Mendelian randomization analysis of factors related to ovulation and reproductive function and endometrial cancer risk - BMC Medicine

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Mendelian randomization analysis of factors related to ovulation and reproductive function and endometrial cancer risk - BMC Medicine
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A study published in BMCMedicine reports that the number of live births causally reduced the risk of endometrial cancer, independent of BMI, age at menarche and age at menopause.

$$\mathrm{Years \ ovulating }=\mathrm{ years \ menstruating }-\mathrm{ years \ on \ pill }- 0.75 \times $$

Women with an early age at menarche of < 8 years were excluded from this analysis . In addition, women with a history of hysterectomy before menopause , who were not sure of their age at menopause due to their hysterectomy , or early menopause were also excluded. For menopause and menarche, we used the average age reported across multiple reporting instances, and women who differed in their reported ages by greater than 3 years were excluded from the analysis.

Age at last live birth was defined as the age of primiparous women at birth or the age at last live birth as reported by women who reported multiple live births. Women with inconsistent reports of age at last live birth across the four data collection instances were excluded . 220,419 women had information available for their age at last live birth.

We also conducted a series of multivariate observational analyses for EC risk. The first model included EC and all of the exposures investigated in the MVMR as well as educational attainment, due to the strong signal observed in the univariate observational analysis. The second model further explored the effect of the number of terminations on EC risk, due to the strong association observed in the univariate observational analyses, while adjusting for other factors and educational attainment.

We conducted further sensitivity analyses to investigate the observational and potentially causal relationships between the number of live births and EC risk. While univariate observational analyses found the number of live births to be significantly associated with EC risk, the association attenuated in the multivariate observational analyses. Further regression analysis was performed, where we investigated the number of live births and EC risk, while adjusting for a single other risk factors .

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