .001). Late menopause (age & GE;55 years) showed an HR of 2.84 (95% CI, 1.78-4.55; P for trend < .001) compared with the youngest age category for menopause (<45 years). Age at first delivery, hormone therapy, and breastfeeding were not associated with endometrial cancer risk.Conclusions and Relevance This large pooled study of individual participant data found that late menarche, early menopause, and a higher number of deliveries were significantly associated with a lower risk of endometrial cancer. These convincing results from Asian prospective studies add to the growing body of evidence for the association between reproductive factors and endometrial cancer.

引用

页数：14

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