RT Journal Article
T1 Theoretical potential for endometrial cancer prevention through primary risk factor modification: Estimates from the EPIC cohort.
A1 Fortner, Renée T
A1 Hüsing, Anika
A1 Dossus, Laure
A1 Tjønneland, Anne
A1 Overvad, Kim
A1 Dahm, Christina C
A1 Arveux, Patrick
A1 Fournier, Agnès
A1 Kvaskoff, Marina
A1 Schulze, Matthias B
A1 Bergmann, Manuela
A1 Trichopoulou, Antonia
A1 Karakatsani, Anna
A1 La Vecchia, Carlo
A1 Masala, Giovanna
A1 Pala, Valeria
A1 Mattiello, Amalia
A1 Tumino, Rosario
A1 Ricceri, Fulvio
A1 van Gils, Carla H
A1 Monninkhof, Evelyn M
A1 Bonet, Catalina
A1 Quirós, José Ramón
A1 Sanchez-Perez, Maria-Jose
A1 Rodríguez-Palacios, Daniel-Ángel
A1 Gurrea, Aurelio B
A1 Amiano, Pilar
A1 Allen, Naomi E
A1 Travis, Ruth C
A1 Gunter, Marc J
A1 Viallon, Vivian
A1 Weiderpass, Elisabete
A1 Riboli, Elio
A1 Kaaks, Rudolf
K1 endometrial cancer
K1 primary prevention
K1 risk factors
AB Endometrial cancer (EC) incidence rates vary ~10-fold worldwide, in part due to variation in EC risk factor profiles. Using an EC risk model previously developed in the European EPIC cohort, we evaluated the prevention potential of modified EC risk factor patterns and whether differences in EC incidence between a European population and low-risk countries can be explained by differences in these patterns. Predicted EC incidence rates were estimated over 10 years of follow-up for the cohort before and after modifying risk factor profiles. Risk factors considered were: body mass index (BMI, kg/m2 ), use of postmenopausal hormone therapy (HT) and oral contraceptives (OC) (potentially modifiable); and, parity, ages at first birth, menarche and menopause (environmentally conditioned, but not readily modifiable). Modeled alterations in BMI (to all ≤23 kg/m2 ) and HT use (to all non-HT users) profiles resulted in a 30% reduction in predicted EC incidence rates; individually, longer duration of OC use (to all ≥10 years) resulted in a 42.5% reduction. Modeled changes in not readily modifiable exposures (i.e., those not contributing to prevention potential) resulted in ≤24.6% reduction in predicted EC incidence. Women in the lowest decile of a risk score based on the evaluated exposures had risk similar to a low risk countries; however, this was driven by relatively long use of OCs (median = 23 years). Our findings support avoidance of overweight BMI and of HT use as prevention strategies for EC in a European population; OC use must be considered in the context of benefits and risks.
YR 2020
FD 2020-02-18
LK http://hdl.handle.net/10668/15035
UL http://hdl.handle.net/10668/15035
LA en
DS RISalud
RD Apr 7, 2025