Michele L Cote1,2, Tala Alhajj3, Julie J Ruterbusch3, Leslie Bernstein4, Louise A Brinton5, William J Blot6,7, Chu Chen8, Margery Gass9, Sarah Gaussoin10, Brian Henderson11, Eunjung Lee12, Pamela L Horn-Ross12, Laurence N Kolonel13, Andrew Kaunitz14, Xiaolin Liang15, Wanda K Nicholson16, Amy B Park9, Stacey Petruzella15, Timothy R Rebbeck17, V Wendy Setiawan11, Lisa B Signorello18, Michael S Simon3,19, Noel S Weiss8,20, Nicolas Wentzensen5, Hannah P Yang5, Anne Zeleniuch-Jacquotte21, Sara H Olson15. 1. Department of Oncology, Wayne State University School of Medicine, 4100 John R. Mailstop: MM04EP, Detroit, MI, 48201, USA. cotem@karmanos.org. 2. Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, USA. cotem@karmanos.org. 3. Department of Oncology, Wayne State University School of Medicine, 4100 John R. Mailstop: MM04EP, Detroit, MI, 48201, USA. 4. Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA. 5. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. 6. Vanderbilt-Ingram Cancer Center, Nashville, TN, USA. 7. International Epidemiology Foundation, Rockville, MD, USA. 8. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. 9. Case Western Reserve University School of Medicine, Cleveland, OH, USA. 10. Wake Forest School of Medicine, Winston-Salem, NC, USA. 11. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 12. Cancer Prevention Institute of California, Fremont, CA, USA. 13. University of Hawaii Cancer Center, Honolulu, HI, USA. 14. University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA. 15. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. 16. Diabetes and Obesity Core, Center for Women's Health Research, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA. 17. School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 18. School of Public Health, Harvard University, Boston, MA, USA. 19. Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, USA. 20. School of Public Health, University of Washington, Seattle, WA, USA. 21. Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA.
Abstract
PURPOSE: Endometrial cancer (EC) is the most common gynecologic cancer in the USA. Over the last decade, the incidence rate has been increasing, with a larger increase among blacks. The aim of this study was to compare risk factors for EC in black and white women. METHODS: Data from seven cohort and four case-control studies were pooled. Unconditional logistic regression was used to estimate adjusted odds ratios (OR) and 95 % confidence intervals for each risk factor in blacks and whites separately. RESULTS: Data were pooled for 2,011 black women (516 cases and 1,495 controls) and 19,297 white women (5,693 cases and 13,604 controls). BMI ≥ 30 was associated with an approximate threefold increase in risk of EC in both black and white women (ORblack 2.93, 95 % CI 2.11, 4.07 and ORwhite 2.99, 95 % CI 2.74, 3.26). Diabetes was associated with a 30-40 % increase in risk among both groups. Increasing parity was associated with decreasing risk of EC in blacks and whites (p value = 0.02 and <0.001, respectively). Current and former smoking was associated with decreased risk of EC among all women. Both black and white women who used oral contraceptives for 10 +years were also at reduced risk of EC (OR 0.49, 95 % CI 0.27, 0.88 and OR 0.69, 95 % CI 0.58, 0.83, respectively). Previous history of hypertension was not associated with EC risk in either group. CONCLUSIONS: The major known risk factors for EC exert similar effects on black and white women. Differences in the incidence rates between the two populations may be due to differences in the prevalence of risk factors.
PURPOSE:Endometrial cancer (EC) is the most common gynecologic cancer in the USA. Over the last decade, the incidence rate has been increasing, with a larger increase among blacks. The aim of this study was to compare risk factors for EC in black and white women. METHODS: Data from seven cohort and four case-control studies were pooled. Unconditional logistic regression was used to estimate adjusted odds ratios (OR) and 95 % confidence intervals for each risk factor in blacks and whites separately. RESULTS: Data were pooled for 2,011 black women (516 cases and 1,495 controls) and 19,297 white women (5,693 cases and 13,604 controls). BMI ≥ 30 was associated with an approximate threefold increase in risk of EC in both black and white women (ORblack 2.93, 95 % CI 2.11, 4.07 and ORwhite 2.99, 95 % CI 2.74, 3.26). Diabetes was associated with a 30-40 % increase in risk among both groups. Increasing parity was associated with decreasing risk of EC in blacks and whites (p value = 0.02 and <0.001, respectively). Current and former smoking was associated with decreased risk of EC among all women. Both black and white women who used oral contraceptives for 10 +years were also at reduced risk of EC (OR 0.49, 95 % CI 0.27, 0.88 and OR 0.69, 95 % CI 0.58, 0.83, respectively). Previous history of hypertension was not associated with EC risk in either group. CONCLUSIONS: The major known risk factors for EC exert similar effects on black and white women. Differences in the incidence rates between the two populations may be due to differences in the prevalence of risk factors.
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