Christina C. Dahm

Theoretical potential for endometrial cancer prevention through primary risk factor modification: Estimates from the EPIC cohort

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • Renée Turzanski Fortner, German Cancer Research Center (DKFZ), Heidelberg, Germany
  • Anika Hüsing, German Cancer Research Center (DKFZ), Heidelberg, Germany
  • Laure Dossus, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France., France
  • Anne Tjønneland, University of Copenhagen, Danish Cancer Society Research Center, Diet, Genes and Environment, Copenhagen, Denmark., Denmark
  • Kim Overvad
  • Christina C Dahm
  • Patrick Arveux, Breast and Gynaecologic Cancer Registry of Côte d'Or, Georges-François Leclerc Cancer Centre, UNICANCER, Dijon, France., Universite Paris-Saclay, Institut Gustave Roussy, Villejuif, France., France
  • Agnès Fournier, Institut Gustave Roussy, Villejuif, France., Universite Paris-Saclay, France
  • Marina Kvaskoff, Institut Gustave Roussy, Villejuif, France., Universite Paris-Saclay, France
  • Matthias B Schulze, German Institute of Human Nutrition Potsdam-Rehbruecke, University of Potsdam, Germany
  • Manuela Bergmann, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany
  • Antonia Trichopoulou, Hellenic Health Foundation, Athens, Greece., Greece
  • Anna Karakatsani, Hellenic Health Foundation, Athens, Greece., National and Kapodistrian University of Athens, Greece
  • Carlo La Vecchia, Hellenic Health Foundation, Athens, Greece., Universita degli Studi di Milano, Italy
  • Giovanna Masala, Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for cancer research, prevention and clinical network (ISPRO), Florence, Italy., Italy
  • Valeria Pala, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy., Italy
  • Amalia Mattiello, Federico II University of Naples, Italy
  • Rosario Tumino, Cancer Registry and Histopathology Department , Provincial Health Authority (ASP), Ragusa, Italy., Italy
  • Fulvio Ricceri, University of Turin, Regional Health Service ASL TO3, Italy
  • Carla H van Gils, Utrecht University, Netherlands
  • Evelyn M Monninkhof, Utrecht University, Netherlands
  • Catalina Bonet, L'Hospitalet de Llobregat, Barcelona, Spain
  • J Ramón Quirós, Public Health Directorate, Asturias, Spain., Spain
  • Maria-Jose Sanchez, Andalusian School of Public Health, Granada, Spain., Instituto de Investigación Biosanitaria (ibs.GRANADA), CIBER Epidemiology and Public Health (CIBERESP), Madrid, Universidad de Granada, Spain
  • Daniel-Ángel Rodríguez-Palacios, Hospital Universitario Reina Sofía, Murcia, Spain., Regional Health Council, Madrid, Spain
  • Aurelio Barricarte, CIBER Epidemiology and Public Health (CIBERESP), Madrid, Navarra Public Health Institute, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain., Spain
  • Pilar Amiano, Public Health Division of Gipuzkoa, Biodonostia Health Research Institute, Ministry of Health of the Basque Government, San Sebastian, Spain., CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
  • Naomi E Allen, University of Oxford, United Kingdom
  • Ruth C Travis, University of Oxford, United Kingdom
  • Marc J Gunter, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France.
  • ,
  • Vivian Viallon, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France., France
  • Elisabete Weiderpass, International Agency for Research on Cancer (IARC-WHO), Lyon, France., France
  • Elio Riboli, Imperial College London, United Kingdom
  • Rudolf Kaaks, German Cancer Research Center (DKFZ), Heidelberg, Germany

Endometrial cancer (EC) incidence rates vary ~10-fold worldwide, in part due to variation in EC risk factor profiles. Using an EC risk model previously developed in the European EPIC cohort, we evaluated the prevention potential of modified EC risk factor patterns and whether differences in EC incidence between a European population and low-risk countries can be explained by differences in these patterns. Predicted EC incidence rates were estimated over 10 years of follow-up for the cohort before and after modifying risk factor profiles. Risk factors considered were: body mass index (BMI, kg/m 2), use of postmenopausal hormone therapy (HT) and oral contraceptives (OC) (potentially modifiable); and, parity, ages at first birth, menarche and menopause (environmentally conditioned, but not readily modifiable). Modeled alterations in BMI (to all ≤23 kg/m 2) and HT use (to all non-HT users) profiles resulted in a 30% reduction in predicted EC incidence rates; individually, longer duration of OC use (to all ≥10 years) resulted in a 42.5% reduction. Modeled changes in not readily modifiable exposures (i.e., those not contributing to prevention potential) resulted in ≤24.6% reduction in predicted EC incidence. Women in the lowest decile of a risk score based on the evaluated exposures had risk similar to a low risk countries; however, this was driven by relatively long use of OCs (median = 23 years). Our findings support avoidance of overweight BMI and of HT use as prevention strategies for EC in a European population; OC use must be considered in the context of benefits and risks.

Original languageEnglish
JournalInternational Journal of Cancer
Volume147
Issue5
Pages (from-to)1325-1333
Number of pages9
ISSN0020-7136
DOIs
Publication statusPublished - Sep 2020

    Research areas

  • endometrial cancer, primary prevention, risk factors, COLORECTAL-CANCER, ORAL-CONTRACEPTIVE USE, NUTRITION, OVARIAN-CANCER, BREAST

See relations at Aarhus University Citationformats

ID: 178936970