Organochlorines and Endometrial Cancer Risk

Elisabete Weiderpass; Hans-Olov Adami; John A. Baron; Anders Wicklund-Glynn; Marie Aune; Samuel Atuma; Ingemar Persson

DOI: Published May 2000

Article Figures & Data

Tables

Table 1

Distribution of established or suspected risk factors for endometrial cancer among 154 patients with endometrial cancer and 205 population controls

A.	Characteristic	No. of Cases/controls^a	Cases, mean (SD)	Controls, mean (SD)	P (t test)
	Age (yr)	154 /205	64.6 (7.2)	62.8 (7.4)	0.02
	Age at menarche (yr)	154 /205	13.3 (1.3)	13.6 (1.3)	0.03
	Age at menopause (yr)	134 /181	51.4 (3.8)	50.0 (4.0)	0.002
	Parity among parous (132 cases/179 controls)	154 /205	2.0 (1.3)	2.1 (1.3)	0.28
	Age at first birth (yr)	132 /179	24.5 (4.2)	24.4 (4.4)	0.85
	Age at last birth (yr)	132 /179	29.8 (5.6)	30.3 (5.3)	0.38
	Breast-feeding^b (months)	132 /179	8.1 (7.9)	10.5 (10.3)	0.03
	Height (cm)	154 /205	163.9 (5.4)	164.0 (5.0)	0.89
	BMI (kg/m²)	154 /205	28.4 (5.1)	26.0 (4.2)	0.0001
	Fish consumption (portions per month)
	All fish	142 /205	5.0 (2.6)	5.2 (3.1)	0.55
	Fatty fish^c	142 /204	3.2 (1.7)	3.1 (1.1)	0.32
B.			Proportions			P (χ²)
	Premenopausal	151 /205	8.0	9.8	0.55
	Nulliparous	154 /205	14.3	12.7	0.66
	Ever used oral contraceptives	154 /205	16.9	27.8	0.02
	Ever use of topic estriol, dienestrol, estradiol	154 /205	17.5	3.4	0.001
	First-degree relative with endometrial cancer	154 /205	4.5	6.3	0.46
	Ever smoked regularly	154 /205	26.0	33.2	0.14
	Diabetes mellitus	154 /205	13.0	3.4	<0.001
	Hypertension	154 /205	34.4	19.0	0.001

^a Number of cases and controls providing information.
^b Mean duration of breast-feeding (months) for all women, including nulliparous: cases, 6.9 (SD, 7.9); controls 9.2 (10.3).
^c Herring, Baltic herring, mackerel.

Table 2

Serum levels of organochlorine compounds among 154 case patients with endometrial cancer and 205 control women^a

	Range			Median			Mean (SD)	P^b
		Cases	Controls	Cases	Controls	Cases	Controls	P^b
Pesticides (ng/g lipid)
DDT
p,p′-DDT	2–116	2–96.4	17.8	13.9	23.3 (19.6)	18.6 (16.7)	0.01
o,p′-DDT^c	2–19.7	2–22.7	2	2	2.4 (1.9)	2.4 (2.1)	0.37
p,p′-DDE	15–2881	31.7–2542	582.5	497	702.8 (499.8)	623.6 (479.0)	0.04
p,p′-DDD^c	2–30.2	2–25.7	2	2	2.7 (2.8)	2.7 (2.3)	0.84
HCB	16.5–175	14.6–351	66.8	64.9	70.3 (25.2)	66.2 (30.1)	0.08
HCH
α-HCH^c	1–8.0	1–7.4	1	1	1.1 (0.7)	1.1 (0.7)	0.81
β-HCH	13.2–781	7.4–744	57.8	51.1	71.8 (69.5)	62.7 (60.7)	0.02
γ-HCH^c	1–10.7	1–13.4	1	1	1.4 (1.2)	1.4 (1.5)	0.17
Oxychlordane	3.5–53.6	3.0–48.1	14.4	12.8	16.6 (9.0)	14.3 (7.6)	0.01
trans-Nonachlor	4.3–89.1	5.6–70	25.0	22.5	27.4 (13.4)	25.1 (12.2)	0.06
PCBs (ng/g lipid)
CB 28^c	1–174	1–352	3.8	3.0	6.3 (16.0)	5.5 (24.8)	0.02
CB 52^c	1–11.2	1–12.3	1	1	2.2 (1.9)	2.0 (1.7)	0.45
CB 101^c	1–20.1	1–15.5	1	1	2.0 (2.9)	2.1 (2.3)	0.10
CB 105	1–28.9	1–21.1	6.1	5.6	6.8 (4.7)	6.2 (4.4)	0.14
CB 118	5.3–185	4.8–178	50.2	43.0	52.8 (25.3)	46.5 (24.2)	0.01
CB 138	4.5–259	17.5–264	107.5	101	112.5 (43.2)	108.5 (45.7)	0.30
CB 153	19.7–526	60.4–607	226.5	223	237.1 (85.3)	236.2 (91.9)	0.74
CB 156	7.4–54.1	6.3–58.2	17.4	18.1	19.2 (7.0)	19.6 (7.7)	0.75
CB 167	1–30.5	1–28.4	9.3	8.7	10.5 (4.9)	9.6 (4.6)	0.06
CB 180	40.2–497	55.6–397	147	152	162.2 (61.1)	163.4 (60.0)	0.80

