Incidence of histologic types of uterine sarcoma in relation to menstrual and reproductive history

Weiss, Noel S.; Daling, Janet R.; Newcomb, Polly A.; Liff, Jonathan M.; Gammon, Marilee D.; Thompson, W. Douglas; Watt, Janice D.; Armstrong, Bruce K.; Weyer, Peter J.; Isaacson, Peter G.; Ek, Marit

doi:10.1002/ijc.2910490308

Cited by 15 publications

(9 citation statements)

References 17 publications

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“…It suggests that the development of sarcomas (or at least of the most common subtypes of sarcoma) is not affected by reproductive factors. Our results are thus in agreement with those of Schwartz et al, 26,27 but they conflict with observations from Norway. 22,25 Long-term unopposed estrogen action; anovulatory cycles, 24,28,29 which are common before menopause; and deficient secretion of progesterone 30 predispose the endometrium to unopposed estrogen stimulation, which in turn promotes the malignant transformation of the endometrium.…”

Section: Discussionsupporting

confidence: 82%

Grand multiparity and incidence of endometrial cancer: A population‐based study in Finland

Hinkula¹,

Pukkala²,

Kyyrönen³

et al. 2002

Intl Journal of Cancer

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The hormonal background of endometrial cancer is insufficiently characterised. We investigated the significance of parity, age at first birth, intensity between births, length of time from the first to the last birth and length of delivery-free premenopausal period in a cohort of grand multiparous (GM) women, i.e., women with at least 5 births. Data of the Population Register of Finland (86,978 GM-women) and the population-based Finnish Cancer Registry were combined. Standardised incidence ratios (SIRs) were calculated by dividing the number of observed cancer cases by the expected number based on the national incidence rates. Key words: endometrial cancer; age at first birth; parity; grand multiparity; birth periodEndometrial cancer is a hormone-dependent malignancy. Unopposed estrogen promotes malignant transformation of the endometrium, an action that is counteracted by progesterone. 1 Pregnancy is characterised by continuous progesterone production from the early weeks of gestation until delivery. 2 Possibly for this reason, at least partly, parous women have a markedly lower risk of endometrial cancer than nulliparous women. [3][4][5][6][7][8] The term grand multiparity (GM) defines women who have undergone at least 5 full-term pregnancies. 9 The Population Register of Finland contains detailed information on the births and children of all GM mothers. Using this national population register of GM-women and data of Finnish Cancer Registry, we studied the significance of parity, age at first birth, average intensity between births, birth period and premenopausal delivery-free period as risk determinants of endometrial cancer. MATERIAL AND METHODS Population-based registersThe computerised files of the Finnish Population Register, which includes links between parents and their children who were living at the same address in 1974 or later, revealed 86,978 GMwomen during the period 1974 until the end of 1997. Follow-up for endometrial cancer was done automatically through the files of the national, population-based Finnish Cancer Registry with personal identifiers. Follow-up for cancer started on 1 January 1974 or at the birth of the fifth child, whichever was later, and ended at death, emigration or on 31 December 1997, whichever was first. There were 1.68 million person-years in the study. The mean length of follow-up was 19.3 years.The cancer registry data also included information about the histopathologic diagnosis made by local pathologists and clinical stage at diagnosis. Statistical methodsCases of endometrial cancer and person-years at risk were counted by 5-year age groups and separately for 4 parity categories (5, 6, 7 and 8ϩ children), 4 categories by age at first birth (Ͻ20, 20 -24, 25-29 and 30ϩ years) and 3 birth-intensity categories (average interval between the first 5 deliveries Ͻ2.0, 2.0 -3.0 and Ͼ3.0 years). Age at follow up of cancer was categorised into 3 groups, Ͻ50 years ("premenopausal" women), 50 -64 years ("postmenopausal" women) and 65ϩ years. For women 50 years or older, most of who...

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Section: Discussionsupporting

confidence: 82%

Grand multiparity and incidence of endometrial cancer: A population‐based study in Finland

Hinkula¹,

Pukkala²,

Kyyrönen³

et al. 2002

Intl Journal of Cancer

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“…The extremely high fertility rate among Hispanics may be protective against several types of uterine tumors, although risk factor data for carcinosarcoma and sarcoma are limited. 45,46 As was expected, white Hispanics had lower incidence rates than did white non-Hispanics for all stages and grades of usual types of endometrial adenocarcinoma. Blacks had lower rates than did white non-Hispanics only for Category I tumors staged as local or regional and Category I tumors graded as well-differentiated or moderately differentiated; rates for tumors staged as distant and for poorly differentiated tumors were similar.…”

Section: Discussionsupporting

confidence: 57%

“…Data regarding the five histopathologic categories defined earlier were tabulated by race and ethnicity. Tumors in Category I subsequently were stratified by stage (localized, regional, distant, or unstaged), 22 grade (well-differentiated, moderately differentiated, 23 poorly differentiated, undifferentiated, or unknown), and patient age (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54), 55-74, or Ն 75 years). Rates for white Hispanics and blacks were compared with those for white non-Hispanics.…”

Section: Discussionmentioning

confidence: 99%

Analysis of racial differences in incidence, survival, and mortality for malignant tumors of the uterine corpus

Sherman

Devesa

2003

Cancer

196

107

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Population balance models (PBMs) are widely used to describe the dynamics of particulate systems. The simulation of PBMs becomes challenging with increasing numbers of dimensions and integral terms associated with phenomena, such as coalescence and breakage, which has motivated efforts to develop more computationally efficient numerical algorithms. This article presents high‐resolution finite‐volume methods for the parallel simulation of PBMs that scale well to ∼100 processors on a linux cluster. The high‐resolution methods provide second‐order accuracy with an accurate tracking of sharp fronts. The ParticleSolver software implementing these methods is verified by application to PBMs for (1) aerosol coagulation and condensation, (2) the formation of gold nanoparticles by nucleation, disproportionation, and coagulation, and (3) the nucleation and growth of inorganic crystals with a time‐varying shape distribution. © 2008 American Institute of Chemical Engineers AIChE J, 2008

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“…Owing to the low incidence of this disease, the aetiology of uterine sarcomas has been investigated in only a few small case–control studies (Kvale et al , 1988; Schwartz and Thomas, 1989; Schwartz and Weiss, 1990; Schwartz et al , 1991, 1996; Lavie et al , 2008; Jaakkola et al , 2011). Obesity, menopausal use of oestrogen plus progestin, oral contraceptives (OC), and tamoxifen use are associated with increased risks of uterine sarcoma, whereas cigarette smoking and parity are associated with a reduced risk.…”

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confidence: 99%

The etiology of uterine sarcomas: a pooled analysis of the epidemiology of endometrial cancer consortium

et al. 2013

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Background:Uterine sarcomas are characterised by early age at diagnosis, poor prognosis, and higher incidence among Black compared with White women, but their aetiology is poorly understood. Therefore, we performed a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We also examined risk factor associations for malignant mixed mullerian tumours (MMMTs) and endometrioid endometrial carcinomas (EECs) for comparison purposes.Methods:We pooled data on 229 uterine sarcomas, 244 MMMTs, 7623 EEC cases, and 28 829 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) for risk factors associated with uterine sarcoma, MMMT, and EEC were estimated with polytomous logistic regression. We also examined associations between epidemiological factors and histological subtypes of uterine sarcoma.Results:Significant risk factors for uterine sarcoma included obesity (body mass index (BMI)⩾30 vs BMI<25 kg m−2 (OR: 1.73, 95% CI: 1.22–2.46), P-trend=0.008) and history of diabetes (OR: 2.33, 95% CI: 1.41–3.83). Older age at menarche was inversely associated with uterine sarcoma risk (⩾15 years vs <11 years (OR: 0.70, 95% CI: 0.34–1.44), P-trend: 0.04). BMI was significantly, but less strongly related to uterine sarcomas compared with EECs (OR: 3.03, 95% CI: 2.82–3.26) or MMMTs (OR: 2.25, 95% CI: 1.60–3.15, P-heterogeneity=0.01).Conclusion:In the largest aetiological study of uterine sarcomas, associations between menstrual, hormonal, and anthropometric risk factors and uterine sarcoma were similar to those identified for EEC. Further exploration of factors that might explain patterns of age- and race-specific incidence rates for uterine sarcoma are needed.

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Incidence of histologic types of uterine sarcoma in relation to menstrual and reproductive history

Cited by 15 publications

References 17 publications

Grand multiparity and incidence of endometrial cancer: A population‐based study in Finland

Grand multiparity and incidence of endometrial cancer: A population‐based study in Finland

Analysis of racial differences in incidence, survival, and mortality for malignant tumors of the uterine corpus

The etiology of uterine sarcomas: a pooled analysis of the epidemiology of endometrial cancer consortium

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