The etiology of uterine sarcomas: A pooled analysis of the epidemiology of endometrial cancer consortium

A. S. Felix; L. S. Cook; M. M. Gaudet; T. E. Rohan; L. J. Schouten; V. W. Setiawan; L. A. Wise; K. E. Anderson; L. Bernstein; I. De Vivo; C. M. Friedenreich; S. M. Gapstur; R. A. Goldbohm; B. Henderson; P. L. Horn-Ross; L. Kolonel; J. V. Lacey; X. Liang; J. Lissowska; A. Magliocco; M. L. McCullough; A. B. Miller; S. H. Olson; J. R. Palmer; Y. Park; A. V. Patel; J. Prescott; R. Rastogi; K. Robien; L. Rosenberg; C. Schairer; X. Ou Shu; P. A. Van Den Brandt; R. A. Virkus; N. Wentzensen; Y. B. Xiang; W. H. Xu; H. P. Yang; L. A. Brinton

doi:10.1038/bjc.2013.2

The etiology of uterine sarcomas: A pooled analysis of the epidemiology of endometrial cancer consortium

A. S. Felix, L. S. Cook, M. M. Gaudet, T. E. Rohan, L. J. Schouten, V. W. Setiawan, L. A. Wise, K. E. Anderson, L. Bernstein, I. De Vivo, C. M. Friedenreich, S. M. Gapstur, R. A. Goldbohm, B. Henderson, P. L. Horn-Ross, L. Kolonel, J. V. Lacey, X. Liang, J. Lissowska, A. MaglioccoM. L. McCullough, A. B. Miller, S. H. Olson, J. R. Palmer, Y. Park, A. V. Patel, J. Prescott, R. Rastogi, K. Robien, L. Rosenberg, C. Schairer, X. Ou Shu, P. A. Van Den Brandt, R. A. Virkus, N. Wentzensen, Y. B. Xiang, W. H. Xu, H. P. Yang, L. A. Brinton

Epidemiology & Population Health

Research output: Contribution to journal › Article › peer-review

64 Scopus citations

Abstract

Background: Uterine sarcomas are characterised by early age at diagnosis, poor prognosis, and higher incidence among Black compared with White women, but their aetiology is poorly understood. Therefore, we performed a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We also examined risk factor associations for malignant mixed mullerian tumours (MMMTs) and endometrioid endometrial carcinomas (EECs) for comparison purposes. Methods: We pooled data on 229 uterine sarcomas, 244 MMMTs, 7623 EEC cases, and 28 829 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) for risk factors associated with uterine sarcoma, MMMT, and EEC were estimated with polytomous logistic regression. We also examined associations between epidemiological factors and histological subtypes of uterine sarcoma. Results: Significant risk factors for uterine sarcoma included obesity (body mass index (BMI)≥30 vs BMI<25 kg m-2 (OR: 1.73, 95% CI: 1.22-2.46), P-trend=0.008) and history of diabetes (OR: 2.33, 95% CI: 1.41-3.83). Older age at menarche was inversely associated with uterine sarcoma risk (≥15 years vs <11 years (OR: 0.70, 95% CI: 0.34-1.44), P-trend: 0.04). BMI was significantly, but less strongly related to uterine sarcomas compared with EECs (OR: 3.03, 95% CI: 2.82-3.26) or MMMTs (OR: 2.25, 95% CI: 1.60-3.15, P-heterogeneity=0.01). Conclusion: In the largest aetiological study of uterine sarcomas, associations between menstrual, hormonal, and anthropometric risk factors and uterine sarcoma were similar to those identified for EEC. Further exploration of factors that might explain patterns of age-and race-specific incidence rates for uterine sarcoma are needed.

Original language	English (US)
Pages (from-to)	727-734
Number of pages	8
Journal	British Journal of Cancer
Volume	108
Issue number	3
DOIs	https://doi.org/10.1038/bjc.2013.2
State	Published - Feb 19 2013

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Oncology
Cancer Research

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10.1038/bjc.2013.2

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Felix, A. S., Cook, L. S., Gaudet, M. M., Rohan, T. E., Schouten, L. J., Setiawan, V. W., Wise, L. A., Anderson, K. E., Bernstein, L., De Vivo, I., Friedenreich, C. M., Gapstur, S. M., Goldbohm, R. A., Henderson, B., Horn-Ross, P. L., Kolonel, L., Lacey, J. V., Liang, X., Lissowska, J., ... Brinton, L. A. (2013). The etiology of uterine sarcomas: A pooled analysis of the epidemiology of endometrial cancer consortium. British Journal of Cancer, 108(3), 727-734. https://doi.org/10.1038/bjc.2013.2

Felix, AS, Cook, LS, Gaudet, MM, Rohan, TE, Schouten, LJ, Setiawan, VW, Wise, LA, Anderson, KE, Bernstein, L, De Vivo, I, Friedenreich, CM, Gapstur, SM, Goldbohm, RA, Henderson, B, Horn-Ross, PL, Kolonel, L, Lacey, JV, Liang, X, Lissowska, J, Magliocco, A, McCullough, ML, Miller, AB, Olson, SH, Palmer, JR, Park, Y, Patel, AV, Prescott, J, Rastogi, R, Robien, K, Rosenberg, L, Schairer, C, Ou Shu, X, Van Den Brandt, PA, Virkus, RA, Wentzensen, N, Xiang, YB, Xu, WH, Yang, HP & Brinton, LA 2013, 'The etiology of uterine sarcomas: A pooled analysis of the epidemiology of endometrial cancer consortium', British Journal of Cancer, vol. 108, no. 3, pp. 727-734. https://doi.org/10.1038/bjc.2013.2

@article{dacffed299cf4896b18de9ec8c2a17b6,

title = "The etiology of uterine sarcomas: A pooled analysis of the epidemiology of endometrial cancer consortium",

abstract = "Background: Uterine sarcomas are characterised by early age at diagnosis, poor prognosis, and higher incidence among Black compared with White women, but their aetiology is poorly understood. Therefore, we performed a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We also examined risk factor associations for malignant mixed mullerian tumours (MMMTs) and endometrioid endometrial carcinomas (EECs) for comparison purposes. Methods: We pooled data on 229 uterine sarcomas, 244 MMMTs, 7623 EEC cases, and 28 829 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) for risk factors associated with uterine sarcoma, MMMT, and EEC were estimated with polytomous logistic regression. We also examined associations between epidemiological factors and histological subtypes of uterine sarcoma. Results: Significant risk factors for uterine sarcoma included obesity (body mass index (BMI)≥30 vs BMI<25 kg m-2 (OR: 1.73, 95% CI: 1.22-2.46), P-trend=0.008) and history of diabetes (OR: 2.33, 95% CI: 1.41-3.83). Older age at menarche was inversely associated with uterine sarcoma risk (≥15 years vs <11 years (OR: 0.70, 95% CI: 0.34-1.44), P-trend: 0.04). BMI was significantly, but less strongly related to uterine sarcomas compared with EECs (OR: 3.03, 95% CI: 2.82-3.26) or MMMTs (OR: 2.25, 95% CI: 1.60-3.15, P-heterogeneity=0.01). Conclusion: In the largest aetiological study of uterine sarcomas, associations between menstrual, hormonal, and anthropometric risk factors and uterine sarcoma were similar to those identified for EEC. Further exploration of factors that might explain patterns of age-and race-specific incidence rates for uterine sarcoma are needed.",

author = "Felix, {A. S.} and Cook, {L. S.} and Gaudet, {M. M.} and Rohan, {T. E.} and Schouten, {L. J.} and Setiawan, {V. W.} and Wise, {L. A.} and Anderson, {K. E.} and L. Bernstein and {De Vivo}, I. and Friedenreich, {C. M.} and Gapstur, {S. M.} and Goldbohm, {R. A.} and B. Henderson and Horn-Ross, {P. L.} and L. Kolonel and Lacey, {J. V.} and X. Liang and J. Lissowska and A. Magliocco and McCullough, {M. L.} and Miller, {A. B.} and Olson, {S. H.} and Palmer, {J. R.} and Y. Park and Patel, {A. V.} and J. Prescott and R. Rastogi and K. Robien and L. Rosenberg and C. Schairer and {Ou Shu}, X. and {Van Den Brandt}, {P. A.} and Virkus, {R. A.} and N. Wentzensen and Xiang, {Y. B.} and Xu, {W. H.} and Yang, {H. P.} and Brinton, {L. A.}",

note = "Funding Information: This research was supported by the Intramural Research Program of the National Cancer Institute, National Institutes of Health.",

year = "2013",

month = feb,

day = "19",

doi = "10.1038/bjc.2013.2",

language = "English (US)",

volume = "108",

pages = "727--734",

journal = "British Journal of Cancer",

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number = "3",

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TY - JOUR

T1 - The etiology of uterine sarcomas

T2 - A pooled analysis of the epidemiology of endometrial cancer consortium

AU - Felix, A. S.

AU - Cook, L. S.

AU - Gaudet, M. M.

AU - Rohan, T. E.

AU - Schouten, L. J.

