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Associations between pregnancy-related factors and birth characteristics with risk of rare uterine cancer subtypes: A Nordic population-based case-control study

Jazmine Abril, B. Trabert, R. Troisi, Tom Grotmol, Anders Ekbom, A. Engeland, M. Gissler, I. Glimelius et al.

Cancer Causes and Control, 2023

2 citations

Abstract

Uterine sarcomas are a rare group of uterine malignancies. Due to the low incidence and changes in uterine sarcoma classification, risk factors are not well characterized. Our objective was to evaluate risk factors for uterine sarcoma and compare risk factors between uterine sarcoma, malignant mixed Mullerian tumors (MMMTs), and type I endometrial carcinomas. This nested case–control study utilized linked data from population-based medical birth and cancer registries in Denmark, Finland, Norway, and Sweden. Up to 10 controls were matched on country and birth year for each uterine cancer case. Using multivariable adjusted multinomial logistic regression, estimates of the associations between pregnancy-related factors and risk of uterine sarcoma, MMMTs, and type I endometrial carcinomas were determined. Having a very-low-birth-weight infant (< 1500 vs. 2500–3999 g: OR [95% CI] 2.83 [1.61–4.96]) was associated with an increased risk of uterine sarcoma. Whereas, having a more recent pregnancy was associated with reduced risks of MMMT (< 10 vs. ≥ 30 years: 0.66 [0.20–2.23]) and type 1 endometrial carcinomas (0.35 [0.30–0.41]) but not uterine sarcomas (1.33 [0.90–1.98], p-heterogeneity < 0.01). Our study provides evidence that risk factors for uterine sarcoma and MMMT, previously grouped with uterine sarcomas, vary substantially. Additionally, MMMT and type I endometrial carcinomas are more similar than uterine sarcoma in that pregnancy complications like gestational hypertension…

How strong is the evidence?

Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.

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