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Br J Cancer. 2015 Mar 3;112(5):925-33. doi: 10.1038/bjc.2015.24. Epub 2015 Feb 17.

Infertility and incident endometrial cancer risk: a pooled analysis from the epidemiology of endometrial cancer consortium (E2C2).

Author information

  • 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
  • 2University of New Mexico, Albuquerque, NM 87131, USA.
  • 31] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden [2] Department of Genetic Epidemiology, Folkhälsan Research Center, 00014 Helsinki, Finland [3] Department of Research, Cancer Registry of Norway, N-0304 Oslo, Norway [4] Department of Community Medicine, University of Tromsø, The Arctic University of Norway, 90109 Tromsø, Norway.
  • 41] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden [2] Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
  • 5School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
  • 6Department of Medicine, Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
  • 7Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
  • 8Department of Population Health and NYU Perimutter Cancer Center, New York University School of Medicine, New York, NY 10016, USA.
  • 9Alberta Health Services, Calgary, Alberta T2T 5C7, Canada.
  • 10Institute of Cancer Research, Surrey SM2 5NG, UK.
  • 11Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
  • 12Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
  • 13M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, 02-781 Warsaw, Poland.
  • 14Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA.
  • 15H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL33612, USA.
  • 16Roswell Park Cancer Institute, Buffalo, NY 14203, USA.
  • 171] Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA [2] Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
  • 18Human Genetics Foundation, 10126 Turin, Italy.
  • 191] Human Genetics Foundation, 10126 Turin, Italy [2] Unit of Cancer Epidemiology, University of Turin and Center for Cancer Prevention, 10124 Turin, Italy.
  • 20Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
  • 21QIMR Berghofer Medical Research Institute, Herston, Queensland 4029, Australia.
  • 22Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
  • 23University of Hawaii Cancer Center, Honolulu, HI 96813, USA.

Abstract

BACKGROUND:

Nulliparity is an endometrial cancer risk factor, but whether or not this association is due to infertility is unclear. Although there are many underlying infertility causes, few studies have assessed risk relations by specific causes.

METHODS:

We conducted a pooled analysis of 8153 cases and 11 713 controls from 2 cohort and 12 case-control studies. All studies provided self-reported infertility and its causes, except for one study that relied on data from national registries. Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI).

RESULTS:

Nulliparous women had an elevated endometrial cancer risk compared with parous women, even after adjusting for infertility (OR=1.76; 95% CI: 1.59-1.94). Women who reported infertility had an increased risk compared with those without infertility concerns, even after adjusting for nulliparity (OR=1.22; 95% CI: 1.13-1.33). Among women who reported infertility, none of the individual infertility causes were substantially related to endometrial cancer.

CONCLUSIONS:

Based on mainly self-reported infertility data that used study-specific definitions of infertility, nulliparity and infertility appeared to independently contribute to endometrial cancer risk. Understanding residual endometrial cancer risk related to infertility, its causes and its treatments may benefit from large studies involving detailed data on various infertility parameters.

PMID:
25688738
[PubMed - indexed for MEDLINE]
PMCID:
PMC4453954
Free PMC Article
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