^a Including women with levels below the quantification limit (half of the quantification limit was taken as an estimated value).
^b Wilcoxon test.
^c Variables with many values below quantification limit: o,p′-DDT (n = 336); p,p′-DDD (n = 312);α -HCH (n = 345); γ-HCH (n = 304); CB 28 (n = 114); CB 52 (n = 228); CB 101 (n = 262).

Table 3

ORs with 95% CIs of developing endometrial cancer according to quartiles^a of serum organochlorine pesticide levels

Compound	Model^b	OR (95% CI)						P for trend^c
Compound	Model^b			Quartile 1	Quartile 2	Quartile 3	Quartile 4	P for trend^c
p,p′-DDT	Age-adjusted	1.0	1.3 (0.7–2.5)	1.1 (0.6–2.2)	1.8 (1.0–3.4)	0.08
	Multivariate	1.0	1.1 (0.6–2.2)	0.8 (0.4–1.6)	1.1 (0.5–2.1)	0.95
p,p′-DDE	Age-adjusted	1.0	1.0 (0.6–2.0)	1.4 (0.7–2.5)	1.4 (0.8–2.6)	0.17
	Multivariate	1.0	0.9 (0.5–1.8)	1.1 (0.6–2.0)	1.0 (0.6–2.0)	0.78
HCB	Age-adjusted	1.0	1.3 (0.7–2.4)	1.1 (0.6–2.1)	1.1 (0.6–2.2)	0.95
	Multivariate	1.0	1.2 (0.6–2.2)	1.0 (0.5–1.9)	1.0 (0.5–1.9)	0.76
β-HCH	Age-adjusted	1.0	1.0 (0.5–2.0)	1.4 (0.7–2.7)	1.3 (0.7–2.6)	0.29
	Multivariate	1.0	0.8 (0.4–1.5)	1.0 (0.5–2.0)	0.9 (0.5–1.9)	0.87
Oxychlordane	Age-adjusted	1.0	1.3 (0.7–2.6)	1.2 (0.6–2.4)	1.8 (0.9–3.4)	0.12
	Multivariate	1.0	1.1 (0.6–2.2)	1.0 (0.5–2.0)	1.4 (0.7–2.8)	0.33
trans-Nonachlor	Age-adjusted	1.0	1.4 (0.7–2.7)	1.6 (0.8–3.1)	1.4 (0.7–2.8)	0.31
	Multivariate	1.0	1.2 (0.6–2.3)	1.3 (0.7–2.7)	1.2 (0.6–2.5)	0.56

^a Median values for quartile 1 (cases/controls); quartile 4 (cases/controls), in ng/g lipid: p,p′-DDT, 6.3/4.8; 37.3/34; p,p′-DDE, 209.5/181; 1072/1165; HCB, 40.8/40.2; 109.5/94.2; β-HCH, 26/21.9; 100/98.4; oxychlordane, 6.7/6.9; 24/22.9; trans-nonachlor, 12.4/13; 40.4/39.1.
^b Multivariate adjusted for age and BMI.
^c Tests for trend were performed by assigning consecutive integers to levels of categorized variables.

Table 4

ORs with 95% CIs of developing endometrial cancer according to quartiles of serum levels of specific PCB congeners^a

Congener	Model^b	OR (95% CI)						P for trend^c
Congener	Model^b			Quartile 1	Quartile 2	Quartile 3	Quartile 4	P for trend^c
CB 105	Age-adjusted	1.0	1.4 (0.7–2.6)	1.2 (0.6–2.4)	1.2 (0.6–2.3)	0.69
	Multivariate	1.0	1.2 (0.6–2.3)	1.0 (0.5–1.8)	0.8 (0.4–1.6)	0.42
CB 118	Age-adjusted	1.0	1.7 (0.9–3.3)	1.6 (0.8–3.1)	1.9 (1.0–3.7)	0.11
	Multivariate	1.0	0.6 (0.8–3.0)	1.2 (0.6–2.4)	1.4 (0.7–2.8)	0.58
CB 138	Age-adjusted	1.0	0.9 (0.5–1.8)	1.2 (0.7–2.2)	1.0 (0.6–1.9)	0.74
	Multivariate	1.0	0.8 (0.4–1.6)	1.2 (0.6–2.2)	0.9 (0.5–1.7)	0.95
CB 153	Age-adjusted	1.0	0.9 (0.5–1.7)	1.1 (0.6–2.0)	0.8 (0.4–1.4)	0.58
	Multivariate	1.0	0.9 (0.5–1.7)	1.2 (0.6–2.2)	0.9 (0.5–1.7)	0.94
CB 156	Age-adjusted	1.0	1.4 (0.8–2.5)	1.1 (0.6–2.0)	0.7 (0.4–1.3)	0.18
	Multivariate	1.0	1.6 (0.8–2.9)	1.4 (0.7–2.6)	1.0 (0.5–2.0)	0.90
CB 167	Age-adjusted	1.0	2.2 (1.1–4.2)	1.6 (0.8–3.2)	2.0 (1.0–4.1)	0.19
	Multivariate	1.0	2.0 (1.0–3.9)	1.4 (0.7–2.9)	1.9 (0.9–3.9)	0.24
CB 180	Age-adjusted	1.0	0.9 (0.5–1.6)	0.8 (0.5–1.5)	0.7 (0.4–1.4)	0.32
	Multivariate	1.0	1.1 (0.6–2.0)	1.1 (0.6–2.2)	1.2 (0.6–2.2)	0.67

