Diabetes and endometrial cancer: an Italian case-control study.
We considered the association between diabetes and risk of endometrial cancer using data from a large case-control study conducted in Italy. Cases were 752 women with incident, histologically confirmed endometrial cancer < 75 years of age (median age 60 years, range 28-74) admitted to a network of hospitals in Milan. Controls were 2,606 patients (median age 54 years, range 25-74) aged < 75 years, admitted for acute non-neoplastic, non-gynecological, non-hormone-related conditions to the same network of hospitals where cases had been identified. A total of 132 (17.6%) cases and 116 controls (4.5%) reported a history of diabetes. The corresponding multivariate odds ratio (OR) was 2.9 [95% confidence interval (CI) 2.2-3.9]. No association emerged with diabetes diagnosed under age 40 (likely to be insulin-dependent diabetes), whereas the OR of endometrial cancer was 3.1 (95% CI 2.3-4.2) for diabetes diagnosed at age > or = 40 years. The OR of endometrial cancer in women with history of diabetes was 3.0 for women with a body mass index (BMI) (QI) kg/m2 < 25, 3.6 for those with a BMI of 25-29, and 3.3 for those with a BMI > or = 30. No consistent interaction or modifying effect was observed for any other covariate. Our results confirm that non-insulin-dependent diabetes is associated with the risk of endometrial cancer. The association may be mediated through elevated oestrogen levels in diabetic women, hyperinsulinemia or insulin-like growth factor-I (IGF-I).
Parazzini
F
F
Istituto di Ricerche Farmacologiche Mario Negri, and I Clinica Ostetrico Ginecologica, Università di Milano, Milan, Italy. garimoldi@irfmn.mnegri.it
La Vecchia
C
C
Negri
E
E
Riboldi
G L
GL
Surace
M
M
Benzi
G
G
Maina
A
A
Chiaffarino
F
F
D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D016001:Confidence Intervals; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D016889:Endometrial Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology