Metabolic syndrome and rare gynecological cancers in the metabolic syndrome and cancer project (Me-Can).
BACKGROUND
Risk factors for rare gynecological cancers are largely unknown. Initial research has indicated that the metabolic syndrome (MetS) or individual components could play a role.


METHODS
The Metabolic syndrome and Cancer project cohort includes 288,834 women. During an average follow-up of 11 years, 82 vulvar, 26 vaginal and 43 other rare gynecological cancers were identified. Hazard ratios (HRs) were estimated fitting Cox proportional hazards regression models for tertiles and standardized z-scores [with a mean of 0 and a standard deviation (SD) of 1] of body mass index (BMI), blood pressure, glucose, cholesterol, triglycerides and MetS. Risk estimates were corrected for random error in the measurement of metabolic factors.


RESULTS
The MetS was associated with increased risk of vulvar [HR 1.78, 95% confidence interval (CI) 1.30-2.41) and vaginal cancer (HR 1.87, 95% CI 1.07-3.25). Among separate MetS components, 1 SD increase in BMI was associated with overall risk (HR 1.43, 95% CI 1.23-1.66), vulvar (HR 1.36, 95% CI 1.11-1.69) and vaginal cancer (HR 1.79, 95% CI 1.30-2.46). Blood glucose and triglyceride concentrations were associated with increased risk of vulvar cancer (HR 1.98, 95% CI 1.10-3.58 and HR 2.09, 95% CI 1.39-3.15, respectively).


CONCLUSIONS
The results from this first prospective study on rare gynecological cancers suggest that the MetS and its individual components may play a role in the development of these tumors.
Institute of Epidemiology, Ulm University, Ulm, Germany. Electronic address: gabriele.nagel@uni-ulm.de.
G
G
Nagel
Agency for Preventive and Social Medicine, Bregenz, Austria.
H
H
Concin
Department of Public Health and Primary Health Care, University of Bergen, Bergen; Division of Epidemiology, Norwegian Institute of Public Health, Oslo/Bergen, Norway.
T
T
Bjørge
Institute of Epidemiology, Ulm University, Ulm, Germany.
K
K
Rapp
Department of Surgery, Malmö University Hospital, Lund University, Malmö.
J
J
Manjer
Departments of Public Health and Clinical Medicine, Nutritional Research.
G
G
Hallmans
Agency for Preventive and Social Medicine, Bregenz, Austria.
G
G
Diem
Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå.
C
C
Häggström
Department of Public Health and Primary Health Care, University of Bergen, Bergen; Division of Epidemiology, Norwegian Institute of Public Health, Oslo/Bergen, Norway.
A
A
Engeland
Department of Surgery, Lund University Hospital, Lund.
M
M
Almquist
Department of Radiation Science, Oncology, Umeå University, Umeå, Sweden.
H
H
Jonsson
Division of Epidemiology, Norwegian Institute of Public Health, Oslo/Bergen, Norway.
R
R
Selmer
Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå.
T
T
Stocks
Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
S
S
Tretli
Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria.
H
H
Ulmer
Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå.
P
P
Stattin
Department of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.
A
A
Lukanova
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol