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  • 1
    Digitale Medien
    Digitale Medien
    Childbearing at older age and endometrial cancer risk (Sweden) (1999)
    Springer
    Cancer causes & control 10 (1999), S. 43-49 
    Details
    ISSN: 1573-7225
    Schlagwort(e): age at birth ; case-control ; endometrial cancer ; parity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objectives: Several studies have found an inverse association between older age at last birth and endometrial cancer risk. A nested case-control study was undertaken to examine the influence of this and other aspects of reproductive patterns on the risk of developing endometrial cancer. Methods: Among women born in 1925 and later, 4,839 eligible patients were identified in the Swedish Cancer Register. For each case, five individually age-matched controls were randomly selected from a population-based Fertility Register. Relative risks were estimated from odds ratios obtained from conditional logistic regression analyses. Results: Compared to uniparous women, childless women were at a higher risk of endometrial cancer (odds ratio [OR]=1.38, 95% confidence interval [CI]=1.25–1.52). This association was stronger in younger (〈50 years) than in older (50+ years) women. At all ages of first birth, a delivery was associated with a reduced risk of endometrial cancer that slowly diminished with time. Among parous women, the risk decreased by almost 20% for each additional live birth (OR=0.81, CI=0.78–0.84). In an analysis limited to women with two or more births that compared the independent effects of age at first and at last birth, only older age at last birth was associated with a lowered risk of endometrial cancer. The risk decreased at a rate of about 15% per five-year delay of last birth. Conclusions: Endometrial cancer is often referred to as the prototype hormonally-determined disease in women. However, our findings give further support to the hypothesis that a birth may not only affect risk through hormonal influences, but possibly also through mechanical shedding of cells that have undergone malignant transformation.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1023/A:1008860615584
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  • 2
    Digitale Medien
    Digitale Medien
    Risks of breast and endometrial cancer after estrogen and estrogen–progestin replacement (1999)
    Springer
    Cancer causes & control 10 (1999), S. 253-260 
    Details
    ISSN: 1573-7225
    Schlagwort(e): breast neoplasms ; cohort ; endometrial neoplasms ; estrogens ; hormone replacement therapy ; progestins
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objective: We studied the risk of breast and endometrial cancer in a cohort of 11,231 Swedish women prescribed different replacement hormone regimens. Methods: All 10,472 women at risk of developing breast cancer and 8,438 women at risk of endometrial cancer were followed up from the time of the questionnaire in 1987–88 through 1993, by record-linkages to the National Swedish Cancer Registry. Using data from a questionnaire we analyzed the relationships between hormone exposures and cancer risk, with non-compliers and users of less than 1 year as a reference group. Results: For breast cancer, women reporting use of estrogens combined with progestins had evidence of an increased risk relative to women denying intake or taking hormones for less than 1 year; relative risk (RR) = 1.4 (95% confidence interval 0.9–2.3) after 1–6 years of intake, and RR=1.7 (95% CI 1.1–2.6) after more than 6 years. This excess risk seemed confined to recent exposure. We found no association with intake of estrogens alone using non-compliers and short-term takers as the reference group. The risk of invasive endometrial cancer was increased four-fold in women using medium-potency estrogens alone for 6 years or longer, RR = 4.2 (95% CI 2.5–8.4). Women on such long-term progestin-combined treatment had a lower, non-significant, excess risk (RR = 1.4; 95% CI 0.6–3.3). Conclusions: We conclude that long-term recent use of estrogen–progestin combined replacement therapy may increase the risk of breast cancer. Exposure to estrogen alone substantially elevates the risk of endometrial cancer, an increase that can be reduced or perhaps avoided by adding progestins.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1023/A:1008909128110
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  • 3
    Digitale Medien
    Digitale Medien
    Body size in different periods of life, diabetes mellitus, hypertension, and risk of postmenopausal endometrial cancer (Sweden) (2000)
    Springer
    Cancer causes & control 11 (2000), S. 185-192 
