Female hormonal factors and the risk of endometrial cancer in Lynch syndrome

Seyedeh Ghazaleh Dashti, Rowena Chau, Driss Ait Ouakrim, Daniel D. Buchanan, Mark Clendenning, Joanne P. Young, Ingrid M. Winship, Julie Arnold, Dennis J. Ahnen, Robert W. Haile, Graham Casey, Steven Gallinger, Stephen N. Thibodeau, Noralane M. Lindor, Loïc Le Marchand, Polly A. Newcomb, John D. Potter, John A. Baron, John L. Hopper, Mark A. JenkinsAung Ko Win

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

IMPORTANCE: Apart from hysterectomy, there is no consensus recommendation for reducing endometrial cancer risk for women with a mismatch repair gene mutation (Lynch syndrome). OBJECTIVE: To investigate the association between hormonal factors and endometrial cancer risk in Lynch syndrome. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study included 1128 women with a mismatch repair gene mutation identified from the Colon Cancer Family Registry. Data were analyzed with a weighted cohort approach. Participants were recruited between 1997 and 2012 from centers across the United States, Australia, Canada, and New Zealand. EXPOSURES: Age at menarche, first and last live birth, and menopause; number of live births; hormonal contraceptive use; and postmenopausal hormone use. MAIN OUTCOMES AND MEASURES: Self-reported diagnosis of endometrial cancer. RESULTS: Endometrial cancer was diagnosed in 133 women (incidence rate per 100 person-years, 0.29; 95% CI, 0.24 to 0.34). Later age at menarche, parity (≥1 live births), and hormonal contraceptive use (≥1 year) were associated with a lower risk of endometrial cancer. (Table presented.) There was no statistically significant association between endometrial cancer and age at first and last live birth, age at menopause, and postmenopausal hormone use. CONCLUSIONS AND RELEVANCE: For women with a mismatch repair gene mutation, some endogenous and exogenous hormonal factors were associated with a lower risk of endometrial cancer. These directions and strengths of associations were similar to those for the general population. If replicated, these findings suggest that women with a mismatch repair gene mutation may be counseled like the general population in regard to hormonal influences on endometrial cancer risk.

Original languageEnglish (US)
Pages (from-to)61-71
Number of pages11
JournalJAMA - Journal of the American Medical Association
Volume314
Issue number1
DOIs
StatePublished - Jul 7 2015

ASJC Scopus subject areas

  • Medicine(all)

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    Dashti, S. G., Chau, R., Ouakrim, D. A., Buchanan, D. D., Clendenning, M., Young, J. P., Winship, I. M., Arnold, J., Ahnen, D. J., Haile, R. W., Casey, G., Gallinger, S., Thibodeau, S. N., Lindor, N. M., Le Marchand, L., Newcomb, P. A., Potter, J. D., Baron, J. A., Hopper, J. L., ... Win, A. K. (2015). Female hormonal factors and the risk of endometrial cancer in Lynch syndrome. JAMA - Journal of the American Medical Association, 314(1), 61-71. https://doi.org/10.1001/jama.2015.6789