Reproductive Factors and Endometrial Cancer Risk Among Women-Reference-Cited by-同舟云学术

Reproductive Factors and Endometrial Cancer Risk Among Women

Published:2023-09-05 Issue:9 Volume:6 Page:e2332296
ISSN:2574-3805
Container-title:JAMA Network Open
language:en
Short-container-title:JAMA Netw Open

Author:

Katagiri Ryoko¹²,Iwasaki Motoki¹³,Abe Sarah Krull⁴,Islam Md. Rashedul⁴⁵,Rahman Md. Shafiur⁴⁶,Saito Eiko⁷,Merritt Melissa A.⁸,Choi Ji-Yeob⁹,Shin Aesun¹⁰¹¹,Sawada Norie¹,Tamakoshi Akiko¹²,Koh Woon-Puay¹³¹⁴,Sakata Ritsu¹⁵,Tsuji Ichiro¹⁶,Kim Jeongseon¹⁷,Nagata Chisato¹⁸,Park Sue K.¹¹,Kweon Sun-Seog¹⁹,Shu Xiao-Ou²⁰,Gao Yu-Tang²¹,Tsugane Shoichiro¹,Kimura Takashi¹²,Yuan Jian-Min²²²³,Kanemura Seiki¹⁶,Lu Yukai¹⁶,Sugawara Yumi¹⁶,Wada Keiko¹⁸,Shin Min-Ho¹⁹,Ahsan Habibul²⁴,Boffetta Paolo²⁵²⁶,Chia Kee Seng²⁷,Matsuo Keitaro²⁸²⁹,Qiao You-Lin³⁰,Rothman Nathaniel³¹,Zheng Wei²⁰,Inoue Manami⁴,Kang Daehee³²

Affiliation:

1. Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan

2. National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan

3. Division of Epidemiology, National Cancer Center Institute for Cancer Control, Tokyo, Japan

4. Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan

5. Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan

6. Research Center for Child Mental Development, Hamamatsu University School of Medicine, Shizuoka, Japan

7. Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan

8. The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia

9. Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea

10. Cancer Research Institute, Seoul National University, Seoul, Korea

11. Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea

12. Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan

13. Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

14. Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore

15. Radiation Effects Research Foundation, Hiroshima, Japan

16. Tohoku University Graduate School of Medicine, Miyagi, Japan

17. Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea

18. Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan

19. Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea

20. Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee

21. Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China

22. Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania

23. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania

24. Department of Public Health Sciences, University of Chicago, Chicago, Illinois

25. Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York

26. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy

27. Saw Swee Hock School of Public Health, National University of Singapore, Singapore

28. Division Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan

29. Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan

30. School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

31. Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland

32. Seoul National University College of Medicine, Seoul, Korea

Abstract

ImportanceDespite evidence of an association between reproductive factors and endometrial cancer risk, prospective studies have been conducted mainly in non-Asian countries.ObjectiveTo assess the association between reproductive factors, such as number of deliveries, age at menarche, or menopause, and endometrial cancer risk.Design, Setting, and ParticipantsThis cohort study used pooled individual data from 13 prospective cohort studies conducted between 1963 and 2014 in the Asia Cohort Consortium. Participants were Asian women. Data analysis was conducted from September 2019 to April 2023.ExposuresReproductive factors were assessed using a questionnaire in each cohort.Main Outcomes and MeasuresThe main outcome was time to incidence of endometrial cancer. A Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% CIs.ResultsA total of 1005 endometrial cancer cases were detected among 332 625 women (mean [SD] age, 54.3 [10.4] years) during a mean (SD) of 16.5 (6.4) years of follow-up. Increasing number of deliveries was associated with a decreased endometrial cancer risk in a dose-response manner (≥5 deliveries vs nulliparous [reference]: HR, 0.37; 95% CI, 0.26-0.53; P for trend &lt; .001). Compared with menarche at younger than 13 years, menarche at 17 years or older had an HR of 0.64 (95% CI, 0.48-0.86; P for trend &lt; .001). Late menopause (age ≥55 years) showed an HR of 2.84 (95% CI, 1.78-4.55; P for trend &lt; .001) compared with the youngest age category for menopause (&lt;45 years). Age at first delivery, hormone therapy, and breastfeeding were not associated with endometrial cancer risk.Conclusions and RelevanceThis large pooled study of individual participant data found that late menarche, early menopause, and a higher number of deliveries were significantly associated with a lower risk of endometrial cancer. These convincing results from Asian prospective studies add to the growing body of evidence for the association between reproductive factors and endometrial cancer.

Publisher

American Medical Association (AMA)

Subject

General Medicine

Link

https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2808906/katagiri_2023_oi_230933_1692805593.68909.pdf

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