Risk factors for developing endometrial cancer after benign endometrial sampling

Michelle L. Torres, Amy L. Weaver, Sanjeev Kumar, Stefano Uccella, Abimbola O. Famuyide, William Arthur Cliby, Sean Christopher Dowdy, Bobbie S. Gostout, Andrea Mariani

Research output: Contribution to journalArticle

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Abstract

Objective: To identify risk factors for endometrial cancer after benign results of endometrial biopsy or dilation and curettage (D&C). Methods: Nested case-control study from Rochester Epidemiology Project data. Among 370 Olmsted County, Minnesota, residents who received an endometrial cancer diagnosis between 1970 and 2008, we identified 90 patients (24.5%) who had previous benign endometrial biopsy or D&C results (no atypical hyperplasia). We compared them with 172 matched control group participants who had benign endometrial biopsy or D&C results without subsequent endometrial cancer. Results: Using a multivariable conditional logistic regression model, we found that oral contraceptive pill (OCP) use was protective (odds ratio [OR] 0.18, 95% CI [CI] 0.08-0.45; P<.001), and personal history of colorectal cancer (OR 4.44, 95% CI 1.02-19.31; P<.05), endometrial polyp (OR 4.12, 95% CI 1.40-12.17; P=.01), and morbid obesity (OR 3.40, 95% CI 1.18-9.78; P<.03) were independently associated with subsequent endometrial cancer. Compared with the presence of no risk factor, presence of one and two or more risk factors increased the risk of endometrial cancer by 8.12 (95% CI 3.08-21.44) and 17.87 (95% CI 5.57-57.39) times, respectively. Assuming a 2.6% lifetime risk of endometrial cancer, ORs of 8.12 and 17.87 for one and two or more of the four aforementioned risk factors confer a lifetime risk of approximately 18% and 32%, respectively. Conclusion: One fourth of patients with endometrial cancer had previous benign endometrial biopsy or D&C results. Personal history of colorectal cancer, presence of endometrial polyps, and morbid obesity are the strongest risk factors for having endometrial cancer after a benign endometrial biopsy or D&C result, and OCP use is the strongest protective factor.

Original languageEnglish (US)
Pages (from-to)998-1004
Number of pages7
JournalObstetrics and Gynecology
Volume120
Issue number5
DOIs
StatePublished - Nov 2012

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Endometrial Neoplasms
Biopsy
Odds Ratio
Morbid Obesity
Oral Contraceptives
Polyps
Colorectal Neoplasms
Logistic Models
Dilatation and Curettage
Curettage
Hyperplasia
Case-Control Studies
Dilatation
Epidemiology
Research Design
Control Groups

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Torres, M. L., Weaver, A. L., Kumar, S., Uccella, S., Famuyide, A. O., Cliby, W. A., ... Mariani, A. (2012). Risk factors for developing endometrial cancer after benign endometrial sampling. Obstetrics and Gynecology, 120(5), 998-1004. https://doi.org/10.1097/AOG.0b013e31826b9fef

Risk factors for developing endometrial cancer after benign endometrial sampling. / Torres, Michelle L.; Weaver, Amy L.; Kumar, Sanjeev; Uccella, Stefano; Famuyide, Abimbola O.; Cliby, William Arthur; Dowdy, Sean Christopher; Gostout, Bobbie S.; Mariani, Andrea.

In: Obstetrics and Gynecology, Vol. 120, No. 5, 11.2012, p. 998-1004.

Research output: Contribution to journalArticle

Torres, ML, Weaver, AL, Kumar, S, Uccella, S, Famuyide, AO, Cliby, WA, Dowdy, SC, Gostout, BS & Mariani, A 2012, 'Risk factors for developing endometrial cancer after benign endometrial sampling', Obstetrics and Gynecology, vol. 120, no. 5, pp. 998-1004. https://doi.org/10.1097/AOG.0b013e31826b9fef
Torres, Michelle L. ; Weaver, Amy L. ; Kumar, Sanjeev ; Uccella, Stefano ; Famuyide, Abimbola O. ; Cliby, William Arthur ; Dowdy, Sean Christopher ; Gostout, Bobbie S. ; Mariani, Andrea. / Risk factors for developing endometrial cancer after benign endometrial sampling. In: Obstetrics and Gynecology. 2012 ; Vol. 120, No. 5. pp. 998-1004.
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abstract = "Objective: To identify risk factors for endometrial cancer after benign results of endometrial biopsy or dilation and curettage (D&C). Methods: Nested case-control study from Rochester Epidemiology Project data. Among 370 Olmsted County, Minnesota, residents who received an endometrial cancer diagnosis between 1970 and 2008, we identified 90 patients (24.5{\%}) who had previous benign endometrial biopsy or D&C results (no atypical hyperplasia). We compared them with 172 matched control group participants who had benign endometrial biopsy or D&C results without subsequent endometrial cancer. Results: Using a multivariable conditional logistic regression model, we found that oral contraceptive pill (OCP) use was protective (odds ratio [OR] 0.18, 95{\%} CI [CI] 0.08-0.45; P<.001), and personal history of colorectal cancer (OR 4.44, 95{\%} CI 1.02-19.31; P<.05), endometrial polyp (OR 4.12, 95{\%} CI 1.40-12.17; P=.01), and morbid obesity (OR 3.40, 95{\%} CI 1.18-9.78; P<.03) were independently associated with subsequent endometrial cancer. Compared with the presence of no risk factor, presence of one and two or more risk factors increased the risk of endometrial cancer by 8.12 (95{\%} CI 3.08-21.44) and 17.87 (95{\%} CI 5.57-57.39) times, respectively. Assuming a 2.6{\%} lifetime risk of endometrial cancer, ORs of 8.12 and 17.87 for one and two or more of the four aforementioned risk factors confer a lifetime risk of approximately 18{\%} and 32{\%}, respectively. Conclusion: One fourth of patients with endometrial cancer had previous benign endometrial biopsy or D&C results. Personal history of colorectal cancer, presence of endometrial polyps, and morbid obesity are the strongest risk factors for having endometrial cancer after a benign endometrial biopsy or D&C result, and OCP use is the strongest protective factor.",
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AU - Torres, Michelle L.

