Cote Michele L, Alhajj Tala, Ruterbusch Julie J, Bernstein Leslie, Brinton Louise A, Blot William J, Chen Chu, Gass Margery, Gaussoin Sarah, Henderson Brian, Lee Eunjung, Horn-Ross Pamela L, Kolonel Laurence N, Kaunitz Andrew, Liang Xiaolin, Nicholson Wanda K, Park Amy B, Petruzella Stacey, Rebbeck Timothy R, Setiawan V Wendy, Signorello Lisa B, Simon Michael S, Weiss Noel S, Wentzensen Nicolas, Yang Hannah P, Zeleniuch-Jacquotte Anne, Olson Sara H
Department of Oncology, Wayne State University School of Medicine, 4100 John R. Mailstop: MM04EP, Detroit, MI, 48201, USA.
Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, USA.
Cancer Causes Control. 2015 Feb;26(2):287-296. doi: 10.1007/s10552-014-0510-3. Epub 2014 Dec 23.
Endometrial cancer (EC) is the most common gynecologic cancer in the USA. Over the last decade, the incidence rate has been increasing, with a larger increase among blacks. The aim of this study was to compare risk factors for EC in black and white women.
Data from seven cohort and four case-control studies were pooled. Unconditional logistic regression was used to estimate adjusted odds ratios (OR) and 95 % confidence intervals for each risk factor in blacks and whites separately.
Data were pooled for 2,011 black women (516 cases and 1,495 controls) and 19,297 white women (5,693 cases and 13,604 controls). BMI ≥ 30 was associated with an approximate threefold increase in risk of EC in both black and white women (ORblack 2.93, 95 % CI 2.11, 4.07 and ORwhite 2.99, 95 % CI 2.74, 3.26). Diabetes was associated with a 30-40 % increase in risk among both groups. Increasing parity was associated with decreasing risk of EC in blacks and whites (p value = 0.02 and <0.001, respectively). Current and former smoking was associated with decreased risk of EC among all women. Both black and white women who used oral contraceptives for 10 +years were also at reduced risk of EC (OR 0.49, 95 % CI 0.27, 0.88 and OR 0.69, 95 % CI 0.58, 0.83, respectively). Previous history of hypertension was not associated with EC risk in either group.
The major known risk factors for EC exert similar effects on black and white women. Differences in the incidence rates between the two populations may be due to differences in the prevalence of risk factors.
子宫内膜癌（EC）是美国最常见的妇科癌症。在过去十年中，其发病率一直在上升，黑人的上升幅度更大。本研究的目的是比较黑人和白人女性患EC的风险因素。
汇总了七项队列研究和四项病例对照研究的数据。采用无条件逻辑回归分别估计黑人和白人中各风险因素的调整优势比（OR）及95%置信区间。
汇总了2011名黑人女性（516例病例和1495名对照）和19297名白人女性（5693例病例和13604名对照）的数据。体重指数（BMI）≥30与黑人和白人女性患EC风险增加约三倍相关（黑人OR为2.93，95%置信区间为2.11至4.07；白人OR为2.99，95%置信区间为2.74至3.26）。糖尿病与两组人群风险增加30%-40%相关。生育次数增加与黑人和白人患EC风险降低相关（p值分别为0.02和<0.001）。当前和既往吸烟与所有女性患EC风险降低相关。使用口服避孕药10年以上的黑人和白人女性患EC风险也降低（OR分别为0.49，95%置信区间为0.27至0.88；OR为0.69，95%置信区间为0.58至0.83）。两组中既往高血压病史均与EC风险无关。
已知的EC主要风险因素对黑人和白人女性的影响相似。两个人群发病率的差异可能归因于风险因素流行率的差异。
