Type I and II endometrial cancers

have they different risk factors?

Veronica Wendy Setiawan, Hannah P. Yang, Malcolm C. Pike, Susan E. McCann, Herbert Yu, Yong Bing Xiang, Alicja Wolk, Nicolas Wentzensen, Noel S. Weiss, Penelope M. Webb, Piet A. van den Brandt, Koen van de Vijver, Pamela J. Thompson, National Endometrial Cancer Study Group Australian National Endometrial Cancer Study Group, Brian L. Strom, Amanda B. Spurdle, Robert A. Soslow, Xiao ou Shu, Catherine Schairer, Thomas E. Rohan & 42 others Thomas E. Rohan, Kim Robien, Harvey A. Risch, Fulvio Ricceri, Timothy R. Rebbeck, Radhai Rastogi, Jennifer Prescott, Silvia Polidoro, Yikyung Park, Sara H. Olson, Kirsten B. Moysich, Anthony B. Miller, Marjorie L. McCullough, Rayna K. Matsuno, Anthony M. Magliocco, Galina Lurie, Lingeng Lu, Jolanta Lissowska, Xiaolin Liang, James V. Lacey, Laurence N. Kolonel, Brian E. Henderson, Susan E. Hankinson, Niclas Håkansson, Marc T. Goodman, Mia M. Gaudet, Montserrat Garcia-Closas, Christine M. Friedenreich, J. L. Freudenheim, Jennifer Doherty, Immaculata De Vivo, Kerry S. Courneya, Linda S. Cook, Chu Chen, James R. Cerhan, Hui Cai, Louise A. Brinton, Leslie Bernstein, Kristin E. Anderson, Hoda Anton-Culver, Leo J. Schouten, Pamela L. Horn-Ross

Research output: Contribution to journalArticle

271 Citations (Scopus)

Abstract

Endometrial cancers have long been divided into estrogen-dependent type I and the less common clinically aggressive estrogen-independent type II. Little is known about risk factors for type II tumors because most studies lack sufficient cases to study these much less common tumors separately. We examined whether so-called classical endometrial cancer risk factors also influence the risk of type II tumors. Individual-level data from 10 cohort and 14 case-control studies from the Epidemiology of Endometrial Cancer Consortium were pooled. A total of 14,069 endometrial cancer cases and 35,312 controls were included. We classified endometrioid (n = 7,246), adenocarcinoma not otherwise specified (n = 4,830), and adenocarcinoma with squamous differentiation (n = 777) as type I tumors and serous (n = 508) and mixed cell (n = 346) as type II tumors. Parity, oral contraceptive use, cigarette smoking, age at menarche, and diabetes were associated with type I and type II tumors to similar extents. Body mass index, however, had a greater effect on type I tumors than on type II tumors: odds ratio (OR) per 2 kg/m(2) increase was 1.20 (95% CI, 1.19 to 1.21) for type I and 1.12 (95% CI, 1.09 to 1.14) for type II tumors (P heterogeneity < .0001). Risk factor patterns for high-grade endometrioid tumors and type II tumors were similar. The results of this pooled analysis suggest that the two endometrial cancer types share many common etiologic factors. The etiology of type II tumors may, therefore, not be completely estrogen independent, as previously believed.

Original languageEnglish (US)
Pages (from-to)2607-2618
Number of pages12
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology
Volume31
Issue number20
DOIs
StatePublished - Jul 10 2013

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Endometrial Neoplasms
Neoplasms
Estrogens
Adenocarcinoma
Menarche
Oral Contraceptives
Parity
Case-Control Studies
Epidemiology
Body Mass Index
Smoking
Odds Ratio

