Cited by 321Cancer Risks and FactorsMenopause: Health Impacts and TreatmentsEndometrial and Cervical Cancer Treatments

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Body Mass Index, Hormone Replacement Therapy, and Endometrial Cancer Risk: A Meta-Analysis

Crosbie, Emma J., Zwahlen, Marcel, Kitchener, Henry C., Egger, Matthias, Renehan, Andrew G.·2010·Cancer Epidemiology, Biomarkers & Prevention

DOI 10.1158/1055-9965.epi-10-0832

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Abstract

Background: Body mass index (BMI) is a risk factor for endometrial cancer. We quantified the risk and investigated whether the association differed by use of hormone replacement therapy (HRT), menopausal status, and histologic type. Methods: We searched MEDLINE and EMBASE (1966 to December 2009) to identify prospective studies of BMI and incident endometrial cancer. We did random-effects meta-analyses, meta-regressions, and generalized least square regressions for trend estimations assuming linear, and piecewise linear, relationships. Results: Twenty-four studies (17,710 cases) were analyzed; 9 studies contributed to analyses by HRT, menopausal status, or histologic type, all published since 2003. In the linear model, the overall risk ratio (RR) per 5 kg/m2 increase in BMI was 1.60 (95% CI, 1.52–1.68), P < 0.0001. In the piecewise model, RRs compared with a normal BMI were 1.22 (1.19–1.24), 2.09 (1.94–2.26), 4.36 (3.75–5.10), and 9.11 (7.26–11.51) for BMIs of 27, 32, 37, and 42 kg/m2, respectively. The association was stronger in never HRT users than in ever users: RRs were 1.90 (1.57–2.31) and 1.18 (95% CI, 1.06–1.31) with P for interaction = 0.003. In the piecewise model, the RR in never users was 20.70 (8.28–51.84) at BMI 42 kg/m2, compared with never users at normal BMI. The association was not affected by menopausal status (P = 0.34) or histologic type (P = 0.26). Conclusions: HRT use modifies the BMI-endometrial cancer risk association. Impact: These findings support the hypothesis that hyperestrogenia is an important mechanism underlying the BMI-endometrial cancer association, whilst the presence of residual risk in HRT users points to the role of additional systems. Cancer Epidemiol Biomarkers Prev; 19(12); 3119–30. ©2010 AACR.

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“Most notably for female reproductive cancers, the magnitude of the obesity association appears to be greater for women who are never users of hormone replacement therapy, providing further evidence that oestradiol lies on the causal pathway 181–183 .”
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“This is true for endometrial cancer, ranked highest in terms of risk among obesity-associated cancers in women [17], but where the predominant obesitylinked histological type is endometrioid type 1 (estrogendependent), which in turn, has a better survival compared with type 2 endometrial cancer [18].”
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“progestin, has been associated with increased risk of EC.(5,6) Additionally, the prevalence of hyperinsulinemia”
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“INTRODUCTION Endometrial carcinoma is the most common cancer of the female reproductive sys- tem that presents as two different clinicopathologic conditions (an estrogendependent type and an estrogen-independent type) (Crosbie et al., 2010).”
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Advances in genetic technologies result in improved diagnosis of mismatch repair deficiency in colorectal and endometrial cancers
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Women’s Risk Perceptions and Willingness to Engage in Risk-Reducing Interventions for the Prevention of Obesity-Related Endometrial Cancer
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Background

Authors: Crosbie, E. J., Zwahlen, M., Kitchener, H. C., Egger, M., & Renehan, A. G.
Affiliations: University of Bern (CH)
ORCID: Crosbie, Emma J.
Zwahlen, Marcel
Kitchener, Henry C.
Egger, Matthias
Renehan, Andrew G.
Venue: Cancer Epidemiology, Biomarkers & Prevention
Publisher: American Association for Cancer Research (AACR)
Published: 2010-12-01
Volume: 19
Issue: 12
Pages: 3119-3130
ISSN: 1055-9965 (ISSN-L)
1538-7755
DOI: 10.1158/1055-9965.epi-10-0832
OpenAlex: W2076975509
Cited by: 321
References: 85
Citations by year: 2026: 21 · 2025: 19 · 2024: 15 · 2023: 24 · 2022: 25 · 2021: 25 · 2020: 26 · 2019: 15 · 2018: 19 · 2017: 20 · 2016: 21 · 2015: 33 · 2014: 23 · 2013: 21 · 2012: 9
FWCI: 1.18
Type: journal article
Language: en
Open access: closed
Locations: Cancer Epidemiology Biomarkers & Prevention (publishedVersion)
PubMed (publishedVersion)
Research Explorer (The University of Manchester) (publishedVersion)
BORIS (University Library Bern) (submittedVersion)
Funders: National Institute for Health and Care Research (CL-2007-06-005)
Topics: Health Sciences › Medicine › Oncology › Cancer Risks and Factors
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
Keywords: body mass index, endometrial cancer, hormone replacement therapy, obesity, menopausal status, histological subtypes, cancer risk modification, dose-response relationship, postmenopausal women, endometrial hyperplasia, endometrial adenocarcinoma, endometrioid carcinoma, serous carcinoma
MeSH terms: Female, Humans, Risk Factors, Cohort Studies, Body Mass Index, Endometrial Neoplasms, Hormone Replacement Therapy

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Body Mass Index, Hormone Replacement Therapy, and Endometrial Cancer Risk: A Meta-Analysis

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