Christina Nagle

QIMR

Senior Research Officer

PLCO (Learn more about this study)

PLCO-81

Apr 29, 2014

Inflammation-related factors and endometrial cancer risk: an E2C2 Study

Chronic inflammation has been hypothesized to play a role in the development of endometrial cancer, possibly in conjunction with, or in addition to, estrogen exposure [1, 2]. Testing the inflammation hypothesis in epidemiological studies some investigators have found that pro-inflammatory factors such as perineal talc use [3], history of uterine fibroids increased endometrial cancer risk [4], whereas others conditions such as endometriosis, PID did not increase risk of endometrial cancer. Epidemiological studies have also been carried out to examine if the use of anti-inflammatory medications, such as aspirin and NSAIDs, reduce the risk of endometrial cancer. In general these studies have produced inconsistent results; however we have recently undertaken a systematic review and meta-analysis of all published data to date which shows a significant inverse association between use of aspirin and endometrial cancer, particularly among obese women. Extending these epidemiological analyses, there is also some evidence that higher levels of inflammatory markers such as C-reactive protein, interleukin 6, IL1 receptor antagonist[6] and tumor necrosis factor-a[7], are associated with increased risk of endometrial cancer.

The potential role of these pro- and anti-inflammatory factors in the development of endometrial cancer remains an open question. The 30+ research groups collaborating in E2C2 have extensive questionnaire data on reproductive and lifestyle factors available for analysis making a precise and comprehensive assessment of this research question possible. Furthermore we will be able to separate the more common ‘estrogen dependent’ endometrial cancers (Type 1) from the more aggressive Type 2 or ‘non-estrogen dependent’ cancers.

We propose to use PLCO data, and data from participating E2C2 studies, to examine the association between inflammation-related factors and endometrial cancer risk.


Reference List

1. Modugno, F., et al., Inflammation and endometrial cancer: a hypothesis. Cancer Epidemiol Biomarkers Prev, 2005. 14(12): p. 2840-7.
2. Wallace, A.E., et al., Inflammatory events in endometrial adenocarcinoma. J Endocrinol, 2010. 206(2): p. 141-57.
3. Karageorgi, S., et al., Perineal use of talcum powder and endometrial cancer risk. Cancer Epidemiol Biomarkers Prev, 2010. 19(5): p. 1269-75.
4. Rowlands, I.J., et al., Gynecological conditions and the risk of endometrial cancer. Gynecol Oncol, 2011. 123(3): p. 537-41.
5. Neill, A.S., et al., Use of talcum powder and endometrial cancer risk. Cancer Causes Control, 2012.
6. Dossus, L., et al., Obesity, inflammatory markers, and endometrial cancer risk: a prospective case-control study. Endocr Relat Cancer, 2010. 17(4): p. 1007-19.
7. Dossus, L., et al., Tumor necrosis factor (TNF)-alpha, soluble TNF receptors and endometrial cancer risk: The EPIC study. Int J Cancer, 2010.