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Type I and II endometrial cancers : have they different risk factors? / Setiawan, Veronica Wendy; Yang, Hannah P.; Pike, Malcolm C.; McCann, Susan E.; Yu, Herbert; Xiang, Yong Bing; Wolk, Alicja; Wentzensen, Nicolas; Weiss, Noel S.; Webb, Penelope M.; van den Brandt, Piet A.; van de Vijver, Koen; Thompson, Pamela J.; Australian National Endometrial Cancer Study Group, National Endometrial Cancer Study Group; Strom, Brian L.; Spurdle, Amanda B.; Soslow, Robert A.; Shu, Xiao ou; Schairer, Catherine; Rohan, Thomas E.; Rohan, Thomas E.; Robien, Kim; Risch, Harvey A.; Ricceri, Fulvio; Rebbeck, Timothy R.; Rastogi, Radhai; Prescott, Jennifer; Polidoro, Silvia; Park, Yikyung; Olson, Sara H.; Moysich, Kirsten B.; Miller, Anthony B.; McCullough, Marjorie L.; Matsuno, Rayna K.; Magliocco, Anthony M.; Lurie, Galina; Lu, Lingeng; Lissowska, Jolanta; Liang, Xiaolin; Lacey, James V.; Kolonel, Laurence N.; Henderson, Brian E.; Hankinson, Susan E.; Håkansson, Niclas; Goodman, Marc T.; Gaudet, Mia M.; Garcia-Closas, Montserrat; Friedenreich, Christine M.; Freudenheim, J. L.; Doherty, Jennifer; De Vivo, Immaculata; Courneya, Kerry S.; Cook, Linda S.; Chen, Chu; Cerhan, James R.; Cai, Hui; Brinton, Louise A.; Bernstein, Leslie; Anderson, Kristin E.; Anton-Culver, Hoda; Schouten, Leo J.; Horn-Ross, Pamela L.

In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Vol. 31, No. 20, 10.07.2013, p. 2607-2618.