AU - Setiawan, V. W.

AU - Wise, L. A.

AU - Anderson, K. E.

AU - Bernstein, L.

AU - De Vivo, I.

AU - Friedenreich, C. M.

AU - Gapstur, S. M.

AU - Goldbohm, R. A.

AU - Henderson, B.

AU - Horn-Ross, P. L.

AU - Kolonel, L.

AU - Lacey, J. V.

AU - Liang, X.

AU - Lissowska, J.

AU - Magliocco, A.

AU - McCullough, M. L.

AU - Miller, A. B.

AU - Olson, S. H.

AU - Palmer, J. R.

AU - Park, Y.

AU - Patel, A. V.

AU - Prescott, J.

AU - Rastogi, R.

AU - Robien, K.

AU - Rosenberg, L.

AU - Schairer, C.

AU - Ou Shu, X.

AU - Van Den Brandt, P. A.

AU - Virkus, R. A.

AU - Wentzensen, N.

AU - Xiang, Y. B.

AU - Xu, W. H.

AU - Yang, H. P.

AU - Brinton, L. A.

N1 - Funding Information: This research was supported by the Intramural Research Program of the National Cancer Institute, National Institutes of Health.

PY - 2013/2/19

Y1 - 2013/2/19

N2 - Background: Uterine sarcomas are characterised by early age at diagnosis, poor prognosis, and higher incidence among Black compared with White women, but their aetiology is poorly understood. Therefore, we performed a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We also examined risk factor associations for malignant mixed mullerian tumours (MMMTs) and endometrioid endometrial carcinomas (EECs) for comparison purposes. Methods: We pooled data on 229 uterine sarcomas, 244 MMMTs, 7623 EEC cases, and 28 829 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) for risk factors associated with uterine sarcoma, MMMT, and EEC were estimated with polytomous logistic regression. We also examined associations between epidemiological factors and histological subtypes of uterine sarcoma. Results: Significant risk factors for uterine sarcoma included obesity (body mass index (BMI)≥30 vs BMI<25 kg m-2 (OR: 1.73, 95% CI: 1.22-2.46), P-trend=0.008) and history of diabetes (OR: 2.33, 95% CI: 1.41-3.83). Older age at menarche was inversely associated with uterine sarcoma risk (≥15 years vs <11 years (OR: 0.70, 95% CI: 0.34-1.44), P-trend: 0.04). BMI was significantly, but less strongly related to uterine sarcomas compared with EECs (OR: 3.03, 95% CI: 2.82-3.26) or MMMTs (OR: 2.25, 95% CI: 1.60-3.15, P-heterogeneity=0.01). Conclusion: In the largest aetiological study of uterine sarcomas, associations between menstrual, hormonal, and anthropometric risk factors and uterine sarcoma were similar to those identified for EEC. Further exploration of factors that might explain patterns of age-and race-specific incidence rates for uterine sarcoma are needed.

AB - Background: Uterine sarcomas are characterised by early age at diagnosis, poor prognosis, and higher incidence among Black compared with White women, but their aetiology is poorly understood. Therefore, we performed a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We also examined risk factor associations for malignant mixed mullerian tumours (MMMTs) and endometrioid endometrial carcinomas (EECs) for comparison purposes. Methods: We pooled data on 229 uterine sarcomas, 244 MMMTs, 7623 EEC cases, and 28 829 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) for risk factors associated with uterine sarcoma, MMMT, and EEC were estimated with polytomous logistic regression. We also examined associations between epidemiological factors and histological subtypes of uterine sarcoma. Results: Significant risk factors for uterine sarcoma included obesity (body mass index (BMI)≥30 vs BMI<25 kg m-2 (OR: 1.73, 95% CI: 1.22-2.46), P-trend=0.008) and history of diabetes (OR: 2.33, 95% CI: 1.41-3.83). Older age at menarche was inversely associated with uterine sarcoma risk (≥15 years vs <11 years (OR: 0.70, 95% CI: 0.34-1.44), P-trend: 0.04). BMI was significantly, but less strongly related to uterine sarcomas compared with EECs (OR: 3.03, 95% CI: 2.82-3.26) or MMMTs (OR: 2.25, 95% CI: 1.60-3.15, P-heterogeneity=0.01). Conclusion: In the largest aetiological study of uterine sarcomas, associations between menstrual, hormonal, and anthropometric risk factors and uterine sarcoma were similar to those identified for EEC. Further exploration of factors that might explain patterns of age-and race-specific incidence rates for uterine sarcoma are needed.

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The etiology of uterine sarcomas: A pooled analysis of the epidemiology of endometrial cancer consortium

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