美国肥胖与子宫内膜样子宫内膜癌的相关趋势。
Associated Trends in Obesity and Endometrioid Endometrial Cancer in the United States.
作者信息
Francoeur Alex A, Liao Cheng-I, Chang Jenny, Johnson Caitlin R, Clair Kiran, Tewari Krishnansu S, Kapp Daniel S, Chan John K, Bristow Robert E
机构信息
Department of Obstetrics and Gynecology and the Department of Medicine, University of California, Irvine, Orange, the Division of Gynecologic Oncology, California Pacific/Palo Alto/Sutter Health Research Institute, San Francisco, and the Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California; and the Department of Obstetrics and Gynecology, Pingtung Veterans Hospital, Pingtung City, Taiwan.
出版信息
Obstet Gynecol. 2025 Mar 1;145(3):e107-e116. doi: 10.1097/AOG.0000000000005814. Epub 2025 Jan 2.
OBJECTIVE
To evaluate the correlation in temporal trends in obesity and endometrioid endometrial cancer incidence in the United States using two comprehensive national databases.
METHODS
This is a cohort study in which data on endometrioid endometrial cancer were obtained from the U.S. Cancer Statistics from 2001 to 2018 and corrected for hysterectomy and pregnancy. Data on obesity were collected from the NHANES (National Health and Nutrition Examination Survey) database from 1988 to 2018. Average annual percentage changes (AAPCs) were used to describe trends. Pearson correlation coefficients ( r ) were calculated to examine the relationship between trends. SEER*Stat 8.3.9.2 and joinpoint regression program 5.2.0 were used for statistical analysis.
RESULTS
From U.S. Cancer Statistics data, 586,742 cases of endometrioid cancer were identified from 2001 to 2018. The average annual increase in endometrioid cancer was as follows: Hispanic 1.37% (95% CI, 1.14-1.60, P <.001), Black 1.30% (95% CI, 1.04-1.57, P <.001), and White -0.17 (95% CI, -0.91 to 0.58, P =.656). Women aged 20-29 years had a 4.48% annual increase (95% CI, 3.72-5.25, P <.001) and women aged 30-39 years had a 3.00% annual increase in rates (95% CI, 2.65-3.36, P <.001). According to the NHANES data, the prevalence of obesity in 2018 in adult women was as follows: Black 56.80%, Hispanic 44.10%, and White 40.90%. An examination of trends by age showed that women aged 20-29 years had the highest annual rise in obesity compared with other age groups (AAPC 7.36%, 95% CI, 4.0-10.8, P <.05). Strong and statistically significant correlations between endometrioid cancer and obesity trends were noted for Black ( r =0.78, P =.01) and Hispanic ( r =0.91, P <.001) women, as well as women aged 20-29 years ( r =0.72, P =.03) and 30-39 years ( r =0.88, P =.001).
CONCLUSION
The current data demonstrate a temporal association between the increasing incidence of obesity and endometrioid endometrial cancer, and this effect disproportionately affects younger women and Black and Hispanic women.
目的
使用两个全面的国家数据库评估美国肥胖症与子宫内膜样子宫内膜癌发病率的时间趋势相关性。
方法
这是一项队列研究，其中子宫内膜样子宫内膜癌的数据取自2001年至2018年的美国癌症统计数据，并针对子宫切除术和妊娠进行了校正。肥胖数据收集自1988年至2018年的美国国家健康与营养检查调查（NHANES）数据库。使用平均年度百分比变化（AAPC）来描述趋势。计算Pearson相关系数（r）以检验趋势之间的关系。使用SEER*Stat 8.3.9.2和Joinpoint回归程序5.2.0进行统计分析。
结果
根据美国癌症统计数据，2001年至2018年共确诊586,742例子宫内膜样癌病例。子宫内膜样癌的年均增长率如下：西班牙裔为1.37%（95%CI，1.14-1.60，P<.001），黑人1.30%（95%CI，1.04-1.57，P<.001），白人-0.17（95%CI，-0.91至0.58，P=.656）。20-29岁女性的年增长率为4.48%（95%CI，3.72-5.25，P<.001），30-39岁女性的年增长率为3.00%（95%CI，2.65-3.36，P<.001）。根据NHANES数据，2018年成年女性肥胖症患病率如下：黑人56.80%，西班牙裔44.1%，白人40.9%。按年龄检查趋势显示，与其他年龄组相比，20-29岁女性的肥胖年增长率最高（AAPC 7.36%，95%CI，4.0-10.8，P<.05）。黑人（r=0.78，P=.01）、西班牙裔（r=0.91，P<.001）女性以及20-29岁（r=0.72，P=.03）和30-39岁（r=0.88，P=.001）女性的子宫内膜样癌与肥胖趋势之间存在强且具有统计学意义的相关性。
结论
当前数据表明肥胖症发病率上升与子宫内膜样子宫内膜癌之间存在时间关联，且这种影响对年轻女性以及黑人和西班牙裔女性的影响尤为严重。
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