Diabetes and endometrial cancer: An Italian case‐control study

• Published in: International journal of cancer Vol. 81; no. 4; pp. 539 - 542
• Main Authors: Parazzini, Fabio, La Vecchia, Carlo, Negri, Eva, Luca Riboldi, Gian, Surace, Matteo, Benzi, Guido, Maina, Aldo, Chiaffarino, Francesca
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 17.05.1999; Wiley-Liss
• Subjects: Adult; Age Factors; Aged; Biological and medical sciences; Body Mass Index; Case-Control Studies; Confidence Intervals; Diabetes Complications; Diabetes Mellitus - epidemiology; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - epidemiology; Diabetes Mellitus, Type 1 - physiopathology; Endometrial Neoplasms - complications; Endometrial Neoplasms - epidemiology; Endometrial Neoplasms - pathology; Endometrial Neoplasms - physiopathology; Estrogen Replacement Therapy; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Hypertension - epidemiology; Italy - epidemiology; Medical sciences; Middle Aged; Multivariate Analysis; Odds Ratio; Risk Factors; Smoking - epidemiology; Tumors; Italy; Endocrinopathy; Human; Hyperinsulinemia; Carcinoma; Cytokine; Estrogen; Malignant tumor; Case control study; Insulin like growth factor 1; Non insulin dependent diabetes; Ovarian hormone; Female genital diseases; Risk factor; Uterine diseases; Adult; Female; Sex steroid hormone; Endometrium; Growth factor
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/(SICI)1097-0215(19990517)81:4<539::AID-IJC6>3.0.CO;2-Q

We considered the association between diabetes and risk of endometrial cancer using data from a large case‐control study conducted in Italy. Cases were 752 women with incident, histologically confirmed endometrial cancer <75 years of age (median age 60 years, range 28–74) admitted to a network of hospitals in Milan. Controls were 2,606 patients (median age 54 years, range 25–74) aged <75 years, admitted for acute non‐neoplastic, non‐gynecological, non‐hormone‐related conditions to the same network of hospitals where cases had been identified. A total of 132 (17.6%) cases and 116 controls (4.5%) reported a history of diabetes. The corresponding multivariate odds ratio (OR) was 2.9 [95% confidence interval (CI) 2.2–3.9]. No association emerged with diabetes diagnosed under age 40 (likely to be insulin‐dependent diabetes), whereas the OR of endometrial cancer was 3.1 (95% CI 2.3–4.2) for diabetes diagnosed at age ≥40 years. The OR of endometrial cancer in women with history of diabetes was 3.0 for women with a body mass index (BMI) (QI) kg/m2 <25, 3.6 for those with a BMI of 25–29, and 3.3 for those with a BMI ≥30. No consistent interaction or modifying effect was observed for any other covariate. Our results confirm that non‐insulin‐dependent diabetes is associated with the risk of endometrial cancer. The association may be mediated through elevated oestrogen levels in diabetic women, hyperinsulinemia or insulin‐like growth factor‐I (IGF‐I).Int. J. Cancer 81:539–542, 1999. © 1999 Wiley‐Liss, Inc.