Associations of life course obesity with endometrial cancer in the Epidemiology of Endometrial Cancer Consortium (E2C2)

Summer V. Harvey, Nicolas Wentzensen, Kimberly Bertrand, Amanda Black, Louise A. Brinton, Chu Chen, Laura Costas, Luigino Dal Maso, Immaculata De Vivo, Mengmeng Du, Montserrat Garcia-Closas, Marc T. Goodman, Jessica Gorzelitz, Lisa Johnson, James V. Lacey, Linda Liao, Loren Lipworth, Jolanta Lissowska, Anthony B. Miller, Kelli O’ConnellTracy A. O’Mara, Xiao Ou, Julie R. Palmer, Alpa V. Patel, Sonia Paytubi, Beatriz Pelegrina, Stacey Petruzella, Anna Prizment, Thomas Rohan, Sven Sandin, Veronica Wendy Setiawan, Rashmi Sinha, Britton Trabert, Penelope M. Webb, Lynne R. Wilkens, Wanghong Xu, Hannah P. Yang, Wei Zheng, Megan A. Clarke

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background: Adult obesity is a strong risk factor for endometrial cancer (EC); however, associations of early life obesity with EC are inconclusive. We evaluated associations of young adulthood (18–21 years) and adulthood (at enrolment) body mass index (BMI) and weight change with EC risk in the Epidemiology of Endometrial Cancer Consortium (E2C2). Methods: We pooled data from nine case-control and 11 cohort studies in E2C2. We performed multivariable logistic regression analyses to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for BMI (kg/m2) in young adulthood and adulthood, with adjustment for BMI in adulthood and young adulthood, respectively. We evaluated categorical changes in weight (5-kg increments) and BMI from young adulthood to adulthood, and stratified analyses by histology, menopausal status, race and ethnicity, hormone replacement therapy (HRT) use and diabetes. Results: We included 14 859 cases and 40 859 controls. Obesity in adulthood (OR ¼ 2.85, 95% CI ¼ 2.47–3.29) and young adulthood (OR ¼ 1.26, 95% CI ¼ 1.06–1.50) were positively associated with EC risk. Weight gain and BMI gain were positively associated with EC; weight loss was inversely associated with EC. Young adulthood obesity was more strongly associated with EC among cases diagnosed with endometrioid histology, those who were pre/perimenopausal, non-Hispanic White and non-Hispanic Black, among never HRT users and non-diabetics. Conclusions: Young adulthood obesity is associated with EC risk, even after accounting for BMI in adulthood. Weight gain is also associated with EC risk, whereas weight loss is inversely associated. Achieving and maintaining a healthy weight over the life course is important for EC prevention efforts.

Original languageEnglish (US)
Pages (from-to)1086-1099
Number of pages14
JournalInternational journal of epidemiology
Volume52
Issue number4
DOIs
StatePublished - Aug 1 2023

Bibliographical note

Publisher Copyright:
© 2023 Oxford University Press. All rights reserved.

Keywords

  • BMI
  • BMI change
  • Endometrial cancer
  • epidemiology
  • gynaecology
  • life course exposures
  • obesity
  • uterine cancer
  • weight change
  • weight loss

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

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