^a Median values for quartile 1 (cases/controls); quartile 4 (cases/controls), in ng/g lipid: CB 105, 1/1; 11.5/10.7; CB 118, 25.2/20.3; 73.4/70.9; CB 138, 67/59.1; 154/165; CB 153, 157/143; 342.5/351; CB 156, 12.9/12; 28.3/27.5; CB 167, 5/4.6; 14.7/15; CB 180, 108.5/103; 224.5/227.
^b Multivariate adjusted for age and BMI.
^c Tests for trend were performed by assigning consecutive integers to levels of categorized variables.

Table 5

ORs with 95% CIs of developing endometrial cancer according to quartiles of levels of compound groups (nmol/g lipid)^a

Group of compounds	Model^b	OR (95% CI)						P for trend^c
Group of compounds	Model^b			Quartile 1	Quartile 2	Quartile 3	Quartile 4	P for trend^c
All PCBs^d	Age-adjusted	1.0	1.2 (0.6–2.3)	1.4 (0.7–2.6)	1.5 (0.8–2.8)	0.23
	Multivariate	1.0	1.1 (0.6–2.2)	1.1 (0.6–2.2)	1.2 (0.6–2.2)	0.72
Estrogenic compounds, not including CB 153^e	Age-adjusted	1.0	1.4 (0.7–2.7)	1.6 (0.8–3.2)	1.7 (0.8–3.4)	0.15
	Multivariate	1.0	1.2 (0.6–2.4)	1.2 (0.6–2.4)	1.2 (0.6–2.4)	0.76
Estrogenic compounds, including CB 153^f	Age-adjusted	1.0	1.3 (0.7–2.4)	1.0 (0.5–2.0)	1.2 (0.6–2.4)	0.74
	Multivariate	1.0	1.1 (0.6–2.1)	0.9 (0.4–1.7)	1.1 (0.6–2.2)	0.90
Antiestrogenic compounds^g	Age-adjusted	1.0	1.8 (0.9–3.4)	1.7 (0.9–3.4)	1.7 (0.8–3.3)	0.22
	Multivariate	1.0	1.7 (0.9–3.3)	1.4 (0.7–2.8)	1.5 (0.7–3.0)	0.48
Compounds with no known hormonal effect,	Age-adjusted	1.0	1.2 (0.6–2.3)	1.6 (0.9–3.0)	1.6 (0.9–3.1)	0.08
including p,p′-DDE^h	Multivariate	1.0	1.2 (0.6–2.2)	1.4 (0.7–2.7)	1.3 (0.7–2.4)	0.39
Compounds with no known hormonal effect,	Age-adjusted	1.0	1.8 (1.0–3.4)	1.4 (0.7–2.7)	1.3 (0.6–2.5)	0.83
excluding p,p′-DDEⁱ	Multivariate	1.0	1.9 (1.0–3.6)	1.6 (0.8–3.2)	1.5 (0.7–3.0)	0.47

^a Including women with levels below the quantification limit (half of the quantification limit was taken as an estimated value).
^b Multivariate adjusted for age and BMI.
^c Tests for trend were performed by assigning consecutive integers to levels of categorized variables.
^d CB 28, CB 52, CB 101, CB 105, CB 118, CB 138, CB 153, CB 156, CB 167, and CB 180.
^e o,p′-DDT; p,p′-DDT; p,p′-DDD;β -HCH; γ-HCH; trans-nonachlor; oxychlordane; CB 28; CB 52; and CB 101.
^f o,p′-DDT; p,p′-DDT; p,p′-DDD;β -HCH; γ-HCH; trans-nonachlor; oxychlordane; CB 28; CB 52; CB 101; and CB 153.
^g CB 105, CB 118, CB 156, and CB 167.
^h α-HCH, CB 138, CB 180, HCB, and p,p′-DDE.
ⁱ α-HCH, CB 138, CB 180, and HCB.