Anthropometric factors and risk of endometrial cancer: the European prospective investigation into cancer and nutrition.
OBJECTIVE
To examine the association between anthropometry and endometrial cancer, particularly by menopausal status and exogenous hormone use subgroups.


METHODS
Among 223,008 women in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, there were 567 incident endometrial cancer cases during 6.4 years of follow-up. The analysis was performed with Cox proportional hazards modeling.


RESULTS
Weight, body mass index (BMI), waist and hip circumferences and waist-hip ratio (WHR) were strongly associated with increased risk of endometrial cancer. The relative risk (RR) for obese (BMI 30- < 40 kg/m(2)) compared to normal weight (BMI < 25) women was 1.78, 95% CI = 1.41-2.26, and for morbidly obese women (BMI > or = 40) was 3.02, 95% CI = 1.66-5.52. The RR for women with a waist circumference of > or =88 cm vs. <80 cm was 1.76, 95% CI = 1.42-2.19. Adult weight gain of > or =20 kg compared with stable weight (+/-3 kg) increased risk independent of body weight at age 20 (RR = 1.75, 95% CI = 1.11-2.77). These associations were generally stronger for postmenopausal than premenopausal women, and oral contraceptives never-users than ever-users, and much stronger among never-users of hormone replacement therapy compared to ever-users.


CONCLUSIONS
Obesity, abdominal adiposity, and adult weight gain were strongly associated with endometrial cancer risk. These associations were particularly evident among never-users of hormone replacement therapy.
Friedenreich
Christine
C
Division of Population Health and Information, Alberta Cancer Board, T2N 4N2, Calgary, Alberta, Canada. chrisf@cancerboard.ab.ca
Cust
Anne
A
Lahmann
Petra H
PH
Steindorf
Karen
K
Boutron-Ruault
Marie-Christine
MC
Clavel-Chapelon
Françoise
F
Mesrine
Sylvie
S
Linseisen
Jakob
J
Rohrmann
Sabine
S
Boeing
Heiner
H
Pischon
Tobias
T
Tjønneland
Anne
A
Halkjaer
Jytte
J
Overvad
Kim
K
Mendez
Michelle
M
Redondo
M L
ML
Garcia
Carmen Martinez
CM
Larrañaga
Nerea
N
Tormo
María-José
MJ
Gurrea
Aurelio Barricarte
AB
Bingham
Sheila
S
Khaw
Kay-Tee
KT
Allen
Naomi
N
Key
Tim
T
Trichopoulou
Antonia
A
Vasilopoulou
Effie
E
Trichopoulos
Dimitrios
D
Pala
Valeria
V
Palli
Domenico
D
Tumino
Rosario
R
Mattiello
Amalia
A
Vineis
Paolo
P
Bueno-de-Mesquita
H Bas
HB
Peeters
Petra H M
PH
Berglund
Göran
G
Manjer
Jonas
J
Lundin
Eva
E
Lukanova
Annekatrin
A
Slimani
Nadia
N
Jenab
Mazda
M
Kaaks
Rudolf
R
Riboli
Elio
E
D050154:Adiposity; D000886:Anthropometry; D015992:Body Mass Index; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000503:physiopathology; D005060:Europe / Q000453:epidemiology; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D015994:Incidence; D008593:Menopause; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D009765:Obesity; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors