Age at menarche and endometrial cancer risk: a dose-response meta-analysis of prospective studies

Abstract

Evidence between age at menarche and endometrial cancer risk have been controversial. Therefore, we conducted a meta-analysis of prospective studies to analyze the aforementioned association. Relevant studies were identified by searching PubMed and EMBASE databases until the end of June 2015. A random-effects model was used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs) for associations between menarcheal age and endometrial cancer risk. Our meta-analysis included eight prospective studies involving 4553 subjects with endometrial cancer. The summarized RRs of endometrial cancer for menarcheal age were 0.68 (95%CI = 0.58–0.81, I2 = 41.9%, P = 0.099, n = 8) when comparing women with oldest category of menarcheal age with women with youngest category of menarcheal age. Notably, there was an 4% reduction in risk for per 2 years delay in menarcheal age (summarized RR = 0.96; 95%CI = 0.94–0.98, I2 = 45.7%, P = 0.101, n = 6). Additionally, significant inverse associations were consistent within all stratified analyses. There was no evidence of publication bias or significant heterogeneity between subgroups detected by meta-regression analyses. Our findings support the hypothesis that late menarcheal age is inversely associated with endometrial cancer risk. Further larger prospective or pooled studies are warranted to fully adjust for potential confounders and distinguish whether the associations differ by histological subtypes of endometrial cancer.

Genetics, Genome-Wide Association Studies, and Menarche

“…Adverse consequences of this longer exposure to estrogen includes an increased risks for endometrial and breast cancers. [91][92][93][94] The number of ovulatory cycles and person-years of menstrual cycles presumably contribute to the cumulative exposure of cells to endogenous steroid hormones. Younger age at menarche has also been associated with increased risk for development of the metabolic syndrome.…”

Identifying potential causal effects of age at menarche: a Mendelian randomization phenome-wide association study

“…Menarche (onset of menses) is a hallmark event in a woman's life. Using conventional multivariable regression, a younger age at menarche has been associated with higher risk of death from all causes [1], death from cardiovascular disease [1,2], reproductive cancers [3,4], and depression [5], but lower risk of osteoporosis/fractures [6,7]. It has been proposed that the well-known inverse association between childhood body mass index (BMI) and age at menarche explains some of the observed associations [8,9].…”

Harmonisation of biobanking standards in endometrial cancer research

“…For example, the available literature suggests that >20 kg of adult weight gain to be independently associated with increased risk of EC ( Friedenreich et al , 2007 ) and this information is unlikely to be obtained easily other than directly from the patient. Many other risk factors for EC such as the age of presentation, the postmenopausal status, polycystic ovarian disease ( Fearnley et al , 2010 ), nulliparity ( Schonfeld et al , 2013 ), early age of menarche ( Gong et al , 2015 ), family history of hereditary lynch syndrome-related cancers ( Boilesen et al , 2008 ), past history of lynch syndrome-related cancers, medical conditions such diabetes ( Friberg et al , 2007 ), previous use of tamoxifen ( Bergman et al , 2000 ), hormone replacement therapy use ( Beral et al , 2005 ) and exercise habits have been included in the tool. Some other factors with inconclusive links to EC at present such as smoking ( Lindemann et al , 2008 ) were also included in anticipation of their confirmation in appropriate future studies.…”