- Title
- The preventable burden of endometrial and ovarian cancers in Australia: a pooled cohort study
- Creator
- 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.
- Relation
- NHMRC.1060991 http://purl.org/au-research/grants/nhmrc/1060991
- Relation
- Gynecologic Oncology Vol. 153, Issue 3, p. 580-588
- Publisher Link
- http://dx.doi.org/10.1016/j.ygyno.2019.03.102
- Publisher
- Academic Press
- Resource Type
- journal article
- Date
- 2019
- Description
- 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.
- Subject
- endometrial cancer; ovarian cancer; risk factors; population attributable fraction; preventable; cohort; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1408669
- Identifier
- uon:35870
- Identifier
- ISSN:0090-8258
- Language
- eng
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