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dc.contributor.authorTrabert, Britton
dc.contributor.authorTroisi, Rebecca
dc.contributor.authorGrotmol, Tom
dc.contributor.authorEkbom, Anders
dc.contributor.authorEngeland, Anders
dc.contributor.authorGissler, Mika
dc.contributor.authorGlimelius, Ingrid
dc.contributor.authorMadanat-Harjuoja, Laura M.
dc.contributor.authorSørensen, Henrik Toft
dc.contributor.authorTretli, Steinar
dc.contributor.authorOrding, Anne Gulbech
dc.contributor.authorBjørge, Tone
dc.date.accessioned2019-08-22T13:10:12Z
dc.date.available2019-08-22T13:10:12Z
dc.date.issued2019
dc.identifier.citationTrabert B, Troisi R, Grotmol T, Ekbom A, Engeland A, Gissler M, Glimelius I, Madanat-Harjuoja LM, Sørensen HT, Tretli S, Ording AG, Bjørge T. Associations of pregnancy-related factors and birth characteristics with risk of endometrial cancer: A Nordic population-based case-control study. International Journal of Cancer. 2019eng
dc.identifier.urihttp://hdl.handle.net/1956/20710
dc.description.abstractMany pregnancy‐related factors are associated with reduced endometrial cancer risk. However, it remains unclear whether pregnancy‐related complications (e.g., hypertensive conditions) are associated with risk and whether these associations vary by endometrial cancer subtype. Thus, we evaluated the risk of endometrial cancer, overall and by subtype, in relation to pregnancy‐related factors, pregnancy complications and birth characteristics. Utilizing population‐based register data from four Nordic countries, we conducted a nested case–control analysis of endometrial cancer risk. We included 10,924 endometrial cancer cases and up to 10 matched controls per case. Odds ratios (ORs) with 95% confidence intervals (CIs) were derived from unconditional logistic regression models. We further evaluated associations by individual histology (i.e., endometrioid, serous, etc.) or, for rare exposures (e.g., pregnancy complications), by dualistic type (Type I [n = 10,343] and Type II [n = 581]). Preexisting and pregnancy‐related hypertensive conditions were associated with increased endometrial cancer risk (OR [95% CI]: preexisting hypertension 1.88 [1.39–2.55]; gestational hypertension 1.47 [1.33–1.63]; preeclampsia 1.43 [1.30–1.58]), with consistent associations across dualistic type. Increasing number of pregnancies (≥4 vs. 1 birth: 0.64 [0.59–0.69]) and shorter time since last birth (<10 vs. ≥30 years: 0.34 [0.29–0.40]) were associated with reduced endometrial cancer risk, with consistent associations across most subtypes. Our findings support the role for both hormonal exposures and cell clearance as well as immunologic/inflammatory etiologies for endometrial cancer. This research supports studying endometrial hyperplasia, a precursor condition of endometrial cancer, in the context of pregnancy‐related exposures, as this may provide insight into the mechanisms by which pregnancy affects subsequent cancer risk.eng
dc.language.isoengeng
dc.publisherWileyeng
dc.subjectendometrial cancereng
dc.subjectNordic countrieseng
dc.subjectpregnancy timingeng
dc.subjectpreeclampsiaeng
dc.subjecthypertensioneng
dc.titleAssociations of pregnancy-related factors and birth characteristics with risk of endometrial cancer: A Nordic population-based case-control studyeng
dc.typeJournal articleeng
dc.date.updated2019-06-25T09:58:29Z
dc.type.versionacceptedVersioneng
bora.peerreviewedPeer reviewedeng
dc.type.documentJournal article
dc.identifier.cristinID1707472
dc.identifier.doi10.1002/ijc.32494eng
dc.source.issn0020-7136eng
dc.source.issn1097-0215eng
dc.relation.journalInternational Journal of Cancer
dc.rights.termsUnder embargo until: 07.06.2020


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