Research output: Contribution to journalArticle

Setiawan, VW, Yang, HP, Pike, MC, McCann, SE, Yu, H, Xiang, YB, Wolk, A, Wentzensen, N, Weiss, NS, Webb, PM, van den Brandt, PA, van de Vijver, K, Thompson, PJ, Australian National Endometrial Cancer Study Group, NECSG, Strom, BL, Spurdle, AB, Soslow, RA, Shu, XO, Schairer, C, Rohan, TE, Rohan, TE, Robien, K, Risch, HA, Ricceri, F, Rebbeck, TR, Rastogi, R, Prescott, J, Polidoro, S, Park, Y, Olson, SH, Moysich, KB, Miller, AB, McCullough, ML, Matsuno, RK, Magliocco, AM, Lurie, G, Lu, L, Lissowska, J, Liang, X, Lacey, JV, Kolonel, LN, Henderson, BE, Hankinson, SE, Håkansson, N, Goodman, MT, Gaudet, MM, Garcia-Closas, M, Friedenreich, CM, Freudenheim, JL, Doherty, J, De Vivo, I, Courneya, KS, Cook, LS, Chen, C, Cerhan, JR, Cai, H, Brinton, LA, Bernstein, L, Anderson, KE, Anton-Culver, H, Schouten, LJ & Horn-Ross, PL 2013, 'Type I and II endometrial cancers: have they different risk factors?', Journal of clinical oncology : official journal of the American Society of Clinical Oncology, vol. 31, no. 20, pp. 2607-2618. https://doi.org/10.1200/JCO.2012.48.2596
Setiawan, Veronica Wendy ; Yang, Hannah P. ; Pike, Malcolm C. ; McCann, Susan E. ; Yu, Herbert ; Xiang, Yong Bing ; Wolk, Alicja ; Wentzensen, Nicolas ; Weiss, Noel S. ; Webb, Penelope M. ; van den Brandt, Piet A. ; van de Vijver, Koen ; Thompson, Pamela J. ; Australian National Endometrial Cancer Study Group, National Endometrial Cancer Study Group ; Strom, Brian L. ; Spurdle, Amanda B. ; Soslow, Robert A. ; Shu, Xiao ou ; Schairer, Catherine ; Rohan, Thomas E. ; Rohan, Thomas E. ; Robien, Kim ; Risch, Harvey A. ; Ricceri, Fulvio ; Rebbeck, Timothy R. ; Rastogi, Radhai ; Prescott, Jennifer ; Polidoro, Silvia ; Park, Yikyung ; Olson, Sara H. ; Moysich, Kirsten B. ; Miller, Anthony B. ; McCullough, Marjorie L. ; Matsuno, Rayna K. ; Magliocco, Anthony M. ; Lurie, Galina ; Lu, Lingeng ; Lissowska, Jolanta ; Liang, Xiaolin ; Lacey, James V. ; Kolonel, Laurence N. ; Henderson, Brian E. ; Hankinson, Susan E. ; Håkansson, Niclas ; Goodman, Marc T. ; Gaudet, Mia M. ; Garcia-Closas, Montserrat ; Friedenreich, Christine M. ; Freudenheim, J. L. ; Doherty, Jennifer ; De Vivo, Immaculata ; Courneya, Kerry S. ; Cook, Linda S. ; Chen, Chu ; Cerhan, James R. ; Cai, Hui ; Brinton, Louise A. ; Bernstein, Leslie ; Anderson, Kristin E. ; Anton-Culver, Hoda ; Schouten, Leo J. ; Horn-Ross, Pamela L. / Type I and II endometrial cancers : have they different risk factors?. In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2013 ; Vol. 31, No. 20. pp. 2607-2618.
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title = "Type I and II endometrial cancers: have they different risk factors?",
abstract = "Endometrial cancers have long been divided into estrogen-dependent type I and the less common clinically aggressive estrogen-independent type II. Little is known about risk factors for type II tumors because most studies lack sufficient cases to study these much less common tumors separately. We examined whether so-called classical endometrial cancer risk factors also influence the risk of type II tumors. Individual-level data from 10 cohort and 14 case-control studies from the Epidemiology of Endometrial Cancer Consortium were pooled. A total of 14,069 endometrial cancer cases and 35,312 controls were included. We classified endometrioid (n = 7,246), adenocarcinoma not otherwise specified (n = 4,830), and adenocarcinoma with squamous differentiation (n = 777) as type I tumors and serous (n = 508) and mixed cell (n = 346) as type II tumors. Parity, oral contraceptive use, cigarette smoking, age at menarche, and diabetes were associated with type I and type II tumors to similar extents. Body mass index, however, had a greater effect on type I tumors than on type II tumors: odds ratio (OR) per 2 kg/m(2) increase was 1.20 (95{\%} CI, 1.19 to 1.21) for type I and 1.12 (95{\%} CI, 1.09 to 1.14) for type II tumors (P heterogeneity < .0001). Risk factor patterns for high-grade endometrioid tumors and type II tumors were similar. The results of this pooled analysis suggest that the two endometrial cancer types share many common etiologic factors. The etiology of type II tumors may, therefore, not be completely estrogen independent, as previously believed.",
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TY - JOUR

T1 - Type I and II endometrial cancers

T2 - have they different risk factors?

AU - Setiawan, Veronica Wendy

AU - Yang, Hannah P.

AU - Pike, Malcolm C.

AU - McCann, Susan E.

AU - Yu, Herbert

AU - Xiang, Yong Bing

AU - Wolk, Alicja

AU - Wentzensen, Nicolas

AU - Weiss, Noel S.

AU - Webb, Penelope M.

AU - van den Brandt, Piet A.

AU - van de Vijver, Koen

AU - Thompson, Pamela J.

AU - Australian National Endometrial Cancer Study Group, National Endometrial Cancer Study Group

AU - Strom, Brian L.

AU - Spurdle, Amanda B.

AU - Soslow, Robert A.

AU - Shu, Xiao ou

AU - Schairer, Catherine

AU - Rohan, Thomas E.

AU - Rohan, Thomas E.

AU - Robien, Kim

AU - Risch, Harvey A.

AU - Ricceri, Fulvio

AU - Rebbeck, Timothy R.

AU - Rastogi, Radhai

AU - Prescott, Jennifer

AU - Polidoro, Silvia

AU - Park, Yikyung

AU - Olson, Sara H.

AU - Moysich, Kirsten B.

