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

Autor: Patrick Arveux, Elio Riboli, Carla H. van Gils, Marina Kvaskoff, Rudolf Kaaks, María José Sánchez, Kim Overvad, Pilar Amiano, Naomi E. Allen, Elisabete Weiderpass, Christina C. Dahm, Catalina Bonet, Carlo La Vecchia, Giovanna Masala, Amalia Mattiello, José Ramón Quirós, Manuela M. Bergmann, Matthias B. Schulze, Marc J. Gunter, Anna Karakatsani, Daniel Ángel Rodríguez-Palacios, Vivian Viallon, Valeria Pala, Ruth C. Travis, Renée T. Fortner, Fulvio Ricceri, Rosario Tumino, Antonia Trichopoulou, Evelyn M. Monninkhof, Anne Tjønneland, Laure Dossus, Agnès Fournier, Aurelio Barricarte Gurrea, Anika Hüsing
Přispěvatelé: Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Cancer Research Foundation in Northern Sweden Ministerie van Volksgezondheid, Welzijn en Sport, VWS Deutsche Krebshilfe Cancer Research UK, CRUK: C8221/A19170, C570/A16491 Vetenskapsrådet, VR Ministerie van Volksgezondheid, Welzijn en Sport, VWS Ligue Contre le Cancer German Cancer Research Center, DKFZ Bundesministerium für Bildung und Forschung, BMBF Bundesministerium für Bildung und Forschung, BMBF Kræftens Bekæmpelse, DCS German Cancer Research Center, DKFZ Associazione Italiana per la Ricerca sul Cancro, AIRC National Research Council, NRC Mutuelle Générale de l'Education Nationale, MGEN Hellenic Health Foundation, HHF Institut National de la Santé et de la Recherche Médicale, Inserm Fondation Gustave Roussy European Commission, EC Centre International de Recherche sur le Cancer, IARC RD06/0020 German Cancer Research Center, DKFZ Deutsche Krebshilfe Cancerfonden World Cancer Research Fund, WCRF: ERC‐2009‐AdG 232997 PI13/01162, PI13/00061 NordForsk Medical Research Council, MRC: MR/M012190/1, The coordination of EPIC is financially supported by the European Commission (DG‐SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany), the Hellenic Health Foundation (Greece), Associazione Italiana per la Ricerca sul Cancro‐AIRC‐Italy and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands), ERC‐2009‐AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway), Health Research Fund (FIS), PI13/00061 to Granada, PI13/01162 to EPIC‐Murcia), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII RETIC (RD06/0020) (Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten, The Cancer Research Foundation of Northern Sweden (Sweden), Cancer Research UK (C570/A16491 and C8221/A19170), Medical Research Council (MR/M012190/1) (EPIC‐Oxford, United Kingdom). The EPIC‐Norfolk study (doi: 10.22025/2019.10.105.00004) has received funding from the Medical Research Council (MR/N003284/1 and MC‐UU_12015/1) and Cancer Research UK (C864/A14136). We are grateful to all the participants who have been part of the project and to the many members of the study teams at the University of Cambridge who have enabled this research. For information on how to submit an application for gaining access to EPIC data and/or biospecimens, please follow the instructions at http://epic.iarc.fr/access/index.php .
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Dipòsit Digital de la UB
Universidad de Barcelona
Fortner, R T, Hüsing, A, Dossus, L, Tjønneland, A, Overvad, K, Dahm, C C, Arveux, P, Fournier, A, Kvaskoff, M, Schulze, M B, Bergmann, M, Trichopoulou, A, Karakatsani, A, La Vecchia, C, Masala, G, Pala, V, Mattiello, A, Tumino, R, Ricceri, F, van Gils, C H, Monninkhof, E M, Bonet, C, Quirós, J R, Sanchez, M-J, Rodríguez-Palacios, D-Á, Barricarte, A, Amiano, P, Allen, N E, Travis, R C, Gunter, M J, Viallon, V, Weiderpass, E, Riboli, E & Kaaks, R 2020, ' Theoretical potential for endometrial cancer prevention through primary risk factor modification : Estimates from the EPIC cohort ', International Journal of Cancer, vol. 147, no. 5, pp. 1325-1333 . https://doi.org/10.1002/ijc.32901
Fortner, R T, Hüsing, A, Dossus, L, Tjønneland, A, Overvad, K, Dahm, C C, Arveux, P, Fournier, A, Kvaskoff, M, Schulze, M B, Bergmann, M, Trichopoulou, A, Karakatsani, A, La Vecchia, C, Masala, G, Pala, V, Mattiello, A, Tumino, R, Ricceri, F, van Gils, C H, Monninkhof, E M, Bonet, C, Quirós, J R, Sanchez, M-J, Rodríguez-Palacios, D-Á, Gurrea, A B, Amiano, P, Allen, N E, Travis, R C, Gunter, M J, Viallon, V, Weiderpass, E, Riboli, E & Kaaks, R 2020, ' Theoretical potential for endometrial cancer prevention through primary risk factor modification : Estimates from the EPIC cohort ', International Journal of Cancer, vol. 147, no. 5, pp. 1325-1333 . https://doi.org/10.1002/ijc.32901
International Journal of Cancer
International Journal of Cancer, Wiley, 2020, 147 (5), pp.1325-1333. ⟨10.1002/ijc.32901⟩
Fortner, R T, Hüsing, A, Dossus, L, Tjønneland, A, Overvad, K, Dahm, C C, Arveux, P, Fournier, A, Kvaskoff, M, Schulze, M B, Bergmann, M, Trichopoulou, A, Karakatsani, A, La Vecchia, C, Masala, G, Pala, V, Mattiello, A, Tumino, R, Ricceri, F, van Gils, C H, Monninkhof, E M, Bonet, C, Quirós, J R, Sanchez, M-J, Rodriguez-Palacios, D-Á, Gurrea, A B, Amiano, P, Allen, N E, Travis, R C, Gunter, M J, Viallon, V, Weiderpass, E, Riboli, E & Kaaks, R 2020, ' Theoretical potential for endometrial cancer prevention through primary risk factor modification : Estimates from the EPIC cohort ', International Journal of Cancer, vol. 147, no. 5, pp. 1325-1333 . https://doi.org/10.1002/ijc.32901
ISSN: 0020-7136
1097-0215
Popis: 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/m2), 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/m2) 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.
What's new? Endometrial cancer rates vary considerably around the world, with incidence rates higher in Europe and North America than in parts of Asia and Africa. Here, the authors investigated how much of the risk disparity arises from modifiable factors, and how much modifying these factors could reduce cancer incidence. The 10% of European women with lowest risk had similar incidence to women in low‐risk countries, they found. Their model predicted that in European women, maintaining BMI below 23 kg/m2 and avoiding postmenopausal hormone use could reduce risk by 30%. Long‐term use of oral contraceptives could reduce risk by 42.5%.
Databáze: OpenAIRE
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