AU - Weaver, Amy L.

AU - Kumar, Sanjeev

AU - Uccella, Stefano

AU - Famuyide, Abimbola O.

AU - Cliby, William Arthur

AU - Dowdy, Sean Christopher

AU - Gostout, Bobbie S.

AU - Mariani, Andrea

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N2 - Objective: To identify risk factors for endometrial cancer after benign results of endometrial biopsy or dilation and curettage (D&C). Methods: Nested case-control study from Rochester Epidemiology Project data. Among 370 Olmsted County, Minnesota, residents who received an endometrial cancer diagnosis between 1970 and 2008, we identified 90 patients (24.5%) who had previous benign endometrial biopsy or D&C results (no atypical hyperplasia). We compared them with 172 matched control group participants who had benign endometrial biopsy or D&C results without subsequent endometrial cancer. Results: Using a multivariable conditional logistic regression model, we found that oral contraceptive pill (OCP) use was protective (odds ratio [OR] 0.18, 95% CI [CI] 0.08-0.45; P<.001), and personal history of colorectal cancer (OR 4.44, 95% CI 1.02-19.31; P<.05), endometrial polyp (OR 4.12, 95% CI 1.40-12.17; P=.01), and morbid obesity (OR 3.40, 95% CI 1.18-9.78; P<.03) were independently associated with subsequent endometrial cancer. Compared with the presence of no risk factor, presence of one and two or more risk factors increased the risk of endometrial cancer by 8.12 (95% CI 3.08-21.44) and 17.87 (95% CI 5.57-57.39) times, respectively. Assuming a 2.6% lifetime risk of endometrial cancer, ORs of 8.12 and 17.87 for one and two or more of the four aforementioned risk factors confer a lifetime risk of approximately 18% and 32%, respectively. Conclusion: One fourth of patients with endometrial cancer had previous benign endometrial biopsy or D&C results. Personal history of colorectal cancer, presence of endometrial polyps, and morbid obesity are the strongest risk factors for having endometrial cancer after a benign endometrial biopsy or D&C result, and OCP use is the strongest protective factor.

AB - Objective: To identify risk factors for endometrial cancer after benign results of endometrial biopsy or dilation and curettage (D&C). Methods: Nested case-control study from Rochester Epidemiology Project data. Among 370 Olmsted County, Minnesota, residents who received an endometrial cancer diagnosis between 1970 and 2008, we identified 90 patients (24.5%) who had previous benign endometrial biopsy or D&C results (no atypical hyperplasia). We compared them with 172 matched control group participants who had benign endometrial biopsy or D&C results without subsequent endometrial cancer. Results: Using a multivariable conditional logistic regression model, we found that oral contraceptive pill (OCP) use was protective (odds ratio [OR] 0.18, 95% CI [CI] 0.08-0.45; P<.001), and personal history of colorectal cancer (OR 4.44, 95% CI 1.02-19.31; P<.05), endometrial polyp (OR 4.12, 95% CI 1.40-12.17; P=.01), and morbid obesity (OR 3.40, 95% CI 1.18-9.78; P<.03) were independently associated with subsequent endometrial cancer. Compared with the presence of no risk factor, presence of one and two or more risk factors increased the risk of endometrial cancer by 8.12 (95% CI 3.08-21.44) and 17.87 (95% CI 5.57-57.39) times, respectively. Assuming a 2.6% lifetime risk of endometrial cancer, ORs of 8.12 and 17.87 for one and two or more of the four aforementioned risk factors confer a lifetime risk of approximately 18% and 32%, respectively. Conclusion: One fourth of patients with endometrial cancer had previous benign endometrial biopsy or D&C results. Personal history of colorectal cancer, presence of endometrial polyps, and morbid obesity are the strongest risk factors for having endometrial cancer after a benign endometrial biopsy or D&C result, and OCP use is the strongest protective factor.

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