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dc.contributor.authorTrabert, Brittonen_US
dc.contributor.authorTroisi, Rebeccaen_US
dc.contributor.authorGrotmol, Tomen_US
dc.contributor.authorEkbom, Andersen_US
dc.contributor.authorEngeland, Andersen_US
dc.contributor.authorGissler, Mikaen_US
dc.contributor.authorGlimelius, Ingriden_US
dc.contributor.authorMadanat-Harjuoja, Laura M.en_US
dc.contributor.authorSørensen, Henrik Toften_US
dc.contributor.authorTretli, Steinaren_US
dc.contributor.authorOrding, Anne Gulbechen_US
dc.contributor.authorBjørge, Toneen_US
dc.date.accessioned2019-08-22T13:10:12Z
dc.date.available2019-08-22T13:10:12Z
dc.date.issued2019
dc.PublishedTrabert 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.issn0020-7136
dc.identifier.issn1097-0215
dc.identifier.urihttps://hdl.handle.net/1956/20710
dc.descriptionUnder embargo until: 07.06.2020en_US
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.en_US
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 studyen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2019-06-25T09:58:29Z
dc.description.versionacceptedVersionen_US
dc.identifier.doihttps://doi.org/10.1002/ijc.32494
dc.identifier.cristin1707472
dc.source.journalInternational Journal of Cancer


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