Risk factors for endometrial cancer in Black women

Todd R. Sponholtz, Julie R. Palmer, Lynn Rosenberg, Chu Chen, Yu Chen, Megan A. Clarke, Tess Clendenen, Mengmeng Du, Lisa Johnson, Linda M. Liao, Kara A. Michels, Kelli O’Connell, Sara H. Olson, Stacey Petruzella, Timothy R. Rebbeck, Veronica Wendy Setiawan, Britton Trabert, Noel S. Weiss, Nicholas Wentzensen, Lynne WilkensLauren A. Wise

Research output: Contribution to journalArticlepeer-review


Purpose: The incidence of endometrial cancer (EC) has been increasing faster among Black women than among other racial/ethnic groups in the United States. Although the mortality rate is nearly twice as high among Black than White women, there is a paucity of literature on risk factors for EC among Black women, particularly regarding menopausal hormone use and severe obesity. Methods: We pooled questionnaire data on 811 EC cases and 3,124 controls from eight studies with data on self-identified Black women (4 case–control and 4 cohort studies). We analyzed cohort studies as nested case–control studies with up to 4 controls selected per case. We used logistic regression to estimate multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: We observed a positive association between BMI and EC incidence (Ptrend < 0.0001) The OR comparing BMI ≥ 40 vs. < 25 kg/m2 was 3.92 (95% CI 2.91, 5.27). Abdominal obesity among those with BMI < 30 kg/m2 was not appreciably associated with EC risk (OR 1.21, 95% CI 0.74, 1.99). Associations of reproductive history with EC were similar to those observed in studies of White women. Long-term use of estrogen-only menopausal hormones was associated with an increased risk of EC (≥ 5 years vs. never use: OR 2.08, 95% CI: 1.06, 4.06). Conclusions: Our results suggest that the associations of established risk factors with EC are similar between Black and White women. Other explanations, such as differences in the prevalence of known risk factors or previously unidentified risk factors likely underlie the recent increases in EC incidence among Black women.

Original languageEnglish (US)
Pages (from-to)421-430
Number of pages10
JournalCancer Causes and Control
Issue number5
StatePublished - May 2023


  • Black women
  • Endometrial cancer
  • Exogenous hormones
  • Obesity
  • Reproductive history

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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