    Details
    ISSN: 1573-7225
    Schlagwort(e): diabetes mellitus Types 1 and 2 ; endometrial neoplasms ; hypertension ; obesity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objective: To measure the association between endometrial cancer risk and obesity at age 18 and recently, adult weight gain, diabetes mellitus and hypertension. Methods: We performed a population-based, nationwide case–control study among postmenopausal women aged 50–74 years in Sweden, including 709 incident cases with histopathologically verified endometrial cancer and 3368 controls. Results: Compared to lean women (recent body mass index (BMI), i.e. kg/m2 below 22.5), overweight women (recent BMI 28–29.99) had a 50% increase in risk for endometrial cancer (OR 1.5, 95% CI 1.0–2.1). Obese women (recent BMI 30–33.99) had a 3-fold increased risk (OR 2.9, 95% CI 2.0–4.0), and markedly obese women (recent BMI ≥ 34) a 6-fold increased risk (OR 6.3, 95% CI 4.2–9.5). The OR for Type 2 diabetes mellitus was 1.5 (95% CI 1.0–2.1) and for Type 1 diabetes mellitus it was 13.3 (3.1–56.4). The effect of recent BMI was similar for tumors having different degrees of differentiation and myometrial invasion, and did not vary with age, time since menopause, smoking status, diabetes mellitus, and use of contraceptives. Hypertension increased risk only among obese women. BMI at age 18, height, and adult weight change were not independent risk factors. Conclusions: Recent overweight/obesity and diabetes mellitus (Types 1 and 2) are associated with endometrial cancer risk. Hypertension increases risk among obese women.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1023/A:1008946825313
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  • 4
    Digitale Medien
    Digitale Medien
    Use of oral contraceptives and endometrial cancer risk (Sweden) (1999)
    Springer
    Cancer causes & control 10 (1999), S. 277-284 
    Details
    ISSN: 1573-7225
    Schlagwort(e): combined oral contraceptives ; endometrial neoplasms ; Sweden
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objectives: To estimate the magnitude and persistence of the protective effect of use of combined oral contraceptives (COCs) and endometrial cancer risk. Methods: We performed a nation-wide, population-based case–control study among postmenopausal women aged 50–74 years in Sweden, which included 709 subjects with incident, histopathologically verified endometrial cancer, and 3,368 controls with an intact uterus. We used unconditional logistic regression to calculate odds ratios as estimates of relative risks. Results: Use of any sort of oral contraceptive decreased risk for endometrial cancer by 30%, while progestin-only pills reduced risk more markedly. For COCs the reduction in risk was noticeable following 3 or more years of use (OR 0.5, 95% CI 0.3–0.7), and increased with duration of intake, reaching 80% lower risk after 10 years of use. The protective effect of COC use was similar for all degrees of tumor differentiation and invasiveness, and remained for at least 20 years after cessation of use. Subsequent use of hormone replacement did not modify these protective effects. Conclusions: We conclude that COC use confers a long-lasting protection against endometrial cancer risk which is particularly marked for long-term users.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1023/A:1008945721786
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  • 5
    Digitale Medien
    Digitale Medien
    Hydatidiform moles and the long-term risk of breast cancer (Sweden) (2000)
    Springer
    Cancer causes & control 11 (2000), S. 117-120 
    Details
    ISSN: 1573-7225
    Schlagwort(e): breast cancer ; cohort ; hydatidiform
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objectives: The etiology of breast cancer is only partially understood. Based on the findings that pregnancies reduce breast cancer risk, a possible inverse association between exposure to the placental hormone human chorionic gonadotropin (hCG) and the risk of breast cancer has been suggested. Hydatidiform mole, a gestational trophoblastic disease, is associated with a high expression of hCG. We performed a population-based cohort study in which women with a history of hydatidiform mole were followed up for future cancer outcomes. Methods: All 3371 women with a notification of hydatidiform mole in the Swedish Cancer Registry between 1958 and 1993 were followed up for future cancer outcomes by record linkages within the registry. Results: In a total of 57,075 person-years of follow-up, 59 women had a diagnosis of breast cancer during follow-up, yielding an overall standardized incidence ratio of 1.3 (95% CI 1.0–1.7). Conclusion: This finding is not consistent with the hypothesis of a protective effect of hCG exposure on breast cancer risk, but rather suggests an adverse association.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1023/A:1008915217389
