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. 2022 Aug;129(9):1521-1529.
doi: 10.1111/1471-0528.17087. Epub 2022 Jan 18.

Adult lifetime body mass index trajectories and endometrial cancer risk

Michela Dalmartello  1 , Jeroen Vermunt  2 , Eva Negri  1   3   4 , Fabio Levi  5 , Carlo La Vecchia  1
Affiliations
Free article

Adult lifetime body mass index trajectories and endometrial cancer risk

Michela Dalmartello et al. BJOG. 2022 Aug.
Free article

Abstract

Objective: To identify body mass index (BMI) trajectories in adult life and to examine their association with endometrial cancer (EC) risk, also exploring whether relations differ by hormonal replacement therapy use.

Design: Pooled analysis of two case-control studies.

Setting: Italy and Switzerland.

Population: A total of 458 EC cases and 782 controls.

Methods: We performed a latent class growth model to identify homogeneous BMI trajectories over six decades of age, with a polynomial function of age. Odds ratios (ORs) and the corresponding 95% CI for EC risk were derived through a multiple logistic regression model, correcting for classification error.

Main outcome measures: The relation of BMI trajectories with endometrial cancer.

Results: We identified five BMI trajectories. Compared with women in the 'Normal weight-stable' trajectory, a reduction by about 50% in the risk of EC emerged for those in the 'Underweight increasing to normal weight' (95% CI 0.28-0.99). The 'Normal weight increasing to overweight' and the 'Overweight-stable' trajectories were associated with, respectively, an excess of 3% (95% CI 0.66-1.60) and of 71% (95% CI 1.12-2.59) in cancer risk. The OR associated to the trajectory 'Overweight increasing to obese' was 2.03 (95% CI 1.31-3.13). Stronger effects emerged among hormonal replacement therapy never users (OR 2.19 for the 'Overweight-stable' trajectory and OR 2.49 for the 'Overweight increasing to obese' trajectory).

Conclusions: Our study suggests that longer exposure to overweight and obesity across a lifetime is associated with an increased risk of endometrial cancer. Weight during adulthood also appears to play an important role.

Tweetable abstract: Longer exposure to overweight and obesity across a lifetime is associated with an increased risk of endometrial cancer.

Keywords: body mass index; body mass index trajectories; endometrial cancer; latent class growth models; prevention.

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