Department of Epidemiology and Public Health, Yale Cancer Center, Yale School of Public Health, New Haven, CT 06520-8034, USA.
Int J Cancer. 2011 Sep 1;129(5):1237-43. doi: 10.1002/ijc.26046. Epub 2011 Apr 25.
Long-term overweight and substantial weight gain over adulthood are known risk factors of endometrial cancer, but the timing of weight gain in relation to risk and the effect of weight change on age at diagnosis remain unclear. A population-based case-control study was conducted to evaluate the long-term effect of body weight on endometrial cancer risk. The study enrolled 668 incident cases and 674 population controls. Anthropometric features in each decade of adult life were ascertained through in-person interview and analyzed for their associations with endometrial cancer using unconditional logistic regression. As expected, high body mass index (BMI) was significantly associated with increased risk. Women who were overweight or obese at the time of interview had adjusted odds ratios of 1.54 (95%CI 1.13-2.10) and 4.76 (95%CI 3.50-6.49), respectively, compared to women of normal weight. Similar associations were observed for BMI assessed at each decade of adult life. More importantly, women who were overweight (BMI ≥ 25) in their 20s or 30s and maintained the overweight throughout life had significantly higher risk than those who became overweight at ages 40s or 50s. Women with substantial weight gain (≥35%) in early adulthood (age 20s) developed the disease 10 years earlier than those without such weight change in early life. These observations further confirm the critical link between body weight and development of endometrial cancer.
长期超重和成年后体重显著增加是子宫内膜癌的已知危险因素，但体重增加与风险的时间关系以及体重变化对诊断年龄的影响仍不清楚。本研究开展了一项基于人群的病例对照研究，以评估体重对子宫内膜癌风险的长期影响。该研究纳入了 668 例新发病例和 674 例人群对照。通过面对面访谈确定了每个成年十年的人体测量特征，并使用非条件逻辑回归分析其与子宫内膜癌的关系。正如预期的那样，高体重指数（BMI）与风险增加显著相关。与体重正常的女性相比，肥胖或超重（BMI≥25）的女性调整后的比值比分别为 1.54（95%CI 1.13-2.10）和 4.76（95%CI 3.50-6.49）。在每个成年十年评估的 BMI 也观察到了类似的关联。更重要的是，20 多岁或 30 多岁超重（BMI≥25）且终生保持超重的女性，其风险明显高于 40 多岁或 50 多岁才超重的女性。在成年早期（20 多岁）体重显著增加（≥35%）的女性比在早期生活中没有这种体重变化的女性发病早 10 年。这些观察结果进一步证实了体重与子宫内膜癌发展之间的关键联系。
