. 2015 Mar 3;112(5):925-33.

doi: 10.1038/bjc.2015.24. Epub 2015 Feb 17.

Infertility and incident endometrial cancer risk: a pooled analysis from the epidemiology of endometrial cancer consortium (E2C2)

H P Yang¹, L S Cook², E Weiderpass³, H-O Adami⁴, K E Anderson⁵, H Cai⁶, J R Cerhan⁷, T V Clendenen⁸, A S Felix¹, C M Friedenreich⁹, M Garcia-Closas¹⁰, M T Goodman¹¹, X Liang¹², J Lissowska¹³, L Lu¹⁴, A M Magliocco¹⁵, S E McCann¹⁶, K B Moysich¹⁶, S H Olson¹², S Petruzella¹², M C Pike¹⁷, S Polidoro¹⁸, F Ricceri¹⁸, H A Risch¹⁴, C Sacerdote¹⁹, V W Setiawan²⁰, X O Shu⁶, A B Spurdle²¹, B Trabert¹, P M Webb²¹, N Wentzensen¹, Y-B Xiang²², Y Xu¹², H Yu²³, A Zeleniuch-Jacquotte⁸, L A Brinton¹

Affiliations

¹ Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
² University of New Mexico, Albuquerque, NM 87131, USA.
³ 1] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden [2] Department of Genetic Epidemiology, Folkhälsan Research Center, 00014 Helsinki, Finland [3] Department of Research, Cancer Registry of Norway, N-0304 Oslo, Norway [4] Department of Community Medicine, University of Tromsø, The Arctic University of Norway, 90109 Tromsø, Norway.
⁴ 1] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden [2] Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
⁵ School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
⁶ Department of Medicine, Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
⁷ Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
⁸ Department of Population Health and NYU Perimutter Cancer Center, New York University School of Medicine, New York, NY 10016, USA.
⁹ Alberta Health Services, Calgary, Alberta T2T 5C7, Canada.
¹⁰ Institute of Cancer Research, Surrey SM2 5NG, UK.
¹¹ Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
¹² Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
¹³ M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, 02-781 Warsaw, Poland.
¹⁴ Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA.
¹⁵ H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL33612, USA.
¹⁶ Roswell Park Cancer Institute, Buffalo, NY 14203, USA.
¹⁷ 1] Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA [2] Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
¹⁸ Human Genetics Foundation, 10126 Turin, Italy.
¹⁹ 1] Human Genetics Foundation, 10126 Turin, Italy [2] Unit of Cancer Epidemiology, University of Turin and Center for Cancer Prevention, 10124 Turin, Italy.
²⁰ Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
²¹ QIMR Berghofer Medical Research Institute, Herston, Queensland 4029, Australia.
²² Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
²³ University of Hawaii Cancer Center, Honolulu, HI 96813, USA.

PMID: 25688738
PMCID: PMC4453954
DOI: 10.1038/bjc.2015.24

Infertility and incident endometrial cancer risk: a pooled analysis from the epidemiology of endometrial cancer consortium (E2C2)

H P Yang et al. Br J Cancer. 2015.

. 2015 Mar 3;112(5):925-33.

doi: 10.1038/bjc.2015.24. Epub 2015 Feb 17.

Authors

Affiliations

¹ Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
² University of New Mexico, Albuquerque, NM 87131, USA.
³ 1] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden [2] Department of Genetic Epidemiology, Folkhälsan Research Center, 00014 Helsinki, Finland [3] Department of Research, Cancer Registry of Norway, N-0304 Oslo, Norway [4] Department of Community Medicine, University of Tromsø, The Arctic University of Norway, 90109 Tromsø, Norway.
⁴ 1] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden [2] Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
⁵ School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
⁶ Department of Medicine, Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
⁷ Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
⁸ Department of Population Health and NYU Perimutter Cancer Center, New York University School of Medicine, New York, NY 10016, USA.
⁹ Alberta Health Services, Calgary, Alberta T2T 5C7, Canada.
¹⁰ Institute of Cancer Research, Surrey SM2 5NG, UK.
¹¹ Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
¹² Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
¹³ M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, 02-781 Warsaw, Poland.
¹⁴ Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA.
¹⁵ H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL33612, USA.
¹⁶ Roswell Park Cancer Institute, Buffalo, NY 14203, USA.
¹⁷ 1] Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA [2] Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
¹⁸ Human Genetics Foundation, 10126 Turin, Italy.
¹⁹ 1] Human Genetics Foundation, 10126 Turin, Italy [2] Unit of Cancer Epidemiology, University of Turin and Center for Cancer Prevention, 10124 Turin, Italy.
²⁰ Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
²¹ QIMR Berghofer Medical Research Institute, Herston, Queensland 4029, Australia.
²² Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
²³ University of Hawaii Cancer Center, Honolulu, HI 96813, USA.

PMID: 25688738
PMCID: PMC4453954
DOI: 10.1038/bjc.2015.24

Abstract

Background: Nulliparity is an endometrial cancer risk factor, but whether or not this association is due to infertility is unclear. Although there are many underlying infertility causes, few studies have assessed risk relations by specific causes.

Methods: We conducted a pooled analysis of 8153 cases and 11 713 controls from 2 cohort and 12 case-control studies. All studies provided self-reported infertility and its causes, except for one study that relied on data from national registries. Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI).

Results: Nulliparous women had an elevated endometrial cancer risk compared with parous women, even after adjusting for infertility (OR=1.76; 95% CI: 1.59-1.94). Women who reported infertility had an increased risk compared with those without infertility concerns, even after adjusting for nulliparity (OR=1.22; 95% CI: 1.13-1.33). Among women who reported infertility, none of the individual infertility causes were substantially related to endometrial cancer.

Conclusions: Based on mainly self-reported infertility data that used study-specific definitions of infertility, nulliparity and infertility appeared to independently contribute to endometrial cancer risk. Understanding residual endometrial cancer risk related to infertility, its causes and its treatments may benefit from large studies involving detailed data on various infertility parameters.

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Figures

**Figure 1**
**Study-specific adjusted odds ratio and 95% confidence interval for endometrial cancer in relation to infertility in the E2C2 pooled analysis, ordered by standard error.** ^aAdjusted for age, race, ever oral contraceptive use, ever menopausal hormone therapy use, parity, interview year, body mass index, and nulliparity. Missing set as a separate category for each covariate.

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Infertility and incident endometrial cancer risk: a pooled analysis from the epidemiology of endometrial cancer consortium (E2C2)

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Infertility and incident endometrial cancer risk: a pooled analysis from the epidemiology of endometrial cancer consortium (E2C2)

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