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Reproductive factors and risk of endometrial cancer. The Iowa Women's Health Study.

Abstract

Gravidity and parity have strong inverse relations with endometrial cancer occurrence. To determine whether gravidity masks an association with other reproductive factors, the authors analyzed data from a cohort study of 24,848 postmenopausal Iowa women aged 55-69 years who were cancer free at baseline in 1986 and who had not had a hysterectomy. During 5 years of follow-up, 167 incident endometrial cancer cases were documented. As expected, the mean gravidity of cases was lower than that of noncases (2.6 vs. 3.5, p < 0.0001). Endometrial cancer occurrence was associated positively with early age at menarche, late age at natural menopause, and total length of ovulation span, but history of infertility and ages at first and last pregnancy were unrelated to risk after adjustment for gravidity. Two additional factors remained statistically significant independent of gravidity: a history of ever (vs. never) having had an induced abortion (relative risk = 2.5, 95% confidence interval 1.1-5.7) and timing of spontaneous abortions (miscarriages). Results suggest that a miscarriage late in reproductive life, followed by lack of a subsequent full-term pregnancy, may be a marker for progesterone deficiency. If so, the findings support the "unopposed" estrogen hypothesis for the etiology of endometrial cancer.

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  • Authors+Show Affiliations

    ,

    Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015, USA.

    , , ,

    Source

    American journal of epidemiology 143:12 1996 Jun 15 pg 1195-202

    MeSH

    Age Factors
    Aged
    Cohort Studies
    Endometrial Neoplasms
    Female
    Humans
    Middle Aged
    Pregnancy
    Reproductive History
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    8651218

    Citation

    McPherson, C P., et al. "Reproductive Factors and Risk of Endometrial Cancer. the Iowa Women's Health Study." American Journal of Epidemiology, vol. 143, no. 12, 1996, pp. 1195-202.
    McPherson CP, Sellers TA, Potter JD, et al. Reproductive factors and risk of endometrial cancer. The Iowa Women's Health Study. Am J Epidemiol. 1996;143(12):1195-202.
    McPherson, C. P., Sellers, T. A., Potter, J. D., Bostick, R. M., & Folsom, A. R. (1996). Reproductive factors and risk of endometrial cancer. The Iowa Women's Health Study. American Journal of Epidemiology, 143(12), pp. 1195-202.
    McPherson CP, et al. Reproductive Factors and Risk of Endometrial Cancer. the Iowa Women's Health Study. Am J Epidemiol. 1996 Jun 15;143(12):1195-202. PubMed PMID: 8651218.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Reproductive factors and risk of endometrial cancer. The Iowa Women's Health Study. AU - McPherson,C P, AU - Sellers,T A, AU - Potter,J D, AU - Bostick,R M, AU - Folsom,A R, PY - 1996/6/15/pubmed PY - 1996/6/15/medline PY - 1996/6/15/entrez SP - 1195 EP - 202 JF - American journal of epidemiology JO - Am. J. Epidemiol. VL - 143 IS - 12 N2 - Gravidity and parity have strong inverse relations with endometrial cancer occurrence. To determine whether gravidity masks an association with other reproductive factors, the authors analyzed data from a cohort study of 24,848 postmenopausal Iowa women aged 55-69 years who were cancer free at baseline in 1986 and who had not had a hysterectomy. During 5 years of follow-up, 167 incident endometrial cancer cases were documented. As expected, the mean gravidity of cases was lower than that of noncases (2.6 vs. 3.5, p < 0.0001). Endometrial cancer occurrence was associated positively with early age at menarche, late age at natural menopause, and total length of ovulation span, but history of infertility and ages at first and last pregnancy were unrelated to risk after adjustment for gravidity. Two additional factors remained statistically significant independent of gravidity: a history of ever (vs. never) having had an induced abortion (relative risk = 2.5, 95% confidence interval 1.1-5.7) and timing of spontaneous abortions (miscarriages). Results suggest that a miscarriage late in reproductive life, followed by lack of a subsequent full-term pregnancy, may be a marker for progesterone deficiency. If so, the findings support the "unopposed" estrogen hypothesis for the etiology of endometrial cancer. SN - 0002-9262 UR - https://www.unboundmedicine.com/medline/citation/8651218/full_citation L2 - https://academic.oup.com/aje/article-lookup/doi/10.1093/oxfordjournals.aje.a008707 DB - PRIME DP - Unbound Medicine ER -