The preventable burden of endometrial and ovarian cancers in Australia: A pooled cohort study Academic Article uri icon

abstract

  • OBJECTIVE:Evidence on the endometrial and ovarian cancer burden preventable through modifications to current causal behavioural and hormonal exposures is limited. Whether the burden differs by population subgroup is unknown. METHODS:We linked pooled data from six Australian cohort studies to national cancer and death registries, and quantified exposure-cancer associations using adjusted proportional hazards models. We estimated exposure prevalence from representative health surveys. We then calculated Population Attributable Fractions (PAFs) with 95% confidence intervals (CIs), accounting for competing risk of death, and compared PAFs for population subgroups. RESULTS:During a median 4.9 years follow-up, 510 incident endometrial and 303 ovarian cancers were diagnosed. Overweight and obesity explained 41.9% (95% CI 32.3-50.1) of the endometrial cancer burden and obesity alone 34.5% (95% CI 27.5-40.9). This translates to 12,800 and 10,500 endometrial cancers in Australia in the next 10 years, respectively. The body fatness-related endometrial cancer burden was highest (49-87%) among women with diabetes, living remotely, of older age, lower socio-economic status or educational attainment and born in Australia. Never use of oral contraceptives (OCs) explained 8.1% (95% CI 1.8-14.1) or 2500 endometrial cancers. A higher BMI and current long-term MHT use increased, and long-term OC use decreased, the risk of ovarian cancer, but the burden attributable to overweight, obesity or exogenous hormonal factors was not statistically significant. CONCLUSIONS:Excess body fatness, a trait that is of high and increasing prevalence globally, is responsible for a large proportion of the endometrial cancer burden, indicating the need for effective strategies to reduce adiposity.

authors

  • Laaksonen, Maarit A
  • Arriaga, Maria E
  • Canfell, Karen
  • MacInnis, Robert J
  • Byles, Julie E
  • Banks, Emily
  • Shaw, Jonathan E
  • Mitchell, Paul
  • Giles, Graham G
  • Magliano, Dianna J
  • Gill, Tiffany K
  • Klaes, Elizabeth
  • Velentzis, Louiza S
  • Hirani, Vasant
  • Cumming, Robert G
  • Vajdic, Claire M

publication date

  • 2019

has subject area