60 Years Of Data Suggest A Link Between Obesity And Height In Childhood And Endometrial Cancer In Adulthood

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Article Date: 14 May 2013 - 1:00 PDT Current ratings for:
60 Years Of Data Suggest A Link Between Obesity And Height In Childhood And Endometrial Cancer In Adulthood

New research presented at the European Congress in Liverpool (ECO) beginning today (Sunday 12 May) shows a possible link between obesity and height in childhood and endometrial cancer in adulthood. The research* is by Julie Aarestrup, Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark, and colleagues.

Endometrial cancer is in Europe the fourth most common cancer in women with more than 90,000 new cases diagnosed each year. In adult women, a high body mass index (BMI) is associated with an increased risk of endometrial cancer, whereas associations with height are limited. It is largely unknown, however, whether any of the risk originates in childhood. In this new study, the researchers investigated if childhood BMI and height at each age from 7-13 years were associated with risk of endometrial cancer in adulthood.

The total cohort consisted of 158,459 women from the Copenhagen School Health Records Register with data on measured heights and weights at 7-13 years who were born from between 1930 and 1989. BMI and height were transformed into age-specific z-scores, a method for comparing how large or tall a child is compared to a reference population. Follow-up occurred by linkage via a personal identification number to the Danish Cancer Registry, the Hospital Discharge Register (hysterectomy information), and the vital statistics register. Subjects were followed until a diagnosis of endometrial cancer, hysterectomy, death, emigration, loss-to-follow-up, or December 31, 2010; whichever came first.

The researchers found 940 diagnoses of endometrial cancer occurred during follow-up. At age 7 the risk of endometrial cancer in adulthood increased 18% per increase in BMI z-score and by 12% per increase in height z-score. To put this in perspective, compared to an average height and weight girl born in the late 1950s (122.4 cm, 22.9kg), another girl of the same height but who weighed 3.3 kg more would have an 18% higher risk of endometrial cancer. Further, height also increased the risk; compared to the same average girl, another girl of the same age but who was 5.2cm taller had a 12% increased risk of endometrial cancer. When looking at a girl aged 13 years born in the late 1950s compared to an average height and weight girl (156.7cm, 44.6 kg), another girl of the same height but who weighed 6.8kg more had a 24% increased risk of endometrial cancer; and another girl of the same age but who was 6.9cm taller had a 15% increased risk of endometrial cancer.

The peak age of endometrial cancer diagnosis is approximately 65 years. Therefore girls born in the 1950s are approaching their highest risk years. As the cohort members from later birth years continue to age, the study will continue to follow them in order to assess their risk of endometrial cancer.

Aarestrup concludes: "Higher BMI and height during childhood are associated with an increased risk of endometrial cancer in adulthood. These results suggest that some risk of endometrial cancer observed in adult women has its origins in childhood."

Research is ongoing to refine these results by subtypes of endometrial cancer. This project forms part of a series of studies led by Dr. Jennifer L. Baker, also of the Institute of Preventive Medicine, that are exploring associations between childhood body size and the later risk of cancers including those of the liver, prostate and thyroid. *This study is part of the European Research Council (ERC) project 'Childgrowth2cancer: Childhood body size, growth and pubertal timing and the risk of cancer in adulthood' which is run by Associate Professor Jennifer L. Baker.

Article adapted by Medical News Today from original press release. Source: Source: European Congress on Obesity (ECO)
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Obesity Could Hinder Breast Cancer Treatment

Women who are obese continue to have higher levels of estrogen despite treatment with aromatase inhibitors such as ArimidexR (anastrozole) and FemaraR (letrozole)—and these higher estrogen levels could affect their response to treatment, according to the results of a study published in the Journal of Clinical Oncology. ?

The majority of breast cancers are hormone receptor-positive. These cancers are stimulated to grow by the circulating female hormones estrogen and/or progesterone. Treatment of hormone receptor-positive breast cancer often involves hormonal therapy with aromatase inhibitors, which suppress the production of estrogen in postmenopausal women. ?

Researchers from London conducted a study to investigate the relationship between body mass index (BMI) and estrogen levels. The study involved 54 postmenopausal women with estrogen-receptor positive early breast cancer. ?

BMI is a measure of obesity based on height and weight. Individuals with a BMI of 30 or higher are considered obese. Researchers calculated the BMI and estrogen levels for all women in the study at baseline and found that obese women had higher estrogen levels than women of normal weight. In fact, those with a BMI ranging between 30 and 35 had circulating estrogen levels that were three times higher than women with a BMI of less than 25. ?

The women in the study underwent treatment with Arimidex for 3 months followed by Femara for 3 months or the opposite sequence and then researchers analyzed correlations between estrogen suppression and BMI for each drug. They found that after treatment with the hormone-suppressing drugs, estrogen levels did drop significantly in the obese women; however, their estrogen levels were still double those of women of normal weight. Suppression of estrogen was greater with Femara across the full range of BMIs in the study. ?

The researchers concluded that BMI does have an impact on the level of estrogen suppression achieved with aromatase inhibitors. Obese women continue to have higher estrogen levels, despite treatment with one of the drugs. ?

The results of this study should not change compliance with treatment—in other words, obese women should continue to take an aromatase inhibitor if one has been prescribed by their doctor; however, the data indicates that future research may need to focus on individualized treatment options that address such differences.?????

Reference:?

Folkerd EJ, Dixon JM, Renshaw L, et al. Suppression of plasma estrogen levels by letrozole and anastrozole is related to body mass index in patients with breast cancer. Journal of Clinical Oncology. Published early online July 16, 2012. doi: 10.1200/JCO.2012.42.0273?

Posted July 24, 2012

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