The etiology of uterine sarcomas: a pooled analysis of the epidemiology of endometrial cancer consortium
Open accessAbstract
BACKGROUND: Uterine sarcomas are characterised by early age at diagnosis, poor prognosis, and higher incidence among Black compared with White women, but their aetiology is poorly understood. Therefore, we performed a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We also examined risk factor associations for malignant mixed mullerian tumours (MMMTs) and endometrioid endometrial carcinomas (EECs) for comparison purposes. METHODS: We pooled data on 229 uterine sarcomas, 244 MMMTs, 7623 EEC cases, and 28,829 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) for risk factors associated with uterine sarcoma, MMMT, and EEC were estimated with polytomous logistic regression. We also examined associations between epidemiological factors and histological subtypes of uterine sarcoma. RESULTS: Significant risk factors for uterine sarcoma included obesity (body mass index (BMI)≥30 vs BMI<25 kg m(-2) (OR: 1.73, 95% CI: 1.22-2.46), P-trend=0.008) and history of diabetes (OR: 2.33, 95% CI: 1.41-3.83). Older age at menarche was inversely associated with uterine sarcoma risk (≥15 years vs <11 years (OR: 0.70, 95% CI: 0.34-1.44), P-trend: 0.04). BMI was significantly, but less strongly related to uterine sarcomas compared with EECs (OR: 3.03, 95% CI: 2.82-3.26) or MMMTs (OR: 2.25, 95% CI: 1.60-3.15, P-heterogeneity=0.01). CONCLUSION: In the largest aetiological study of uterine sarcomas, associations between menstrual, hormonal, and anthropometric risk factors and uterine sarcoma were similar to those identified for EEC. Further exploration of factors that might explain patterns of age- and race-specific incidence rates for uterine sarcoma are needed.
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Successful, field-altering risk-factor and subphenotype investigations among many centers have been demonstrated by large consortia across an array of health outcomes.
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- Authors
- Felix, A. S., Cook, L. S., Gaudet, M. M., Rohan, T. E., Schouten, L. J., Setiawan, V. W., Wise, L. A., Anderson, K. E., Bernstein, L., De Vivo, I., Friedenreich, C. M., Gapstur, S. M., Goldbohm, R. A., Henderson, B., Horn-Ross, P. L., Kolonel, L., Lacey, J. V., Liang, X., Lissowska, J., Magliocco, A., McCullough, M. L., Miller, A. B., Olson, S. H., Palmer, J. R., Park, Y., Patel, A. V., Prescott, J., Rastogi, R., Robien, K., Rosenberg, L., Schairer, C., Ou Shu, X., van den Brandt, P. A., Virkus, R. A., Wentzensen, N., Xiang, Y.-B., Xu, W.-H., Yang, H. P., & Brinton, L. A.
- Affiliations
- National Institutes of Health (US)
- University of New Mexico (US)
- American Cancer Society (US)
- Albert Einstein College of Medicine (US)
- Maastricht University (NL)
- University of Southern California (US)
- Boston University (US)
- University of Minnesota (US)
- City Of Hope National Medical Center (US)
- Alberta Health Services (CA)
- Netherlands Organisation for Applied Scientific Research (NL)
- University of Hawaii Cancer Center (US)
- Memorial Sloan Kettering Cancer Center (US)
- The Maria Sklodowska-Curie National Research Institute of Oncology (PL)
- Moffitt Cancer Center (US)
- University of Toronto (CA)
- Brigham and Women's Hospital (US)
- Shanghai Cancer Institute (CN)
- Corresponding author
- Felix, A S
- ORCID
- Felix, A S
- Cook, L S
- Gaudet, M M
- Rohan, T E
- Schouten, L J
- Setiawan, V W
- Wise, L A
- Anderson, K E
- Bernstein, L
- Friedenreich, C M
- Gapstur, S M
- Kolonel, L
- Liang, X
- Lissowska, J
- McCullough, M L
- Miller, A B
- Olson, S H
- Palmer, J R
- Park, Y
- Patel, A V
- Prescott, J
- Robien, K
- Rosenberg, L
- Schairer, C
- Virkus, R A
- Wentzensen, N
- Xu, W-H
- Yang, H P
- Brinton, L A
- Venue
- British Journal of Cancer
- Published
- 2013-01-24
- Volume
- 108
- Issue
- 3
- Pages
- 727-734
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC3593566
- OpenAlex
- W2033168622
- Cited by
- 93
- References
- 29
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 5 · 2023: 7 · 2022: 6 · 2021: 11 · 2020: 6 · 2019: 12 · 2018: 5 · 2017: 7 · 2016: 6 · 2015: 6 · 2014: 9 · 2013: 1
- FWCI
- 8.22
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- www.springer.com/tdm (unspecified)
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by-nc-sa)
- TNO Repository (submittedVersion)
- Repository hosted by TU Delft Library (TU Delft) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- National Institutes of Health
- National Cancer Institute (R01CA077398, R01CA058420, R01CA039742, UM1CA164974, P30CA008748)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Keywords
- uterine sarcoma, etiology, risk factors, obesity, body mass index, diabetes mellitus, age at menarche, endometrial cancer, carcinosarcoma, endometrioid endometrial cancer, histological subtypes, Black women
- MeSH terms
- Aged, Female, Follow-Up Studies, Humans, Middle Aged, Obesity, Prognosis, Risk Factors, Sarcoma, United States, Uterine Neoplasms, Body Mass Index, Incidence, Case-Control Studies, Endometrial Neoplasms, Mixed Tumor, Mullerian
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