AU - Miller, Anthony B.

AU - McCullough, Marjorie L.

AU - Matsuno, Rayna K.

AU - Magliocco, Anthony M.

AU - Lurie, Galina

AU - Lu, Lingeng

AU - Lissowska, Jolanta

AU - Liang, Xiaolin

AU - Lacey, James V.

AU - Kolonel, Laurence N.

AU - Henderson, Brian E.

AU - Hankinson, Susan E.

AU - Håkansson, Niclas

AU - Goodman, Marc T.

AU - Gaudet, Mia M.

AU - Garcia-Closas, Montserrat

AU - Friedenreich, Christine M.

AU - Freudenheim, J. L.

AU - Doherty, Jennifer

AU - De Vivo, Immaculata

AU - Courneya, Kerry S.

AU - Cook, Linda S.

AU - Chen, Chu

AU - Cerhan, James R.

AU - Cai, Hui

AU - Brinton, Louise A.

AU - Bernstein, Leslie

AU - Anderson, Kristin E.

AU - Anton-Culver, Hoda

AU - Schouten, Leo J.

AU - Horn-Ross, Pamela L.

PY - 2013/7/10

Y1 - 2013/7/10

N2 - Endometrial cancers have long been divided into estrogen-dependent type I and the less common clinically aggressive estrogen-independent type II. Little is known about risk factors for type II tumors because most studies lack sufficient cases to study these much less common tumors separately. We examined whether so-called classical endometrial cancer risk factors also influence the risk of type II tumors. Individual-level data from 10 cohort and 14 case-control studies from the Epidemiology of Endometrial Cancer Consortium were pooled. A total of 14,069 endometrial cancer cases and 35,312 controls were included. We classified endometrioid (n = 7,246), adenocarcinoma not otherwise specified (n = 4,830), and adenocarcinoma with squamous differentiation (n = 777) as type I tumors and serous (n = 508) and mixed cell (n = 346) as type II tumors. Parity, oral contraceptive use, cigarette smoking, age at menarche, and diabetes were associated with type I and type II tumors to similar extents. Body mass index, however, had a greater effect on type I tumors than on type II tumors: odds ratio (OR) per 2 kg/m(2) increase was 1.20 (95% CI, 1.19 to 1.21) for type I and 1.12 (95% CI, 1.09 to 1.14) for type II tumors (P heterogeneity < .0001). Risk factor patterns for high-grade endometrioid tumors and type II tumors were similar. The results of this pooled analysis suggest that the two endometrial cancer types share many common etiologic factors. The etiology of type II tumors may, therefore, not be completely estrogen independent, as previously believed.

AB - Endometrial cancers have long been divided into estrogen-dependent type I and the less common clinically aggressive estrogen-independent type II. Little is known about risk factors for type II tumors because most studies lack sufficient cases to study these much less common tumors separately. We examined whether so-called classical endometrial cancer risk factors also influence the risk of type II tumors. Individual-level data from 10 cohort and 14 case-control studies from the Epidemiology of Endometrial Cancer Consortium were pooled. A total of 14,069 endometrial cancer cases and 35,312 controls were included. We classified endometrioid (n = 7,246), adenocarcinoma not otherwise specified (n = 4,830), and adenocarcinoma with squamous differentiation (n = 777) as type I tumors and serous (n = 508) and mixed cell (n = 346) as type II tumors. Parity, oral contraceptive use, cigarette smoking, age at menarche, and diabetes were associated with type I and type II tumors to similar extents. Body mass index, however, had a greater effect on type I tumors than on type II tumors: odds ratio (OR) per 2 kg/m(2) increase was 1.20 (95% CI, 1.19 to 1.21) for type I and 1.12 (95% CI, 1.09 to 1.14) for type II tumors (P heterogeneity < .0001). Risk factor patterns for high-grade endometrioid tumors and type II tumors were similar. The results of this pooled analysis suggest that the two endometrial cancer types share many common etiologic factors. The etiology of type II tumors may, therefore, not be completely estrogen independent, as previously believed.

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