Risk of endometrial cancer in relationship to cigarette smoking: results from the EPIC study.

TitleRisk of endometrial cancer in relationship to cigarette smoking: results from the EPIC study.
Publication TypeJournal Article
Year of Publication2007
AuthorsAl-Zoughool, M, Dossus, L, Kaaks, R, Clavel-Chapelon, F, Tjønneland, A, Olsen, A, Overvad, K, Boutron-Ruault, M-C, Gauthier, E, Linseisen, J, Chang-Claude, J, Boeing, H, Schulz, M, Trichopoulou, A, Chryssa, T, Trichopoulos, D, Berrino, F, Palli, D, Mattiello, A, Tumino, R, Sacerdote, C, H Bueno-de-Mesquita, B, Boshuizen, HC, Peeters, PHM, Gram, IT, Braaten, T, Lund, iv, E, Chirlaque, M-D, Ardanaz, E, Agudo, A, Larrañaga, N, Quirós, JRamón, Berglund, G, Manjer, J, Lundin, E, Hallmans, G, Khaw, K-T, Bingham, S, Allen, N, Key, T, Jenab, M, Cust, AE, Rinaldi, S, Riboli, E
JournalInt J Cancer
Volume121
Issue12
Pagination2741-7
Date Published2007 Dec 15
ISSN1097-0215
KeywordsAdult, Age Factors, Aged, Endometrial Neoplasms, Europe, Female, Humans, Middle Aged, Models, Statistical, Odds Ratio, Postmenopause, Premenopause, Prospective Studies, Risk Factors, Smoking, Surveys and Questionnaires, Time Factors
Abstract

Current epidemiologic evidence indicates that cigarette smoking reduces the risk of endometrial cancer. We examined data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to analyze further aspects of the smoking-endometrial cancer relationship, such as possible modifying effects of menopausal status, HRT use, BMI and parity. In a total of 249,986 women with smoking exposure and menopausal status information, 619 incident endometrial cancer cases were identified during 1.56 million person-years of follow-up. Among postmenopausal women, the hazard ratio (HR) for current smokers versus never smokers was 0.70 (95% CI = 0.53-0.93), while it was 1.75 (95% CI = 1.13-2.70) among premenopausal women at recruitment. After adjustment for risk factors, the HR for postmenopausal women was slightly attenuated to 0.78 (95% CI = 0.59-1.03). No heterogeneity of effect was observed with HRT use or BMI. Among premenopausal women, current smokers of more than 15 cigarettes per day or who smoked for 30 years or more at the time of recruitment had a more than 2-fold increased risk of endometrial cancer compared to never smokers (HR = 2.54; 95% CI = 1.47-4.38 and HR = 2.23; 95% CI = 1.04-4.77, respectively). Past smoking was not associated with endometrial cancer risk, either among pre- or postmenopausal women. In this prospective study, we observed an increased risk of endometrial cancer with cigarette smoking in premenopausal women. The reduction of endometrial cancer risk observed among postmenopausal women does not have direct public health relevance since cigarette smoking is the main known risk factor for cancer.

DOI10.1002/ijc.22990
Alternate JournalInt. J. Cancer
Citation Key10.1002/ijc.22990
PubMed ID17657712
Grant ListG0401527 / / Medical Research Council / United Kingdom
/ / Wellcome Trust / United Kingdom