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Anthropometric factors and endometrial cancer risk: a systematic review and dose-response meta-analysis of prospective studies.
Ann Oncol 2015; 26(8):1635-48AO

Abstract

BACKGROUND

Greater body mass index (BMI) has been convincingly related to increased endometrial cancer risk, however, whether adiposity earlier in life or abdominal fatness is an independent risk factor and whether weight gain or greater height increases the risk is not clear.

METHODS

As part of the Continuous Update Project of the World Cancer Research Fund International, we conducted a systematic review and meta-analysis of prospective studies of the association between anthropometric measures and endometrial cancer risk and searched PubMed and several other databases up to February 2015. Summary relative risks (RRs) were calculated using a random-effects model.

RESULTS

Thirty prospective studies of BMI and endometrial cancer risk with 22 320 cases among 6 445 402 participants were included. The summary RR for a 5-unit increment was 1.54 [95% confidence interval (CI) 1.47-1.61, I(2) = 81%]. Although the test for non-linearity was significant, Pnon-linearity < 0.0001, and the curve was steeper within the overweight and obese BMI ranges, there was evidence of increased risk even within the high normal BMI range. The summary RR was 1.45 (95% CI 1.28-1.64, I(2) = 76%) per 5 BMI units for BMI in young adulthood, 1.18 (95% CI 1.14-1.23, I(2) = 67%) per 5 kg increase of weight, and 1.16 (95% CI 1.12-1.20, I(2) = 51%) per 5 kg of weight gained between young adulthood and study baseline, 1.27 (95% CI 1.17-1.39, I(2) = 71%) per 10 cm increase in waist circumference, 1.21 (95% CI 1.13-1.29, I(2) = 0%) per 0.1-unit increment in waist-to-hip ratio and 1.30 (95% CI 1.19-1.41, I(2) = 0%) per 10-cm increase in hips circumference. The summary RR was 1.15 (95% CI 1.09-1.22, I(2) = 61%) for a 10-cm increase in height.

CONCLUSIONS

All measures of adiposity were associated with increased risk of endometrial cancer, and in addition increasing height was associated with increased risk.

Authors+Show Affiliations

Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway d.aune@imperial.ac.uk.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.Biostatistics Unit, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK.Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick Rutgers School of Public Health, Piscataway, USA.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

25791635

Citation

Aune, D, et al. "Anthropometric Factors and Endometrial Cancer Risk: a Systematic Review and Dose-response Meta-analysis of Prospective Studies." Annals of Oncology : Official Journal of the European Society for Medical Oncology, vol. 26, no. 8, 2015, pp. 1635-48.
Aune D, Navarro Rosenblatt DA, Chan DS, et al. Anthropometric factors and endometrial cancer risk: a systematic review and dose-response meta-analysis of prospective studies. Ann Oncol. 2015;26(8):1635-48.
Aune, D., Navarro Rosenblatt, D. A., Chan, D. S., Vingeliene, S., Abar, L., Vieira, A. R., ... Norat, T. (2015). Anthropometric factors and endometrial cancer risk: a systematic review and dose-response meta-analysis of prospective studies. Annals of Oncology : Official Journal of the European Society for Medical Oncology, 26(8), pp. 1635-48. doi:10.1093/annonc/mdv142.
Aune D, et al. Anthropometric Factors and Endometrial Cancer Risk: a Systematic Review and Dose-response Meta-analysis of Prospective Studies. Ann Oncol. 2015;26(8):1635-48. PubMed PMID: 25791635.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anthropometric factors and endometrial cancer risk: a systematic review and dose-response meta-analysis of prospective studies. AU - Aune,D, AU - Navarro Rosenblatt,D A, AU - Chan,D S M, AU - Vingeliene,S, AU - Abar,L, AU - Vieira,A R, AU - Greenwood,D C, AU - Bandera,E V, AU - Norat,T, Y1 - 2015/03/19/ PY - 2014/09/25/received PY - 2015/03/04/accepted PY - 2015/3/21/entrez PY - 2015/3/21/pubmed PY - 2016/4/22/medline KW - body mass index KW - endometrial cancer KW - height KW - meta-analysis KW - waist circumference KW - waist-to-hip ratio SP - 1635 EP - 48 JF - Annals of oncology : official journal of the European Society for Medical Oncology JO - Ann. Oncol. VL - 26 IS - 8 N2 - BACKGROUND: Greater body mass index (BMI) has been convincingly related to increased endometrial cancer risk, however, whether adiposity earlier in life or abdominal fatness is an independent risk factor and whether weight gain or greater height increases the risk is not clear. METHODS: As part of the Continuous Update Project of the World Cancer Research Fund International, we conducted a systematic review and meta-analysis of prospective studies of the association between anthropometric measures and endometrial cancer risk and searched PubMed and several other databases up to February 2015. Summary relative risks (RRs) were calculated using a random-effects model. RESULTS: Thirty prospective studies of BMI and endometrial cancer risk with 22 320 cases among 6 445 402 participants were included. The summary RR for a 5-unit increment was 1.54 [95% confidence interval (CI) 1.47-1.61, I(2) = 81%]. Although the test for non-linearity was significant, Pnon-linearity < 0.0001, and the curve was steeper within the overweight and obese BMI ranges, there was evidence of increased risk even within the high normal BMI range. The summary RR was 1.45 (95% CI 1.28-1.64, I(2) = 76%) per 5 BMI units for BMI in young adulthood, 1.18 (95% CI 1.14-1.23, I(2) = 67%) per 5 kg increase of weight, and 1.16 (95% CI 1.12-1.20, I(2) = 51%) per 5 kg of weight gained between young adulthood and study baseline, 1.27 (95% CI 1.17-1.39, I(2) = 71%) per 10 cm increase in waist circumference, 1.21 (95% CI 1.13-1.29, I(2) = 0%) per 0.1-unit increment in waist-to-hip ratio and 1.30 (95% CI 1.19-1.41, I(2) = 0%) per 10-cm increase in hips circumference. The summary RR was 1.15 (95% CI 1.09-1.22, I(2) = 61%) for a 10-cm increase in height. CONCLUSIONS: All measures of adiposity were associated with increased risk of endometrial cancer, and in addition increasing height was associated with increased risk. SN - 1569-8041 UR - https://www.unboundmedicine.com/medline/citation/25791635/Anthropometric_factors_and_endometrial_cancer_risk:_a_systematic_review_and_dose_response_meta_analysis_of_prospective_studies_ L2 - https://academic.oup.com/annonc/article-lookup/doi/10.1093/annonc/mdv142 DB - PRIME DP - Unbound Medicine ER -