Using their novel prediction algorithm, a team of Harvard researchers identified those at elevated risk for endometrial cancer. The research was published in the Journal of the National Cancer Institute.
Screening guidelines do not recommend evaluating those with Lynch syndrome for endometrial cancer, according to the CDC. Each year, Lynch syndrome causes 4,200 colorectal and 1,800 uterine (endometrial) malignancies.
The Harvard model is the most comprehensive and diverse international research yet conducted. Two previous risk-model investigations on chosen study groups failed to uncover a history of diabetes, education, hypertension, or hormonal treatment use.
Researchers at Harvard hope that this model will serve as the foundation for the development of a risk prediction tool for clinical public health practice and will examine genetic markers associated with an increased risk of endometrial cancer.
The investigation included 19 case-control studies conducted by the Collaboration for the Epidemiology of Endometrial Cancer. There were participants from the United States, Canada, Europe, China, and Australia, among others. The investigation was limited to white postmenopausal women between the ages of 45 and 85.
Using the statistical approach LASSO, researchers were able to accurately predict the high-risk individuals for endometrial cancer. The Harvard team then translated these hazards into an absolute risk prediction to determine the probability that an individual will get the disease during the next decade.
Data from 121,700 female registered nurses aged 30 to 55 years in the Nurses’ Health Study, 116,430 female registered nurses aged 25 to 42 years in the Nurses’ Health Study II, and 78,232 women aged 55 to 74 years in the Prostate, Lung, Colorectal and Ovarian Screening Trial confirmed their findings.
Pathologists and physicians used questionnaires, death records, and medical records to confirm a diagnosis of endometrial cancer in participants in these three cohorts throughout a 10-year period.
Immaculata De Vivo, M.P.H., Ph.D., senior author and professor of Medicine at Harvard Medical School, emphasizes the significance of the three data sets in a university news release.
De Vivo stated, “NHS, NHSII, and PLCO are cohorts with exceptionally rich datasets, containing data on tens of thousands of patients across decades of follow-up.” “Genetic data are also available for many of these study participants, allowing us to evaluate the possible contributions of genetic variables to endometrial cancer risk prediction.”
According to their findings, the average cumulative risk of endometrial cancer for women aged 45 to 85 was 5.4%. Women with low genetic risk factors for endometrial cancer had a risk of developing the disease of less than 2%. In contrast, women with the greatest number of epidemiologic risk factors had the highest probability of having endometrial cancer, ranging from 13.7% to 15.0%.
When their risk model was applied to a more representative sample of white American women, individuals in the 97th percentile of risk had a likelihood of developing endometrial cancer that exceeded 20%. That is comparable to the proportion of patients with Lynch syndrome who are at risk.
Although the study is an enormous step forward, additional research is required to determine the model’s effectiveness with different races. While white women make up 72% of endometrial cancer cases in the U.S., the American Cancer Society says Black women are more likely to attain and die from the disease.