American Journal of Epidemiology Vol. 148, No. 3: 234-240
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Diabetes, Body Size, and Risk of Endometrial Cancer
1 University of Wisconsin Comprehensive Cancer Center Madison, WI
2 Fred Hutchinson Cancer Research Center Seattle, WA
Reprint requests to Dr. Suzanne M. Shoff, University of Wisconsin Comprehensive Cancer Center, Room 4760 Medical Science Center, 1300 University Avenue, Madison, WI 53706.
Data from a population-based case-control study of Wisconsin women were used to evaluate the relation of diabetes to the risk of endometrial cancer on the basis of body mass index (BMI). Cases (n = 723) were identified from a statewide tumor registry; controls (n = 2,291) were selected randomly from population lists. Diabetes status, weight, height, and other factors were ascertained by telephone interview. Subjects were categorized as not overweight (BMI, <29.1), overweight (BMI, 29.1–31.9), or obese (BMI, >31.9) according to the BMI distribution of middle-aged white women in the Second National Health and Nutrition Examination Survey. Joint associations between diabetes status, BMI, and endometrial cancer were evaluated using unconditional logistic regression models that controlled for age, parity, use of hormone replacement therapy, education, and smoking. Compared with persons without diabetes, those with diabetes had an adjusted odds ratio of 1.86 (95% confidence interval (CI) 1.37–2.52) for endometrial cancer. This association was modified by BMI (p interaction = 0.04). Compared with nonoverweight nondiabetic subjects, nonoverweight and overweight women who reported diabetes had nonsignificant elevated risks of endometrial cancer (nonoverweight, odds ratio (OR) = 1.10, CI 0.66–1.86; overweight, OR = 1.58, CI 0.81–3.05). In contrast, elevated risk estimates were observed for obese diabetic women (OR = 2.95, CI 1.60–5.46). These data contradict earlier reports and suggest that diabetes confers no additional risk of endometrial cancer in women who are neither overweight nor obese. Am J Epidemiol 1998;148:234–40.
body mass index; case-control studies; diabetes mellitus,; non-insulin-dependent; endometrial neoplasms; logistic models; obesity in diabetes
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