Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Serial endometrial thickness and risk of non-endometrial hormone-dependent cancers in postmenopausal women in UKCTOCS

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Fetal Costello syndrome: description of phenotype of HRAS exon 1 mutations

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Neurodevelopmental disorder in children believed to have isolated mild ventriculomegaly prenatally

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Assisted reproductive technology treatment and risk of ovarian cancer-a nationwide population-based cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Male factor infertility and risk of death: a nationwide record-linkage study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Risk of hospitalization for early onset of cardiovascular disease among infertile women: a register-based cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Racial and Sociodemographic Differences of Semen Parameters Among US Men Undergoing a Semen Analysis

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Matthew Burnell
  • Aleksandra Gentry-Maharaj
  • Clara Glazer
  • Chloe Karpinskyj
  • Andy Ryan
  • Sophia Apostolidou
  • Jatinderpal Kalsi
  • Mahesh Parmar
  • Stuart Campbell
  • Ian Jacobs
  • Usha Menon
View graph of relations

OBJECTIVES: Estrogen is a well-established risk factor for various cancers. It causes endometrial proliferation which is routinely assessed as endometrial thickness (ET) by transvaginal ultrasound (TVS). Only one study, restricted to endometrial and breast cancer, has previously considered ET and risk of a non-endometrial cancer. This study seeks to explore associations between serial ET in postmenopausal women and nine non-endometrial hormone-sensitive cancers using contemporary statistical methodology that attempts to minimize the biases typical of endogenous serial data.

METHODS: This was a cohort study nested within the United Kingdom Collaborative Trial for Ovarian Cancer Screening (UKCTOCS) with follow-up via linkage to national cancer registries. 50639 postmenopausal women aged 50-74 underwent annual TVS in the ultrasound arm of UKCTOCS, of whom 38105 women with a valid ET measurement, no prior hysterectomy and complete covariate data were included in this study. All were followed through linkage to national cancer registry. The effect of ET was assessed using joint models for longitudinal biomarker and time-to-event data in 6 estrogen-dependent cancers (breast, ovarian, colorectal, bladder, lung and pancreas) and Cox models for baseline ET for these 6 plus liver, gastric and non-Hodgkins lymphoma. All models were adjusted by current HRT use, BMI, age at last period, parity and OCP use.

RESULTS: The 38105 women had a total of 267567 valid ET measurements (median=8; IQR=5-9). During 407838 total years (median=10.9) of follow-up, 1398 breast, 350 endometrial, 381 lung, 495 colorectal, 222 ovarian, 94 pancreas, 79 bladder, 62 gastric, 38 liver cancers and 52 NHLs were registered. Using joint models, a doubling of ET significantly increased risk of breast (HR=1.21; 95% CI=1.09-1.36; p=0.001), ovarian (HR=1.39; 95% CI=1.06-1.82; p=0.018) and lung (HR=1.25; 95% CI=1.02-1.54; p=0.036) cancers. There were no statistically significant associations amongst the remaining 6 cancers.

CONCLUSIONS: Postmenopausal women with high/increasing ET are at increased risk of breast, ovarian and lung cancer. It is important that clinicians are aware of these risks as TVS is a common investigation. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalUltrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN0960-7692
DOIs
Publication statusE-pub ahead of print - 15 Oct 2019

ID: 58404053