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  • 6
    Digitale Medien
    Digitale Medien
    Risk for endometrial cancer following breast cancer: a prospective study in Sweden (1997)
    Springer
    Cancer causes & control 8 (1997), S. 821-827 
    Details
    ISSN: 1573-7225
    Schlagwort(e): Breast cancer ; endometrial cancer ; Sweden ; tamoxifen ; women
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The risk for endometrial cancer among women with breast cancer might increase following use of tamoxifen, recently classified as a carcinogen of the human endometrium. However, the strength of the association remains uncertain and it is unknown whether use of this drug - widely prescribed in Sweden since the mid-1980s - has had any measurable effect at the population level. We analyzed all cases of breast cancer (n = 131,614) detected in the nationwide Swedish Cancer Registry in 1958-93. Incident cases of endometrial cancer during follow-up were identified also through the Cancer Registry. Standardized incidence ratios (SIR) and their 95 percent confidence intervals(CI) were computed by use of nationwide rates of endometrial cancer, adjusted for age and calendar year. During follow-up of up to 35 years of the breast cancer cohort, 803 incident endometrial cancers were identified, yielding an overall SIR of 1.58 (CI = 1.47-1.70). In univariate analyses, there was no increase in SIR in recent years. However, the excess risk increased linearly with increasing age at breast cancer diagnosis (P trend 〈 0.0001) and decreased markedly with longer follow-up (P trend 〈 0.0001). A multivariate regression analysis, with adjustment for age and year of follow-up, revealed no increased risk for subsequent endometrial cancer among breast cancer cases diagnosed more recently (P trend = 0.19); compared with the period 1958-63,the risk estimate in the last time period (1989-93) was 0.72 (CI =0.51-1.01). We conclude that the risk for endometrial cancer following breast cancer has not increased over time in Sweden.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1023/A:1018404110180
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  • 7
    Digitale Medien
    Digitale Medien
    Physical activity and postmenopausal endometrial cancer risk (Sweden) (2000)
    Springer
    Cancer causes & control 11 (2000), S. 829-837 
    Details
    ISSN: 1573-7225
    Schlagwort(e): endometrial cancer ; exercise ; leisure activities ; occupation
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objectives:To examine the hypothesis that sedentary women have an increased risk of endometrial cancer compared to physically active women. Methods:This is a population-based case–control study in the entire Swedish female population aged 50–74 years in 1994–1995. We obtained self-reported information on leisure-time physical activity during childhood, at ages 18–30, and recently from 709 incident case women with endometrial cancer and 3368 population controls. Occupational physical activity was estimated through record linkage to the Swedish census data from 1960, 1970, 1980, and 1990. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for different activity levels by multivariate logistic regression, taking into account potential confounders. Results:Comparing lowest to highest (reference) levels of physical exercise, we observed statistically significant associations with risk of endometrial cancer for leisure-time activity at age 18–30 years (multivariate OR = 1.4; 95% CI = 1.0–1.8; p for trend 0.01) and in recent years (multivariate OR=1.3; 95% CI = 1.0–1.7; p for trend 0.01). We found similar associations comparing lowest to highest (reference) levels of occupational activity assessed at the censuses in 1980 (multivariate OR = 1.4; 95% CI = 1.0–1.9; p for trend 0.03) and 1990 (multivariate OR = 1.3; 95% CI = 0.9–1.9, p for trend 0.05), but a less consistent association with censuses in 1960 and 1970. The increased risk associated with low level of occupational physical activity was confined to women who were not obese and to women who were smokers. Conclusion:Our data, in conjunction with past epidemiological studies, indicate that both occupational and leisure-time physical activity may reduce the risk for postmenopausal endometrial cancer.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1023/A:1008919717930
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