Family History and Risk of Endometrial Cancer: A Systematic Review and Meta-analysis

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 125; no. 1; pp. 89 - 98
• Main Authors: Win, Aung Ko, Reece, Jeanette C., Ryan, Shae
• Format: Journal Article
• Language: English
• Published: United States by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01.01.2015
• Subjects: Breast Neoplasms - epidemiology; Carcinoma - epidemiology; Case-Control Studies; Colorectal Neoplasms - epidemiology; Endometrial Neoplasms - epidemiology; Endometrial Neoplasms - genetics; Female; Humans; Ovarian Neoplasms - epidemiology; Risk Assessment; Uterine Cervical Neoplasms - epidemiology
• ISSN: 0029-7844; 1873-233X; 1873-233X
• DOI: 10.1097/AOG.0000000000000563

To obtain precise estimates of endometrial cancer risk associated with a family history of endometrial cancer or cancers at other sites. For the systematic review, we used PubMed to search for all relevant studies on family history and endometrial cancer that were published before December 2013. Medical Subject Heading terms "endometrial neoplasm" and "uterine neoplasm" were used in combination with one of the key phrases "family history," "first-degree," "familial risk," "aggregation," or "relatedness." Studies were included if they were case-control or cohort studies that investigated the association between a family history of cancer specified to site and endometrial cancer. Studies were excluded if they were review or editorial articles or not translated into English or did not define family history clearly or used spouses as control participants. We included 16 studies containing 3,871 women as cases and 49,475 women as controls from 10 case-control studies and 33,510 women as cases from six cohort studies. We conducted meta-analyses to estimate the pooled relative risk (95% confidence interval [CI]) of endometrial cancer associated with a first-degree family history of endometrial, colorectal, breast, ovarian, and cervical cancer to be: 1.82 (1.65-1.98), 1.17 (1.03-1.31), 0.96 (0.88-1.04), 1.13 (0.85-1.41), and 1.19 (0.83-1.55), respectively. We estimated cumulative risk of endometrial cancer to age 70 years to be 3.1% (95% CI 2.8-3.4) for women with a first-degree relative with endometrial cancer and the population-attributable risk to be 3.5% (95% CI 2.8-4.2). Women with a first-degree family history of endometrial cancer or colorectal cancer have a higher risk of developing endometrial cancer than those without a family history. This study is likely to be of clinical relevance to inform women of their risk of endometrial cancer.