Artikel
Alcohol consumption, cigarette smoking and endometrial cancer risk: results from the Netherlands cohort study
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Veröffentlicht: | 6. September 2007 |
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Introduction/Background: Endometrial carcinogenesis has been related to the exposure to unopposed oestrogens. It has been suggested that oestrogen levels are elevated by alcohol consumption and lowered by smoking. Only very few prospective studies have investigated the association between alcohol consumption, smoking and endometrial cancer comprehensively by using several exposure measures or by examining the underlying hormonal mechanism, e.g., the possibly mediating role of body mass index (BMI) and age at menopause.
Materials and Methods: In 1986, the Netherlands Cohort Study was initiated. A self- administered questionnaire on dietary habits and other cancer risk factors was completed by 62,573 women. Follow-up for cancer was established by record linkage to the Netherlands Cancer Registry. Rate ratios (RR) and 95% confidence intervals (95%CI) were calculated using the Cox proportional hazards model adjusting for age, BMI, parity, oral contraceptive use, non-occupational physical activity, hypertension, age at first child birth, age at menopause, and adjusting mutually for alcohol consumption and smoking.
Results: After 11.3-years of follow-up, 280 incident endometrial cancer cases were available for analyses. In multivariate analysis, the RR for alcohol users versus non-users was 1.06 (95%CI= 0.78-1.43). There were neither dose-dependent trends nor associations with different types of beverages. The RRs for former and current smokers versus never-smokers were 0.83 (95%CI= 0.58-1.20) and 0.59 (95%CI= 0.40-0.88), respectively. These estimates hardly changed when BMI and age at menopause were added to the models.
Discussion/Conclusions: There is no association between alcohol consumption and endometrial cancer. Current smoking is associated with a reduced risk of endometrial cancer. This association is neither mediated by BMI nor by age at menopause.