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Type I and II endometrial cancers: have they different risk factors?
J Clin Oncol. 2013 Jul 10; 31(20):2607-18.JC

Abstract

PURPOSE

Endometrial cancers have long been divided into estrogen-dependent type I and the less common clinically aggressive estrogen-independent type II. Little is known about risk factors for type II tumors because most studies lack sufficient cases to study these much less common tumors separately. We examined whether so-called classical endometrial cancer risk factors also influence the risk of type II tumors.

PATIENTS AND METHODS

Individual-level data from 10 cohort and 14 case-control studies from the Epidemiology of Endometrial Cancer Consortium were pooled. A total of 14,069 endometrial cancer cases and 35,312 controls were included. We classified endometrioid (n = 7,246), adenocarcinoma not otherwise specified (n = 4,830), and adenocarcinoma with squamous differentiation (n = 777) as type I tumors and serous (n = 508) and mixed cell (n = 346) as type II tumors.

RESULTS

Parity, oral contraceptive use, cigarette smoking, age at menarche, and diabetes were associated with type I and type II tumors to similar extents. Body mass index, however, had a greater effect on type I tumors than on type II tumors: odds ratio (OR) per 2 kg/m(2) increase was 1.20 (95% CI, 1.19 to 1.21) for type I and 1.12 (95% CI, 1.09 to 1.14) for type II tumors (P heterogeneity < .0001). Risk factor patterns for high-grade endometrioid tumors and type II tumors were similar.

CONCLUSION

The results of this pooled analysis suggest that the two endometrial cancer types share many common etiologic factors. The etiology of type II tumors may, therefore, not be completely estrogen independent, as previously believed.

Authors+Show Affiliations

Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1450 Biggy St, Los Angeles, CA 90033, USA. vsetiawa@usc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Review

Language

eng

PubMed ID

23733771

Citation

Setiawan, Veronica Wendy, et al. "Type I and II Endometrial Cancers: Have They Different Risk Factors?" Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 31, no. 20, 2013, pp. 2607-18.
Setiawan VW, Yang HP, Pike MC, et al. Type I and II endometrial cancers: have they different risk factors? J Clin Oncol. 2013;31(20):2607-18.
Setiawan, V. W., Yang, H. P., Pike, M. C., McCann, S. E., Yu, H., Xiang, Y. B., Wolk, A., Wentzensen, N., Weiss, N. S., Webb, P. M., van den Brandt, P. A., van de Vijver, K., Thompson, P. J., Strom, B. L., Spurdle, A. B., Soslow, R. A., Shu, X. O., Schairer, C., Sacerdote, C., ... Horn-Ross, P. L. (2013). Type I and II endometrial cancers: have they different risk factors? Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 31(20), 2607-18. https://doi.org/10.1200/JCO.2012.48.2596
Setiawan VW, et al. Type I and II Endometrial Cancers: Have They Different Risk Factors. J Clin Oncol. 2013 Jul 10;31(20):2607-18. PubMed PMID: 23733771.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Type I and II endometrial cancers: have they different risk factors? AU - Setiawan,Veronica Wendy, AU - Yang,Hannah P, AU - Pike,Malcolm C, AU - McCann,Susan E, AU - Yu,Herbert, AU - Xiang,Yong-Bing, AU - Wolk,Alicja, AU - Wentzensen,Nicolas, AU - Weiss,Noel S, AU - Webb,Penelope M, AU - van den Brandt,Piet A, AU - van de Vijver,Koen, AU - Thompson,Pamela J, AU - ,, AU - Strom,Brian L, AU - Spurdle,Amanda B, AU - Soslow,Robert A, AU - Shu,Xiao-ou, AU - Schairer,Catherine, AU - Sacerdote,Carlotta, AU - Rohan,Thomas E, AU - Robien,Kim, AU - Risch,Harvey A, AU - Ricceri,Fulvio, AU - Rebbeck,Timothy R, AU - Rastogi,Radhai, AU - Prescott,Jennifer, AU - Polidoro,Silvia, AU - Park,Yikyung, AU - Olson,Sara H, AU - Moysich,Kirsten B, AU - Miller,Anthony B, AU - McCullough,Marjorie L, AU - Matsuno,Rayna K, AU - Magliocco,Anthony M, AU - Lurie,Galina, AU - Lu,Lingeng, AU - Lissowska,Jolanta, AU - Liang,Xiaolin, AU - Lacey,James V,Jr AU - Kolonel,Laurence N, AU - Henderson,Brian E, AU - Hankinson,Susan E, AU - Håkansson,Niclas, AU - Goodman,Marc T, AU - Gaudet,Mia M, AU - Garcia-Closas,Montserrat, AU - Friedenreich,Christine M, AU - Freudenheim,Jo L, AU - Doherty,Jennifer, AU - De Vivo,Immaculata, AU - Courneya,Kerry S, AU - Cook,Linda S, AU - Chen,Chu, AU - Cerhan,James R, AU - Cai,Hui, AU - Brinton,Louise A, AU - Bernstein,Leslie, AU - Anderson,Kristin E, AU - Anton-Culver,Hoda, AU - Schouten,Leo J, AU - Horn-Ross,Pamela L, Y1 - 2013/06/03/ PY - 2013/6/5/entrez PY - 2013/6/5/pubmed PY - 2013/9/12/medline SP - 2607 EP - 18 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J Clin Oncol VL - 31 IS - 20 N2 - PURPOSE: Endometrial cancers have long been divided into estrogen-dependent type I and the less common clinically aggressive estrogen-independent type II. Little is known about risk factors for type II tumors because most studies lack sufficient cases to study these much less common tumors separately. We examined whether so-called classical endometrial cancer risk factors also influence the risk of type II tumors. PATIENTS AND METHODS: Individual-level data from 10 cohort and 14 case-control studies from the Epidemiology of Endometrial Cancer Consortium were pooled. A total of 14,069 endometrial cancer cases and 35,312 controls were included. We classified endometrioid (n = 7,246), adenocarcinoma not otherwise specified (n = 4,830), and adenocarcinoma with squamous differentiation (n = 777) as type I tumors and serous (n = 508) and mixed cell (n = 346) as type II tumors. RESULTS: Parity, oral contraceptive use, cigarette smoking, age at menarche, and diabetes were associated with type I and type II tumors to similar extents. Body mass index, however, had a greater effect on type I tumors than on type II tumors: odds ratio (OR) per 2 kg/m(2) increase was 1.20 (95% CI, 1.19 to 1.21) for type I and 1.12 (95% CI, 1.09 to 1.14) for type II tumors (P heterogeneity < .0001). Risk factor patterns for high-grade endometrioid tumors and type II tumors were similar. CONCLUSION: The results of this pooled analysis suggest that the two endometrial cancer types share many common etiologic factors. The etiology of type II tumors may, therefore, not be completely estrogen independent, as previously believed. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/23733771/full_citation L2 - https://ascopubs.org/doi/10.1200/JCO.2012.48.2596?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -