Imperial College London
Portrait Picture

Professor Hani Gabra

Faculty of Medicine, Department of Surgery & Cancer

Emeritus Professor of Medical Oncology
 
 
 
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Contact

 

h.gabra Website

 
 
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Assistant

 

Ms Sophie Lions +44 (0)20 7594 2792

 
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Location

 

Garry Weston CentreCancer CentreHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Raglan:2019:10.1002/ijc.31961,
author = {Raglan, O and Kalliala, I and Markozannes, G and Cividini, S and Gunter, MJ and Nautiyal, J and Gabra, H and Paraskevaidis, E and MartinHirsch, P and Tsilidis, KK and Kyrgiou, M},
doi = {10.1002/ijc.31961},
journal = {International Journal of Cancer},
pages = {1719--1730},
title = {Risk factors for endometrial cancer: An umbrella review of the literature},
url = {http://dx.doi.org/10.1002/ijc.31961},
volume = {145},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Although many risk factors could have causal association with endometrial cancer, they are also prone to residual confounding or other biases which could lead to over or underestimation. This umbrella review evaluates the strength and validity of evidence pertaining risk factors for endometrial cancer.Systematic reviews or metaanalyses of observational studies evaluating the association between nongenetic risk factors and risk of developing or dying from endometrial cancer were identified from inception to April 2018 using PubMed, the Cochrane database and manual reference screening. Evidence was graded strong, highly suggestive, suggestive or weak based on statistical significance of randomeffects summary estimate, largest study included, number of cases, betweenstudy heterogeneity, 95% prediction intervals, small study effects, excess significance bias and sensitivity analysis with credibility ceilings.We identified 171 metaanalyses investigating associations between 53 risk factors and endometrial cancer incidence and mortality. Risk factors were categorised: anthropometric indices, dietary intake, physical activity, medical conditions, hormonal therapy use, biochemical markers, gynaecological history and smoking. Of 127 metaanalyses including cohort studies, three associations were graded with strong evidence. Body mass index and waisttohip ratio were associated with increased cancer risk in premenopausal women (RR per 5 kg/m2 1.49; CI 1.39–1.61) and for total endometrial cancer (RR per 0.1unit 1.21; CI 1.13–1.29), respectively. Parity reduced risk of disease (RR 0.66, CI 0.60–0.74).Of many proposed risk factors, only three had strong association without hints of bias. Identification of genuine risk factors associated with endometrial cancer may assist in developing targeted prevention strategies for women at high risk.
AU  - Raglan,O
AU  - Kalliala,I
AU  - Markozannes,G
AU  - Cividini,S
AU  - Gunter,MJ
AU  - Nautiyal,J
AU  - Gabra,H
AU  - Paraskevaidis,E
AU  - MartinHirsch,P
AU  - Tsilidis,KK
AU  - Kyrgiou,M
DO  - 10.1002/ijc.31961
EP  - 1730
PY  - 2019///
SN  - 0020-7136
SP  - 1719
TI  - Risk factors for endometrial cancer: An umbrella review of the literature
T2  - International Journal of Cancer
UR  - http://dx.doi.org/10.1002/ijc.31961
UR  - http://hdl.handle.net/10044/1/65626
VL  - 145
ER  -
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