Abstract
Due to the high effectiveness of cancer screening and therapies, the diagnosis of second primary cancers (SPCs) has increased in women with endometrial cancer (EC). However, previous studies providing adequate evidence to support screening for SPCs in endometrial cancer are lacking. This study aimed to develop effective risk prediction models of second primary endometrial cancer (SPEC) in women with obesity (body mass index (BMI) > 25) and included datasets on the incidence of SPEC and the other risks of SPEC in 4480 primary cancer survivors from a hospital-based cancer registry database. We found that obesity plays a key role in SPEC. We used 10 independent variables as predicting variables, which correlated to obesity, and so should be monitored for the early detection of SPEC in endometrial cancer. Our proposed scheme is promising for SPEC prediction and demonstrates the important influence of obesity and clinical data representation in all cases following primary treatments. Our results suggest that obesity is still a crucial risk factor for SPEC in endometrial cancer.
Highlights
Endometrial cancer (EC) is the most common gynecological malignancy, and its incidence is rising alongside the growing prevalence of obesity [1]
520 patients were diagnosed with second primary endometrial cancer (SPEC) in primary endometrial cancers
For classification and regression tree (CART) decision tree stratification, the status of the branches of the tree is based on the priority of all independent variables
Summary
Endometrial cancer (EC) is the most common gynecological malignancy, and its incidence is rising alongside the growing prevalence of obesity [1]. Endometrial cancer affects women worldwide, resulting in an estimated 42,000 deaths annually [2]. EC most commonly occurs after menopause, related to long-term exposure to unopposed estrogens. The overall 5-year survival rate is around 80%. Overweight (defined as body mass index (BMI) of at least 25 kg/m2 ) represents an important risk factor in 50%. A BMI above 25 kg/m2 doubles a woman’s risk of endometrial cancer, and a BMI above 30 kg/m2 triples the risk [3,4]. Understanding the key mechanisms driving endometrial carcinogenesis in primary endometrial cancer (PEC) may affect second primary endometrial cancer (SPEC) diagnoses if aimed at those at highest risk
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