Endometrial cancer (EC) incidence rates vary ~10‐fold worldwide, in part due to variation in EC risk factor profiles. Using an EC risk model previously developed in the European EPIC cohort, we evaluated the prevention potential of modified EC risk factor patterns and whether differences in EC incidence between a European population and low‐risk countries can be explained by differences in these patterns. Predicted EC incidence rates were estimated over 10 years of follow‐up for the cohort before and after modifying risk factor profiles. Risk factors considered were: body mass index (BMI, kg/m²), use of postmenopausal hormone therapy (HT) and oral contraceptives (OC) (potentially modifiable); and, parity, ages at first birth, menarche and menopause (environmentally conditioned, but not readily modifiable). Modeled alterations in BMI (to all ≤23 kg/m²) and HT use (to all non‐HT users) profiles resulted in a 30% reduction in predicted EC incidence rates; individually, longer duration of OC use (to all ≥10 years) resulted in a 42.5% reduction. Modeled changes in not readily modifiable exposures (i.e., those not contributing to prevention potential) resulted in ≤24.6% reduction in predicted EC incidence. Women in the lowest decile of a risk score based on the evaluated exposures had risk similar to a low risk countries; however, this was driven by relatively long use of OCs (median = 23 years). Our findings support avoidance of overweight BMI and of HT use as prevention strategies for EC in a European population; OC use must be considered in the context of benefits and risks.

中文翻译：

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通过改变主要危险因素预防子宫内膜癌的理论潜力：来自 EPIC 队列的估计。


子宫内膜癌 (EC) 的发病率在全球范围内相差约 10 倍，部分原因是 EC 危险因素概况的变化。使用先前在欧洲 EPIC 队列中开发的 EC 风险模型，我们评估了修改后的 EC 风险因素模式的预防潜力，以及欧洲人群和低风险国家之间 EC 发病率的差异是否可以通过这些模式的差异来解释。预测的 EC 发病率是在修改危险因素概况之前和之后对队列进行 10 年随访时估计的。考虑的危险因素有：体重指数（BMI，kg/m ² ）、绝经后激素治疗（HT）和口服避孕药（OC）（可能可改变）的使用；产次、初产年龄、初潮和更年期（受环境影响，但不易改变）。 BMI（对于所有 ≤23 kg/m ² ）和 HT 使用（对于所有非 HT 用户）概况的建模改变导致预测的 EC 发病率降低了 30%；单独而言，较长的 OC 使用时间（全部≥10 年）导致减少 42.5%。不易改变的暴露（即那些无助于预防潜力的暴露）的建模变化导致预测的 EC 发病率降低 ≤24.6%。根据评估的暴露情况，处于风险评分最低十分位的女性的风险与低风险国家相似；然而，这是由于使用 OC 的时间相对较长（中位数 = 23 年）造成的。我们的研究结果支持避免超重 BMI 和使用 HT 作为欧洲人群 EC 的预防策略；必须在利益和风险的背景下考虑 OC 的使用。