title: Infertility and incident endometrial cancer risk: a pooled analysis from the epidemiology of endometrial cancer consortium (E2C2).
abstract: BACKGROUND
  Nulliparity is an endometrial cancer risk factor, but whether or not this association is due to infertility is unclear. Although there are many underlying infertility causes, few studies have assessed risk relations by specific causes.
  
  
  METHODS
  We conducted a pooled analysis of 8153 cases and 11 713 controls from 2 cohort and 12 case-control studies. All studies provided self-reported infertility and its causes, except for one study that relied on data from national registries. Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI).
  
  
  RESULTS
  Nulliparous women had an elevated endometrial cancer risk compared with parous women, even after adjusting for infertility (OR=1.76; 95% CI: 1.59-1.94). Women who reported infertility had an increased risk compared with those without infertility concerns, even after adjusting for nulliparity (OR=1.22; 95% CI: 1.13-1.33). Among women who reported infertility, none of the individual infertility causes were substantially related to endometrial cancer.
  
  
  CONCLUSIONS
  Based on mainly self-reported infertility data that used study-specific definitions of infertility, nulliparity and infertility appeared to independently contribute to endometrial cancer risk. Understanding residual endometrial cancer risk related to infertility, its causes and its treatments may benefit from large studies involving detailed data on various infertility parameters.
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
authors: H P
authors: HP
authors: Yang
authors: University of New Mexico, Albuquerque, NM 87131, USA.
authors: L S
authors: LS
authors: Cook
authors: 1] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden [2] Department of Genetic Epidemiology, Folkhälsan Research Center, 00014 Helsinki, Finland [3] Department of Research, Cancer Registry of Norway, N-0304 Oslo, Norway [4] Department of Community Medicine, University of Tromsø, The Arctic University of Norway, 90109 Tromsø, Norway.
authors: E
authors: E
authors: Weiderpass
authors: 1] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden [2] Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
authors: H-O
authors: HO
authors: Adami
authors: School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
authors: K E
authors: KE
authors: Anderson
authors: Department of Medicine, Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
authors: H
authors: H
authors: Cai
authors: Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
authors: J R
authors: JR
authors: Cerhan
authors: Department of Population Health and NYU Perimutter Cancer Center, New York University School of Medicine, New York, NY 10016, USA.
authors: T V
authors: TV
authors: Clendenen
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
authors: A S
authors: AS
authors: Felix
authors: Alberta Health Services, Calgary, Alberta T2T 5C7, Canada.
authors: C M
authors: CM
authors: Friedenreich
authors: Institute of Cancer Research, Surrey SM2 5NG, UK.
authors: M
authors: M
authors: Garcia-Closas
authors: Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors: M T
authors: MT
authors: Goodman
authors: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
authors: X
authors: X
authors: Liang
authors: M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, 02-781 Warsaw, Poland.
authors: J
authors: J
authors: Lissowska
authors: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA.
authors: L
authors: L
authors: Lu
authors: H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL33612, USA.
authors: A M
authors: AM
authors: Magliocco
authors: Roswell Park Cancer Institute, Buffalo, NY 14203, USA.
authors: S E
authors: SE
authors: McCann
authors: Roswell Park Cancer Institute, Buffalo, NY 14203, USA.
authors: K B
authors: KB
authors: Moysich
authors: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
authors: S H
authors: SH
authors: Olson
authors: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
authors: S
authors: S
authors: Petruzella
authors: 1] Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA [2] Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
authors: M C
authors: MC
authors: Pike
authors: Human Genetics Foundation, 10126 Turin, Italy.
authors: S
authors: S
authors: Polidoro
authors: Human Genetics Foundation, 10126 Turin, Italy.
authors: F
authors: F
authors: Ricceri
authors: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA.
authors: H A
authors: HA
authors: Risch
authors: 1] Human Genetics Foundation, 10126 Turin, Italy [2] Unit of Cancer Epidemiology, University of Turin and Center for Cancer Prevention, 10124 Turin, Italy.
authors: C
authors: C
authors: Sacerdote
authors: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
authors: V W
authors: VW
authors: Setiawan
authors: Department of Medicine, Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
authors: X O
authors: XO
authors: Shu
authors: QIMR Berghofer Medical Research Institute, Herston, Queensland 4029, Australia.
authors: A B
authors: AB
authors: Spurdle
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
authors: B
authors: B
authors: Trabert
authors: QIMR Berghofer Medical Research Institute, Herston, Queensland 4029, Australia.
authors: P M
authors: PM
authors: Webb
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
authors: N
authors: N
authors: Wentzensen
authors: Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Y-B
authors: YB
authors: Xiang
authors: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
authors: Y
authors: Y
authors: Xu
authors: University of Hawaii Cancer Center, Honolulu, HI 96813, USA.
authors: H
authors: H
authors: Yu
authors: Department of Population Health and NYU Perimutter Cancer Center, New York University School of Medicine, New York, NY 10016, USA.
authors: A
authors: A
authors: Zeleniuch-Jacquotte
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
authors: L A
authors: LA
authors: Brinton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology*; D016015:Logistic Models; D008875:Middle Aged; D010298:Parity; D012307:Risk Factors; D057566:Self Report