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Title: Type I and II endometrial cancers: have they different risk factors?
Authors: Setiawan VW,  Yang HP,  Pike MC,  McCann SE,  Yu H,  Xiang YB,  Wolk A,  Wentzensen N,  Weiss NS,  Webb PM,  van den Brandt PA,  van de Vijver K,  Thompson PJ,  Australian National Endometrial Cancer Study Group,  Strom BL,  Spurdle AB,  Soslow RA,  Shu XO,  Schairer C,  Sacerdote C,  Rohan TE,  Robien K,  Risch HA,  Ricceri F,  Rebbeck TR,  Rastogi R,  Prescott J,  Polidoro S,  Park Y,  Olson SH,  Moysich KB,  Miller AB,  McCullough ML,  Matsuno RK,  Magliocco AM,  Lurie G,  Lu L,  Lissowska J,  Liang X,  Lacey JV Jr,  Kolonel LN,  Henderson BE,  Hankinson SE,  Håkansson N,  Goodman MT,  Gaudet MM,  Garcia-Closas M,  Friedenreich CM,  Freudenheim JL,  Doherty J,  De Vivo I,  Courneya KS,  Cook LS,  Chen C,  Cerhan JR,  Cai H,  Brinton LA,  Bernstein L,  Anderson KE,  Anton-Culver H,  Schouten LJ,  Horn-Ross PL
Journal: J Clin Oncol
Date: 2013 Jul 10
Branches: BB, EBP, HREB, NEB, OEEB
PubMed ID: 23733771
PMC ID: PMC3699726
Abstract: PURPOSE: Endometrial cancers have long been divided into estrogen-dependent type I and the less common clinically aggressive estrogen-independent type II. Little is known about risk factors for type II tumors because most studies lack sufficient cases to study these much less common tumors separately. We examined whether so-called classical endometrial cancer risk factors also influence the risk of type II tumors. PATIENTS AND METHODS: Individual-level data from 10 cohort and 14 case-control studies from the Epidemiology of Endometrial Cancer Consortium were pooled. A total of 14,069 endometrial cancer cases and 35,312 controls were included. We classified endometrioid (n = 7,246), adenocarcinoma not otherwise specified (n = 4,830), and adenocarcinoma with squamous differentiation (n = 777) as type I tumors and serous (n = 508) and mixed cell (n = 346) as type II tumors. RESULTS: Parity, oral contraceptive use, cigarette smoking, age at menarche, and diabetes were associated with type I and type II tumors to similar extents. Body mass index, however, had a greater effect on type I tumors than on type II tumors: odds ratio (OR) per 2 kg/m(2) increase was 1.20 (95% CI, 1.19 to 1.21) for type I and 1.12 (95% CI, 1.09 to 1.14) for type II tumors (P heterogeneity < .0001). Risk factor patterns for high-grade endometrioid tumors and type II tumors were similar. CONCLUSION: The results of this pooled analysis suggest that the two endometrial cancer types share many common etiologic factors. The etiology of type II tumors may, therefore, not be completely estrogen independent, as previously believed.