A full-term pregnancy is associated with reduced endometrial cancer risk; however, whether the effect of additional pregnancies is independent of age at last pregnancy is unknown. The associations between other pregnancy-related factors and endometrial cancer risk are less clear. We pooled individual participant data from 11 cohort and 19 case-control studies participating in the Epidemiology of Endometrial Cancer Consortium (E2C2) including 16,986 women with endometrial cancer and 39,538 control women. We used one- and two-stage meta-analytic approaches to estimate pooled odds ratios (OR) for the association between exposures and endometrial cancer risk. Ever having a full-term pregnancy was associated with a 41% reduction in risk of endometrial cancer compared to never having a full-term pregnancy (OR=0.59, 95% confidence interval (CI) 0.56-0.63). The risk reduction appeared greatest for the first full-term pregnancy (OR=0.78, 95%CI 0.72-0.84), with a further ~15% reduction per pregnancy up to eight pregnancies (OR=0.20, 95%CI 0.14-0.28) that was independent of age at last full-term pregnancy. Incomplete pregnancy was also associated with decreased endometrial cancer risk (7-9% reduction per pregnancy). Twin births appeared to have the same effect as singleton pregnancies. Our pooled analysis shows that, while the magnitude of the risk reduction is greater for a full-term pregnancy than an incomplete pregnancy, each additional pregnancy is associated with further reduction in endometrial cancer risk, independent of age at last full-term pregnancy. These results suggest the very high progesterone level in the last trimester of pregnancy is not the sole explanation for the protective effect of pregnancy.
Pregnancy Outcomes and Risk of Endometrial Cancer : A Pooled Analysis of Individual Participant Data in the Epidemiology of Endometrial Cancer Consortium / J.S. Jordan, R. Na, E. Weiderpass, H.O. Adami, K.E. Anderson, P.A. van den Brandt, L.A. Brinton, C. Chen, L.S. Cook, J.A. Doherty, M. Du, C.M. Friedenreich, G.L. Gierach, M.T. Goodman, V. Krogh, F. Levi, L. Lu, A.B. Miller, S.E. McCann, B.K. Moysich, E. Negri, S.H. Olson, S. Petruzella, J.R. Palmer, F. Parazzini, M.C. Pike, A.E. Prizment, T.R. Rebbeck, P. Reynolds, F. Ricceri, H.A. Risch, T.E. Rohan, C. Sacerdote, L.J. Schouten, D. Serraino, V.W. Setiawan, X.-. Shu, T.R. Sponholtz, A.B. Spurdle, R.Z. Stolzenberg-Solomon, B. Trabert, N. Wentzensen, L.R. Wilkens, L.A. Wise, H. Yu, C. La Vecchia, I. De Vivo, W. Xu, A. Zeleniuch-Jacquotte, P.M. Webb. - In: INTERNATIONAL JOURNAL OF CANCER. - ISSN 0020-7136. - 148:9(2021 May 01), pp. 2068-2078.
|Titolo:||Pregnancy Outcomes and Risk of Endometrial Cancer : A Pooled Analysis of Individual Participant Data in the Epidemiology of Endometrial Cancer Consortium|
|Parole Chiave:||Endometrial cancer; Induced abortion; Miscarriage; Parity; Sex of offspring|
|Settore Scientifico Disciplinare:||Settore MED/01 - Statistica Medica|
|Data di pubblicazione:||1-mag-2021|
|Data ahead of print / Data di stampa:||26-ott-2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1002/ijc.33360|
|Appare nelle tipologie:||01 - Articolo su periodico|
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