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Meta-Analysis
. 2019 May 29:2019:8584130.
doi: 10.1155/2019/8584130. eCollection 2019.

Age at Menopause and Risk of Developing Endometrial Cancer: A Meta-Analysis

Yanjun Wu  1 , Wenjun Sun  1 , Hui Liu  1 , Dongfeng Zhang  1
Affiliations
Meta-Analysis

Age at Menopause and Risk of Developing Endometrial Cancer: A Meta-Analysis

Yanjun Wu et al. Biomed Res Int. .

Abstract

Object: The association of age at menopause with endometrial cancer remains controversial. Therefore, we quantitatively summarized the evidence from observational studies with a meta-analysis.

Methods: We searched PubMed, Web of Science, Embase, Medline, Chinese National Knowledge Infrastructure (CNKI), and Wan Fang Med online up to March 2019, and all eligible case-control and cohort studies were included in the study. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated using the random-effects model. The dose-response relationship was assessed by restricted cubic spline model. The heterogeneity among studies was evaluated by I2. Metaregression was used to explore the potential sources of between-study heterogeneity. Egger's test was used to estimate publication bias.

Results: Eighteen articles including 957242 subjects with 4781 cases were included in the meta-analysis. The pooled RR (95%CI) of endometrial cancer for the highest versus the lowest age at menopause was 1.89 (95%CI: 1.58-2.26). For dose-response analysis, a nonlinear relationship was found between age at menopause and endometrial cancer, and the positive association became statistically significant when age at menopause was greater than 46.5 years old.

Conclusions: This meta-analysis suggested that age at menopause was positively associated with endometrial cancer. For women whose menopausal age over 46.5 years old, the risk of endometrial cancer increased with the age at menopause.

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Figures

Figure 1
Figure 1
Flow chart of the selection of studies included in the meta-analysis.
Figure 2
Figure 2
Forest plot of age at menopause and the risk of endometrial cancer. The size of gray box is positively proportional to the weight assigned to each study, and horizontal lines represent the 95% confidence intervals.
Figure 3
Figure 3
The dose-response analysis between age at menopause and the risk of endometrial cancer with restricted cubic splines in a multivariate random-effects dose-response model. The solid line and the long dash line represent the estimated relative risks and its 95% CIs. Short dash line represents the linear relationship.
Figure 4
Figure 4
Funnel plot with pseudo 95% confidence limits for the analysis of age at menopause and risk of endometrial cancer (RR, relative risk).
See this image and copyright information in PMC

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