The etiology of uterine sarcomas

A pooled analysis of the epidemiology of endometrial cancer consortium

A. S. Felix, L. S. Cook, M. M. Gaudet, Thomas E. Rohan, L. J. Schouten, V. W. Setiawan, L. A. Wise, K. E. Anderson, L. Bernstein, I. De Vivo, C. M. Friedenreich, S. M. Gapstur, R. A. Goldbohm, B. Henderson, P. L. Horn-Ross, L. Kolonel, J. V. Lacey, X. Liang, J. Lissowska, A. Magliocco & 19 others M. L. McCullough, A. B. Miller, S. H. Olson, J. R. Palmer, Y. Park, A. V. Patel, J. Prescott, R. Rastogi, K. Robien, L. Rosenberg, C. Schairer, X. Ou Shu, P. A. Van Den Brandt, R. A. Virkus, N. Wentzensen, Y. B. Xiang, W. H. Xu, H. P. Yang, L. A. Brinton

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)727-734
Number of pages8
JournalBritish Journal of Cancer
Volume108
Issue number3
DOIs
StatePublished - Feb 19 2013

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Endometrial Neoplasms
Sarcoma
Epidemiology
Endometrioid Carcinoma
Malignant Mixed Tumor
Odds Ratio
Confidence Intervals
Body Mass Index
Menarche
Incidence
Obesity
Logistic Models

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Felix, A. S., Cook, L. S., Gaudet, M. M., Rohan, T. E., Schouten, L. J., Setiawan, V. W., ... Brinton, L. A. (2013). The etiology of uterine sarcomas: A pooled analysis of the epidemiology of endometrial cancer consortium. British Journal of Cancer, 108(3), 727-734. https://doi.org/10.1038/bjc.2013.2

The etiology of uterine sarcomas : A pooled analysis of the epidemiology of endometrial cancer consortium. / Felix, A. S.; Cook, L. S.; Gaudet, M. M.; Rohan, Thomas E.; Schouten, L. J.; Setiawan, V. W.; Wise, L. A.; Anderson, K. E.; Bernstein, L.; De Vivo, I.; Friedenreich, C. M.; Gapstur, S. M.; Goldbohm, R. A.; Henderson, B.; Horn-Ross, P. L.; Kolonel, L.; Lacey, J. V.; Liang, X.; Lissowska, J.; Magliocco, A.; McCullough, M. L.; Miller, A. B.; Olson, S. H.; Palmer, J. R.; Park, Y.; Patel, A. V.; Prescott, J.; Rastogi, R.; Robien, K.; Rosenberg, L.; Schairer, C.; Ou Shu, X.; Van Den Brandt, P. A.; Virkus, R. A.; Wentzensen, N.; Xiang, Y. B.; Xu, W. H.; Yang, H. P.; Brinton, L. A.

In: British Journal of Cancer, Vol. 108, No. 3, 19.02.2013, p. 727-734.

Research output: Contribution to journalArticle

Felix, AS, Cook, LS, Gaudet, MM, Rohan, TE, Schouten, LJ, Setiawan, VW, Wise, LA, Anderson, KE, Bernstein, L, De Vivo, I, Friedenreich, CM, Gapstur, SM, Goldbohm, RA, Henderson, B, Horn-Ross, PL, Kolonel, L, Lacey, JV, Liang, X, Lissowska, J, Magliocco, A, McCullough, ML, Miller, AB, Olson, SH, Palmer, JR, Park, Y, Patel, AV, Prescott, J, Rastogi, R, Robien, K, Rosenberg, L, Schairer, C, Ou Shu, X, Van Den Brandt, PA, Virkus, RA, Wentzensen, N, Xiang, YB, Xu, WH, Yang, HP & Brinton, LA 2013, 'The etiology of uterine sarcomas: A pooled analysis of the epidemiology of endometrial cancer consortium', British Journal of Cancer, vol. 108, no. 3, pp. 727-734. https://doi.org/10.1038/bjc.2013.2
Felix, A. S. ; Cook, L. S. ; Gaudet, M. M. ; Rohan, Thomas E. ; Schouten, L. J. ; Setiawan, V. W. ; Wise, L. A. ; Anderson, K. E. ; Bernstein, L. ; De Vivo, I. ; Friedenreich, C. M. ; Gapstur, S. M. ; Goldbohm, R. A. ; Henderson, B. ; Horn-Ross, P. L. ; Kolonel, L. ; Lacey, J. V. ; Liang, X. ; Lissowska, J. ; Magliocco, A. ; McCullough, M. L. ; Miller, A. B. ; Olson, S. H. ; Palmer, J. R. ; Park, Y. ; Patel, A. V. ; Prescott, J. ; Rastogi, R. ; Robien, K. ; Rosenberg, L. ; Schairer, C. ; Ou Shu, X. ; Van Den Brandt, P. A. ; Virkus, R. A. ; Wentzensen, N. ; Xiang, Y. B. ; Xu, W. H. ; Yang, H. P. ; Brinton, L. A. / The etiology of uterine sarcomas : A pooled analysis of the epidemiology of endometrial cancer consortium. In: British Journal of Cancer. 2013 ; Vol. 108, No. 3. pp. 727-734.
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abstract = "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.",
author = "Felix, {A. S.} and Cook, {L. S.} and Gaudet, {M. M.} and Rohan, {Thomas E.} and Schouten, {L. J.} and Setiawan, {V. W.} and Wise, {L. A.} and Anderson, {K. E.} and L. Bernstein and {De Vivo}, I. and Friedenreich, {C. M.} and Gapstur, {S. M.} and Goldbohm, {R. A.} and B. Henderson and Horn-Ross, {P. L.} and L. Kolonel and Lacey, {J. V.} and X. Liang and J. Lissowska and A. Magliocco and McCullough, {M. L.} and Miller, {A. B.} and Olson, {S. H.} and Palmer, {J. R.} and Y. Park and Patel, {A. V.} and J. Prescott and R. Rastogi and K. Robien and L. Rosenberg and C. Schairer and {Ou Shu}, X. and {Van Den Brandt}, {P. A.} and Virkus, {R. A.} and N. Wentzensen and Xiang, {Y. B.} and Xu, {W. H.} and Yang, {H. P.} and Brinton, {L. A.}",
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TY - JOUR

T1 - The etiology of uterine sarcomas

T2 - A pooled analysis of the epidemiology of endometrial cancer consortium

AU - Felix, A. S.

AU - Cook, L. S.

AU - Gaudet, M. M.

AU - Rohan, Thomas E.

AU - Schouten, L. J.

AU - Setiawan, V. W.

AU - Wise, L. A.

AU - Anderson, K. E.

AU - Bernstein, L.

AU - De Vivo, I.

AU - Friedenreich, C. M.

AU - Gapstur, S. M.

AU - Goldbohm, R. A.

AU - Henderson, B.

AU - Horn-Ross, P. L.

AU - Kolonel, L.

AU - Lacey, J. V.

AU - Liang, X.

AU - Lissowska, J.

AU - Magliocco, A.

AU - McCullough, M. L.

AU - Miller, A. B.

AU - Olson, S. H.

AU - Palmer, J. R.

AU - Park, Y.

AU - Patel, A. V.

AU - Prescott, J.

AU - Rastogi, R.

AU - Robien, K.

AU - Rosenberg, L.

AU - Schairer, C.

AU - Ou Shu, X.

AU - Van Den Brandt, P. A.

AU - Virkus, R. A.

AU - Wentzensen, N.

AU - Xiang, Y. B.

AU - Xu, W. H.

AU - Yang, H. P.

AU - Brinton, L. A.

PY - 2013/2/19

Y1 - 2013/2/19

N2 - 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.

AB - 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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