University of Manitoba and CancerCare Manitoba, Winnipeg, Manitoba, Canada.
J Clin Oncol. 2013 Jun 1;31(16):2010-5. doi: 10.1200/JCO.2012.47.6481. Epub 2013 Apr 8.
Site-specific risk of colorectal cancer (CRC) among survivors of endometrial cancer (EC) is not known. The objective of the present study was to assess the risk of CRC (overall and subsite specific) among EC survivors.
A historical cohort study was performed by linking the Manitoba Cancer Registry and the Manitoba Health administrative databases. Each subject diagnosed with EC as her first cancer between 1987 and 2008 was age matched with up to five women with no history of invasive cancer on the index date (date of EC diagnosis). All subjects were followed up to the date of diagnosis of CRC or another cancer, death, migration, or study end point (December 31, 2009). Competing-risk proportional hazards models were used to compare the CRC incidence rates with adjustment for age, history of lower gastrointestinal endoscopy, and socioeconomic status. There were three mutually exclusive (and competing) outcomes: CRC, another primary cancer, and death.
A total of 3,115 women with EC and 15,084 without EC were followed up for a total of 145,502 person-years. Women diagnosed with EC at age ≤ 50 years had an increased risk of being diagnosed with CRC (all CRC: hazard ratio [HR] = 4.41; 95% CI, 1.47 to 13.26; right-sided CRC: HR = 7.48; 95% CI, 1.29 to 43.28). There was no increased risk of all CRC among women 51 to 65 years of age or those older than 65 years at the time of EC diagnosis. However, women 51 to 65 years of age at EC diagnosis had an increased risk of right-sided CRC (HR = 2.30; 95% CI, 1.05 to 5.01).
This study suggests young women (age ≤ 50 years) with EC are at increased risk of CRC; risk of right-sided CRC is also increased in women 51 to 65 years old at EC diagnosis.
子宫内膜癌（EC）幸存者的结直肠癌（CRC）特定部位风险尚不清楚。本研究的目的是评估 EC 幸存者（总体和特定部位）的 CRC（总体和特定部位）风险。
通过链接曼尼托巴癌症登记处和曼尼托巴卫生管理数据库进行了一项历史性队列研究。每位在 1987 年至 2008 年间首次被诊断患有 EC 的患者，均在索引日期（EC 诊断日期）与至多五位无侵袭性癌症病史的女性相匹配。所有患者均随访至 CRC 或另一种癌症的诊断、死亡、移民或研究终点（2009 年 12 月 31 日）。使用竞争风险比例风险模型，根据年龄、下消化道内窥镜检查史和社会经济地位调整后，比较 CRC 发病率。有三个相互排斥（且竞争）的结局：CRC、另一种原发性癌症和死亡。
共对 3115 名患有 EC 的女性和 15084 名未患有 EC 的女性进行了随访，随访总人数为 145502 人年。年龄≤50 岁诊断为 EC 的女性诊断为 CRC 的风险增加（所有 CRC：风险比 [HR] = 4.41；95%CI，1.47 至 13.26；右侧 CRC：HR = 7.48；95%CI，1.29 至 43.28）。年龄在 51 至 65 岁之间或在 EC 诊断时年龄大于 65 岁的女性，CRC 的风险没有增加。然而，在 EC 诊断时年龄在 51 至 65 岁之间的女性，右侧 CRC 的风险增加（HR = 2.30；95%CI，1.05 至 5.01）。
这项研究表明，患有 EC 的年轻女性（年龄≤50 岁）患 CRC 的风险增加；在 EC 诊断时年龄在 51 至 65 岁之间的女性中，右侧 CRC 的风险也增加。
