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Int J Cancer. 2015 Aug 1;137(3):625-37. doi: 10.1002/ijc.29427. Epub 2015 Feb 5.

Prospective study of body size throughout the life-course and the incidence of endometrial cancer among premenopausal and postmenopausal women.

Dougan MM1, Hankinson SE1,2,3,4, Vivo ID3,4,5, Tworoger SS1,3,4, Glynn RJ6,7, Michels KB1,3,4,8.

Author information

1
Department of Epidemiology, Harvard School of Public Health, Boston, MA.
2
Division of Biostatistics and Epidemiology, University of Massachusetts School of Public Health and Health Sciences, Amherst, MA.
3
Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
4
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
5
Department of Epidemiology, Program in Genetic Epidemiology and Statistical Genetics, Harvard School of Public Health, Boston, MA.
6
Center for Cardiovascular Disease Prevention, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
7
Department of Biostatistics, Harvard School of Public Health, Boston, MA.
8
Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Abstract

Although adult obesity is known to increase endometrial cancer risk, evidence for childhood obesity is limited. We prospectively examined the association between body fatness throughout life and endometrial cancer risk. 47,289 participants in the Nurses' Health Study (NHS) and 105,386 of the Nurses' Health Study II (NHS II) recalled their body fatness at ages 5, 10 and 20 using a pictogram. Childhood and adolescent body fatness were derived as the average at ages 5 and 10 and ages 10 and 20, respectively. We obtained adult weight from concurrent questionnaires. We calculated hazard ratios (HR) of endometrial cancer using Cox proportional hazards models. During follow-up, 757 incident cases of endometrial cancer were diagnosed. Body fatness in childhood, at age 10, in adolescence and at age 20 were positively associated with endometrial cancer risk (HR for ≥ Level 5 versus ≤ Level 2 in adolescence: 1.83 (95% CI 1.41-2.37). After adjusting for most recent BMI, none of the associations persisted. Weight change since age 18 was positively associated with endometrial cancer risk [HR for ≥ 25 kg gain versus stable: 2.54 (95% CI 1.80-3.59). Adult BMI was strongly associated with endometrial cancer risk [HR BMI ≥ 35 kg/m(2) versus BMI ≤ 25 kg/m(2) : 4.13 (95% CI 3.29-5.16)]. In postmenopausal women, the association with BMI was significantly stronger among non-users of hormone therapy. In conclusion, obesity throughout life is positively associated with endometrial cancer risk, with adult obesity one of the strongest risk factors. Maintaining a healthy weight throughout life remains important.

KEYWORDS:

body fatness; body mass index; endometrial cancer risk; pictogram; somatotype; weight gain

PMID:
25641700
PMCID:
PMC5241095
DOI:
10.1002/ijc.29427
[Indexed for MEDLINE]
Free PMC Article

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