A full-term pregnancy is associated with reduced endometrial cancer risk; however, whether the effect of additional pregnancies is independent of age at last pregnancy is unknown. The associations between other pregnancy-related factors and endometrial cancer risk are less clear. We pooled individual participant data from 11 cohort and 19 case-control studies participating in the Epidemiology of Endometrial Cancer Consortium (E2C2) including 16,986 women with endometrial cancer and 39,538 control women. We used one- and two-stage meta-analytic approaches to estimate pooled odds ratios (OR) for the association between exposures and endometrial cancer risk. Ever having a full-term pregnancy was associated with a 41% reduction in risk of endometrial cancer compared to never having a full-term pregnancy (OR=0.59, 95% confidence interval (CI) 0.56-0.63). The risk reduction appeared greatest for the first full-term pregnancy (OR=0.78, 95%CI 0.72-0.84), with a further ~15% reduction per pregnancy up to eight pregnancies (OR=0.20, 95%CI 0.14-0.28) that was independent of age at last full-term pregnancy. Incomplete pregnancy was also associated with decreased endometrial cancer risk (7-9% reduction per pregnancy). Twin births appeared to have the same effect as singleton pregnancies. Our pooled analysis shows that, while the magnitude of the risk reduction is greater for a full-term pregnancy than an incomplete pregnancy, each additional pregnancy is associated with further reduction in endometrial cancer risk, independent of age at last full-term pregnancy. These results suggest the very high progesterone level in the last trimester of pregnancy is not the sole explanation for the protective effect of pregnancy.
Titolo: | Pregnancy Outcomes and Risk of Endometrial Cancer : A Pooled Analysis of Individual Participant Data in the Epidemiology of Endometrial Cancer Consortium | |
Autore/i: | J. S. Jordan; R. Na; E. Weiderpass; H. O. Adami; K. E. Anderson; P. A. van den Brandt; L. A. Brinton; C. Chen; L. S. Cook; J. A. Doherty; M. Du; C. M. Friedenreich; G. L. Gierach; M. T. Goodman; V. Krogh; F. Levi; L. Lu; A. B. Miller; S. E. McCann; B. K. Moysich; E. Negri; S. H. Olson; S. Petruzella; J. R. Palmer; F. Parazzini; M. C. Pike; A. E. Prizment; T. R. Rebbeck; P. Reynolds; F. Ricceri; H. A. Risch; T. E. Rohan; C. Sacerdote; L. J. Schouten; D. Serraino; V. W. Setiawan; X. -O. Shu; T. R. Sponholtz; A. B. Spurdle; R. Z. Stolzenberg-Solomon; B. Trabert; N. Wentzensen; L. R. Wilkens; L. A. Wise; H. Yu; C. La Vecchia; I. De Vivo; W. Xu; A. Zeleniuch-Jacquotte; P. M. Webb | |
Autore/i Unibo: | ||
Anno: | 2021 | |
Rivista: | ||
Digital Object Identifier (DOI): | http://dx.doi.org/10.1002/ijc.33360 | |
Abstract: | A full-term pregnancy is associated with reduced endometrial cancer risk; however, whether the effect of additional pregnancies is independent of age at last pregnancy is unknown. The associations between other pregnancy-related factors and endometrial cancer risk are less clear. We pooled individual participant data from 11 cohort and 19 case-control studies participating in the Epidemiology of Endometrial Cancer Consortium (E2C2) including 16,986 women with endometrial cancer and 39,538 control women. We used one- and two-stage meta-analytic approaches to estimate pooled odds ratios (OR) for the association between exposures and endometrial cancer risk. Ever having a full-term pregnancy was associated with a 41% reduction in risk of endometrial cancer compared to never having a full-term pregnancy (OR=0.59, 95% confidence interval (CI) 0.56-0.63). The risk reduction appeared greatest for the first full-term pregnancy (OR=0.78, 95%CI 0.72-0.84), with a further ~15% reduction per pregnancy up to eight pregnancies (OR=0.20, 95%CI 0.14-0.28) that was independent of age at last full-term pregnancy. Incomplete pregnancy was also associated with decreased endometrial cancer risk (7-9% reduction per pregnancy). Twin births appeared to have the same effect as singleton pregnancies. Our pooled analysis shows that, while the magnitude of the risk reduction is greater for a full-term pregnancy than an incomplete pregnancy, each additional pregnancy is associated with further reduction in endometrial cancer risk, independent of age at last full-term pregnancy. These results suggest the very high progesterone level in the last trimester of pregnancy is not the sole explanation for the protective effect of pregnancy. | |
Appare nelle tipologie: | 1.01 Articolo in rivista |