Abstract
Purpose
Uterine cancer risk is high in breast cancer survivors. Although breast cancer and uterine cancer share some common epidemiological risk factors, association of metabolic syndrome with incident uterine cancer in breast cancer survivors is under-studied. We evaluated the association of metabolic syndrome conditions with second primary uterine cancer in breast cancer survivors.
Methods
In this retrospective cohort study, 37,303 breast cancer patients diagnosed between 2008 and 2020 at Kaiser Permanente Southern California, an integrated healthcare system, were included. Data on cancer-related variables, sociodemographic, and clinical variables were extracted from KPSC’s Surveillance, Epidemiology, and End Results (SEER)-affiliated cancer registry and electronic health records, as appropriate. Patients were followed from breast cancer diagnosis until 12/31/2021 for incident uterine cancer. Proportional hazards regression was used to report association [HR (95% CI)] between metabolic conditions and uterine cancer.
Results
More than half (53.1%) of the breast cancer survivors had 1–2 metabolic conditions; 19.4% had 3 + , while 27. 5% had no metabolic conditions. Median time to follow-up was 5.33 years and 185 (0.5%) patients developed second primary uterine cancer. Obesity was associated with an elevated uterine cancer risk in the adjusted model [HR (95% CI) 1.64 (1.20–2.25)]. Having 1–2 metabolic conditions (versus none) was not associated with increased uterine cancer risk [adjusted HR (95% CI) 1.24 (0.85–1.82)]; however, there was an increased uterine cancer risk with 3 + metabolic conditions [adjusted HR (95% CI) 1.82 (1.16–2.87)].
Conclusion
Although not statistically significant, we found a trend demonstrating greater uterine cancer risk by increasing numbers of metabolic syndrome conditions in breast cancer survivors.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
The authors thank all patients included in the study.
Funding
This study was supported by National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI) grant number R01HL154319 (Drs. Haque and Potosky).
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Amrita Mukherjee, Lie Hong Chen, and Reina Haque contributed to the study conception and design. Material preparation and data collection were performed by Lie Hong Chen and Zheng Gu. Formal analysis was done by Amrita Mukherjee. The first draft of the manuscript was written by Amrita Mukherjee. All the authors revised the first draft and approved the final manuscript.
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This study was supported by NIH/NHLBI grant number R01HL154319 (Drs. Haque and Potosky). The contents do not represent the view of the NIH/NHLBI. The authors declare no other financial interests/personal relationships which may be considered as potential competing interests.
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The study was approved by the KPSC Institutional Review Board (IRB).
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Mukherjee, A., Gu, Z., Chen, L.H. et al. Association of metabolic syndrome conditions with risk of second primary uterine cancer in breast cancer survivors. J Cancer Res Clin Oncol 149, 17749–17755 (2023). https://doi.org/10.1007/s00432-023-05489-1
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DOI: https://doi.org/10.1007/s00432-023-05489-1