Endometrial cancer risk factors in Singapore Chinese: a prospective cohort study

Lei M. Adambekov S. Edwards R.P. Wang R. Yuan J.-M. Kalix E. Lopa S. Linkov F.
July 2022 Elsevier Inc.

Annals of Epidemiology
2022 #71 9 - 14 pp.

Purpose: The incidence of Endometrial cancer (EC) has grown substantially in Asia over the past decade. However, few studies have addressed risk factors associated with EC incidence in Asian populations. We explored the association between reproductive and dietary risk factors and EC in the Singapore Chinese Health Study (SCHS), one of the largest prospective cohort studies in Asia. Methods: Data were collected from 34,028 ethnically Chinese women aged 45–74 residing in Singapore, enrolled between 1993 and 1998. Baseline demographic, dietary, and reproductive factors were collected via structured questionnaires. EC cases were identified from the Singapore Cancer Registry (n = 126) up to 2010. Cox proportional hazard models were used to analyze association between EC and personal, reproductive, and dietary factors. Results: The incidence of EC in this population was 28.8 per 100,000 person-years. Regardless of menopausal status, obesity (BMI ≥ 27) was associated with increased EC risk (HR = 2.22, 95% CI 1.26–3.92), while later age at menarche was associated with decreased EC risk (HR = 0.14, 95% CI 0.04–0.46). In postmenopausal women, later age at menopause was associated with increased EC risk (HR = 2.82, 95% CI 1.24–6.43). Lifestyle and nutritional factors were not associated with risk of EC in this cohort. Conclusions: This study is one of the largest cohort studies exploring EC risk factors in Asian populations. Our study identified similarities in EC risk factors for European and Asian populations, which potentially suggests that strategies developed for EC prevention in Western populations can be potentially appropriate for the Singapore Chinese population due to risk factor similarities.

BMI , cancer prevention and control , Endometrial cancer , risk factors

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University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
Department of Gynecology, Xiangya Hospital, Central South University, Hunan, Changsha, China
Al-Farabi Kazakh National University, Department of Epidemiology, Biostatistics, and Evidence Based Medicine, Almaty, Kazakhstan
Graduate School of Public health, University of Pittsburgh, Pittsburgh, PA, United States
UPMC Hillman Cancer Center, Pittsburgh, PA, United States
Magee-Womens Research Institute, Pittsburgh, PA, United States
Duquesne University, Rangos School of Health Sciences, Department of Health Administration and Public Health, Pittsburgh, PA, United States

University of Pittsburgh School of Medicine
Department of Gynecology
Al-Farabi Kazakh National University
Graduate School of Public health
UPMC Hillman Cancer Center
Magee-Womens Research Institute
Duquesne University

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