Endometrial cancer following treatment for breast cancer: A case-control study in Denmark

Ewertz, Marianne; Machado, Stella G.; Boice, John D.; Jensen, Ole Møller

doi:10.1038/bjc.1984.237

Cited by 23 publications

(8 citation statements)

References 17 publications

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“…The height effect that we observed in women aged 60 or older is difficult to interpret, since it was limited to this age group and was in most part explained by the association with weight. Most past studies of this cancer have found no association with height (Blitzer et al, 1976;Elwood et al, 1977;Ewertz et al, 1984;Albanes et al, 1988).…”

Section: Discussionmentioning

confidence: 95%

“…There is now persuasive evidence that body weight is associated with post-menopausal endometrial cancer (Wynder et al, 1966;Blitzer et al, 1976;Elwood et al, 1977;Lew and Garfinkel, 1979;Kelsey et al, 1982;Henderson et al, 1983;La Vecchia et al, 1984;Ewertz et al, 1984;Lawrence et al, 1987;Koumantaki et al, 1989;Folsom et al, 1989). This association has been attributed to the increased levels of biologically active estrogens in obese post-menopausal women (Siiteri, 1978).…”

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confidence: 99%

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Early‐age body size, adult weight gain and endometrial cancer risk

Marchand

Wilkens

1991

Intl Journal of Cancer

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To further characterize the association of obesity and endometrial cancer, in particular with regard to the role of early-age obesity and adult weight gain, the authors assembled by computer linkage a population-based historical cohort of 30,266 women born between 1913 and 1932, for whom weight and height had been recorded in 1942-43 and 1972. Linkage of this cohort to the Hawaii Tumor Registry resulted in the identification of 214 (mainly post-menopausal) incident cases of endometrial cancer for 1972-1986. An average of 37 cancer-free controls were matched to each case on month and year of birth and ethnicity. A case-control analysis, conducted in each 5-year birth cohort, revealed no clear association of endometrial cancer with weight, height or body mass at ages 10 to 29 years. However, positive associations with adult body weight and gain in body mass since 1942 were observed for women diagnosed at age 60 or older. This association with obesity was strongest in women whose body mass was below the median in 1942 and equal to or above the median in 1972. No association with body size was detected in women diagnosed before age 60. Parity, age at first birth and socioeconomic indicators for 1942 and 1972 did not confound the analysis. These findings suggest that obesity affects the late stages of endometrial carcinogenesis, and the possibility that one or more determinants of weight gain may be independently associated with endometrial cancer risk.

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Section: Discussionmentioning

confidence: 95%

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confidence: 99%

Early‐age body size, adult weight gain and endometrial cancer risk

Marchand

Wilkens

1991

Intl Journal of Cancer

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“…In endometrial cancer, on the other hand, a causal relationship with certain characteristics of the reproductive history (Ewertz et al, 1984;Kelsey & Hildreth, 1983;Pettersson et al, 1986) excess endogenous oestrogens (Henderson et al, 1982) and with oestrogen therapy (Ewertz et al, 1984;Persson et al, 1986;Zeil, 1982) seems to be more firmly established. We have recently found that the relation between a long menstruation span -defined as the period between menarche and menopause, adjusted for anovulatory periods during parity and lactation -and an increased risk of endometrial cancer is negatively correlated with age at diagnosis (Pettersson et al, 1986).…”

Section: Discussionmentioning

confidence: 99%

“…Hormonal treatment has been used for palliation only in advanced cases with too short survival time for an oestrogen induced endometrial cancer to develop. A confounding effect of radiation to the pelvic area or of oestrogen treatment is therefore unlikely (Ewertz et al, 1984).…”

Section: Discussionmentioning

confidence: 99%

On the age-dependent association between cancer of the breast and of the endometrium. A nationwide cohort study

