Abstract
Excess circulating insulin may contribute to endometrial cancer (EC) development; studies suggest increased risk of EC associated with type 2 diabetes. We investigated whether gestational diabetes is associated with increased risk of EC and its precursor, endometrial hyperplasia (EH). We conducted a population-based, case-control study of women in Washington State. Cases were women with a hospital discharge record indicating the presence of EH/EC who could be linked to a prior delivery hospitalization or birth record from 1987 to 2013 (n=593). Controls were randomly selected from remaining deliveries, frequency matched 10:1 on delivery year and maternal age at delivery (n=5,743). Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). After adjustment for race/ethnicity, maternal age at delivery, and delivery year, EH/EC was associated with a history of gestational diabetes (OR 1.73, 95% CI 1.27-2.35). This association was present for both EH and EC (OR 1.61, 95% CI 1.00-2.60 and OR 1.80, 95% CI 1.22-2.65, respectively). After adjustment for prepregnancy body mass index, the OR for EH/EC was attenuated and became statistically non-significant (OR 1.22, 95% CI 0.87-1.72), except in women <50years old at the time of case ascertainment (OR 1.49, 95% CI 1.00-2.20). Associations were slightly stronger for EC than EH. We observed an association between EH/EC and a history of gestational diabetes specific to younger women. Future studies focusing on the relationships between gestational diabetes, obesity, and EC, including age at diagnosis, are warranted.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have