232128 Factors associated with Type I and Type II endometrial cancer in a large cohort of cases

Monday, November 8, 2010

Ashley Felix , Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
Roslyn Stone, PhD , Department of Biostatistics, University of Pittsburgh Graduate School, Pittsburgh, PA
Robert Bowser, PhD , Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
Robert Edwards, MD , Department of Obstetrics and Gynecologic Oncology, Magee-Womens Hospital of UPMC Health System, Pittsburgh, PA
Mamatha Chivukula, MD , Department of Pathology, Magee-Womens Hospital of UPMC Health System, Pittsburgh, PA
Faina Y. Linkov, PhD , Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
Joel L. Weissfeld , Graduate School of Public Health: Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
Objective: The goal of this study was to evaluate risk factor differences between two endometrial cancer (EC) subtypes in a large cohort of patients.

Methods: We conducted a retrospective study comparing Type I (N=1,576) and Type II (N=176) EC cases treated at Magee-Womens hospital between 1996 and 2008. Clinical data were available from the University of Pittsburgh Medical Center Network Cancer Registry. Logistic regression analysis was used to calculate the adjusted odds of being diagnosed with Type II EC compared to Type 1 EC. The factors of interest in this analysis were: age, BMI, race, year of diagnosis, parity, menopausal status, and history of additional primaries.

Results: Predictors significantly associated with Type II EC were older age at diagnosis (OR: 1.03, 95% CI 1.02-1.05), non-white race (OR: 2.95, 95% CI 1.66-5.27), obesity (OR: 0.45, 95% CI 0.29-0.70), and history of additional primaries (OR: 1.56, 95% CI 1.05-2.32).

Conclusions: This registry-based study is the most updated evaluation of factors associated with Type I and Type II EC in a large retrospective cohort of patients. The striking difference in risk factors associated with Type I vs. Type II tumors further emphasizes that these subtypes represent different disease entities, potentially requiring different treatment modalities.

Implications for public health: Endometrial cancer is the most common gynecologic malignancy in the U.S. Type II tumors account for a disproportionate amount of EC-related deaths; therefore, an understanding of the etiology of this aggressive disease can lead to prevention opportunities.

Learning Areas:
Public health or related research

Learning Objectives:
Demonstrate an understanding of endometrial cancer etiology. Analyze population-level, cancer registry data. Explain the findings in a clear and concise format. Generate potential hypotheses for future research studies.

Keywords: Epidemiology, Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Delta Omega student nominee
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.