Adami¹,

Krusemo²,

Bergkvist³

et al. 1987

Br J Cancer

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Summary The association between breast and endometrial cancer was investigated in a cohort consisting of 60,065 subjects (99% of all women in whom a first breast cancer was diagnosed in Sweden in 1960-63 and 1968-81 (Dunn, 1975;Cole & Cramer, 1977;Howe et al., 1984;Henderson et al., 1982;Willett & MacMahon, 1984). Descriptive epidemiologic studies have revealed high correlations between breast and endometrial cancer with regard to incidence and mortality rates. Such observations have been reported from international investigations in both low-and high-risk countries and in migrant populations (Dunn, 1975) and also from different parts of high-risk countries such as Canada (Howe et al., 1984) and the United States (Hoover et al., 1975;Winkelstein et al., 1977).The possibility that these demographic correlations reflect common genetic or environmental aetiologic factors has gained some support from cohort studies in which an increased risk of endometrial cancer has been found in breast cancer patients (Schoenberg et al., 1969) and vice versa (Schottenfeld & Berg, 1971;Bailar, 1963;MacMahon & Austin, 1969). The knowledge that can be derived from these analytic studies is generally uncertain, however, because of small numbers of cases, contradictory findings in blacks and whites (Newell et al., 1974), and limited information as to the possible dependence of an association between breast and endometrial cancer on age at diagnosis of the first primary (Bailar, 1963;MacMahon & Austin, 1969). The aim of this investigation was to confirm and extend in a larger cohort our recent finding that the association between breast and endometrial cancer is seemingly restricted to older women (Adami et al., 1984). The availability of a national cancer registry, reliable incidence figures for the studied population and opportunities for complete long-term follow-up facilitated our analysis. The overall frequency of underreporting has been shown to be -5% (Mattsson, 1977) and the completeness of registration of breast and endometrial cancer has been assessed from death certificates to be 98 and 95% respectively (Mattsson & Wallgren, 1984).The cohort was based on all women reported as having a first breast cancer diagnosed in 1960 through 1963 and 1968 through 1981. The four-year period of our previous study (Adami et al., 1984), 1964 through 1967, was excluded, since one major aim was to rule out the possibility that the excess risk previously found was due to chance (type I error) i.e. to a random high relative risk among the large number of tumour sites and subgroups that were analysed. Patients were included irrespective of whether they had had any other malignant disease reported prior to the breast cancer.A total of 61,341 women with breast cancer were notified to the Cancer Registry during the period of study. We excluded 583 women with an incomplete national registration number (a number which permits exclusive identification), precluding computerized linkages and followup in the Cancer Registry and other registers. The b...

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“…We considered as second invasive cancer events loco‐regional invasive recurrences, distant recurrences (metastases) or a second invasive cancer of any primary sites up to December 2011. All cancer events diagnosed within a same three‐month period were considered as synchronous events …”

Section: Methodsmentioning

confidence: 99%

Prediagnostic body size and breast cancer survival in the E3N cohort study

His

Fagherazzi

Mesrine

et al. 2016

Intl Journal of Cancer

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Obesity has been associated with poor breast cancer prognosis, however most studies have focused on body mass index (BMI) and few have considered the distribution of adipose tissue. We investigated associations between prediagnostic adiposity and breast cancer survival, considering BMI, waist and hip circumferences (WC and HC), and waist-to-hip ratio (WHR).Analyses included 3,006 women from the French E3N prospective cohort study diagnosed with primary invasive breast cancer between 1995 and 2008. We investigated overall, breast cancer-specific, and disease-free survival, overall and according to stage, menopausal and hormonal status and year of diagnosis, using Cox proportional hazard models adjusted for tumor characteristics and lifestyle risk factors.Women with a prediagnostic HC > 100 cm were at increased risk of death from all causes (hazard ratio (HR) >100vs < 95 cm 5 1.38, 95% Confidence Interval (CI) 5 1.02-1.86, P trend 5 0.02) and from breast cancer (HR >100vs < 95 cm 5 1.50, CI 5 1.03-2.17, P trend 5 0.03), and of second invasive cancer event (HR >100vs < 95 cm 5 1.36, CI 5 1.11-1.67, P trend 5 0.002), compared to those with HC <95 cm. Associations were stronger after adjustment for BMI. BMI, WC and WHR were not associated with survival after breast cancer. Our study underlines the importance of going beyond BMI when studying the association between adiposity and breast cancer survival. Further studies should be conducted to confirm our results on hip circumference.Breast cancer is the most prevalent cancer in women in both developed and developing countries. 1 With 5-year relative survival rates of 80% or more in developed countries, 2 an increasing number of women are currently living with a diagnosis of breast cancer. For these cancer survivors, it is essential to identify modifiable risk factors that could influence their prognosis.Breast cancer characteristics such as TNM stage, lymph node status, tumor size, tumor grade, histological type, lymphatic and vascular invasion, hormone receptor and HER2 status, and age at diagnosis are known predictive or prognostic factors. 3,4 A recent meta-analysis conducted by the World Cancer Research Fund (WCRF) has shown that obesity and excess weight before diagnosis were associated with increased mortality (from all causes and from breast cancer). 5 However, the WCRF expert panel judged that the level of evidence for the association between a healthy body mass index (BMI) and a better survival was only limited, despite suggestive evidence. 6 Weaknesses have been underlined in observational studies as well as in clinical trials. In particular, cohort studies need to assess more systematically important prognostic factors, such as tumor characteristics, treatment or time period of cancer diagnosis (because of rapid changes in treatments). On the other hand, results from clinical trials, which

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Endometrial cancer following treatment for breast cancer: A case-control study in Denmark

Cited by 23 publications

References 17 publications

Early‐age body size, adult weight gain and endometrial cancer risk

Early‐age body size, adult weight gain and endometrial cancer risk

On the age-dependent association between cancer of the breast and of the endometrium. A nationwide cohort study

Prediagnostic body size and breast cancer survival in the E3N cohort study

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