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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Body mass index (BMI) is known to differ among the various diseases, potentially due to etiologic causes, which can lead to bias in estimating the effects of other risk factors. The relationship between BMI and disease must be identified to control for this potential bias in epidemiological investigations. We used the data from our large hospital-based case-control study to analyze the difference in BMI (computed as kg/m2) by diagnosis, separately in males (n = 20,011) and females (n = 9,083) admitted to the hospital between 1977 and 1992. The difference in BMI between diagnoses is most clearly represented through the quartile distributions, whereas the mean tends to camouflage it. Although some associations between BMI and disease differed between the sexes, in general, fractures and diseases of the respiratory tract were associated with the lowest BMI and arthritis, cataract/glaucoma, and endometrial cancer with the highest BMI. Potential disease risk factors, including alcohol use, smoking, and education, showed a strongly negative and age a strongly positive association with BMI in females, but little or no association was found between BMI and these factors in males. The data presented provide information on the correlation between BMI and several diseases and the potential distortion of etiologic factors that can occur as a result of these correlations. The reported associations with BMI can be useful in the evaluation of independent risk factors or when selecting appropriate controls in epidemiological investigations of diseases.
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PMID:The association between body mass index and the relative frequencies of diseases in a sample of hospitalized patients. 807 78

Epidemiological, experimental, and clinical data strongly support the possibility that breast cancer will be prevented by using anti-estrogenic interventions in healthy women. Three trials involving over 20,000 women have so far been reported using tamoxifen 20 mg/day or placebo in healthy women to chemoprevent breast cancer. The American National Surgical Adjuvant Breast and Bowel P-1 Project randomized over 13,000 women to take tamoxifen or placebo and showed a 49% reduction in the early incidence of breast cancer. This was associated with a reduction in osteoporotic fractures but increases in the risks of endometrial cancer, cataract, and thromboembolism. The Royal Marsden tamoxifen trial randomized 2,500 women, and the Italian national trial randomized 5,000 women. Interim analyses from these two trials showed no effect on the early incidence of breast cancer. These results, therefore, have not been able to clearly show an overall clinical benefit of giving tamoxifen to healthy women, nor have they shown which women are likely to benefit. Another selective anti-estrogen (SERM), raloxifene, has been used in a clinical trial to prevent osteoporotic fractures in women with low bone mineral density. Annual mammography in this trial has shown an approximate 80% reduction in the early incidence of breast cancer, and further follow-up of this trial continues. New trials in chemoprevention of breast cancer being started or being proposed use luteinizing-hormone-releasing hormone analogues, aromatase inhibitors, and other SERMs.
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PMID:Breast cancer prevention. 1185 47

Breast cancer is the most frequent female malignant disease in developed countries. Various approaches are being developed for breast cancer prevention. Medical prevention called chemoprevention is reviewed. Prior to any intervention estimation of breast cancer risk is mandatory. For practical reasons distinction of two risk groups is useful. In the high risk group inherited gene mutation showing high penetrance may be suspected, while in the medium risk group hormonal factors play an important role. The antiestrogen tamoxifen has been extensively investigated in breast cancer and also tested for the prevention of breast cancer. The results of four randomized tamoxifen prevention studies have been published. In the largest, American trial the number of invasive or "in situ" breast cancers was halved by tamoxifen. Particularly estrogen receptor positive and relatively good prognosis breast cancers were reduced. Similar results were obtained in the "International Breast Intervention Study". Tamoxifen has been registered for breast cancer prevention for high risk individuals in the United States. The Italian and English ("Royal Marsden Hospital") studies did not prove significant preventative effect for tamoxifen that may be explained by the characteristics of the study protocols and study populations. Increased rates of endometrial cancer, thromboembolic events and cataract were observed under tamoxifen treatment, especially over the age of 50. Prevention has an increased importance in gene mutation carriers. Besides prophylactic mastectomy and close surveillance tamoxifen and bilateral oophorectomy or the use of gonadotropin releasing-hormone analogs seem efficient in this group. Various new chemoprevention strategies are under testing. Raloxifene and the aromatase inhibitors show advantage in menopausal women, the retinoid fenretinide and the gonadotropin releasing-hormone analogs seem promising for premenopausal individuals. The use of these agents are investigated in clinical trials. It is likely that not one single method will be applied for breast cancer prevention in the future. Preferably individual prevention strategies based on individual risk assessment will be developed.
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PMID:[Breakthrough in breast cancer chemoprevention]. 1272 84

Epidemiological, experimental and clinical data strongly support the possibility that breast cancer can be prevented by using anti-estrogenic interventions in healthy women. Four trials involving over 25,000 women have so far been reported using tamoxifen 20 mg/day or placebo in healthy women to chemoprevent breast cancer, and several trials utilizing raloxifene or aromatase inhibitors are underway. Interim analyses of the Royal Marsden tamoxifen trial and the Italian national trial showed no effect on the early incidence of breast cancer. The NSABP-P1 showed a 49% reduction in early incidence of breast cancer. This was associated with a reduction in osteoporotic fractures but increases in the risks of endometrial cancer, cataract and thromboembolism. The IBIS trial showed a 32% reduction with a two-fold increase in endometrial cancer and in thromboembolic events. Mortality rates of breast cancer in women receiving tamoxifen prophylactically should be monitored and further follow-up of these trials is needed to determine whether tamoxifen provides an overall health benefit or increase specific or overall survival of breast cancer. High-risk women should not be advised to take anti-estrogens outside of a clinical trial setting.
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PMID:Should women be advised to take prophylactic endocrine treatment outside of a clinical trial setting? 1598 Jan 59

Toremifene has been in clinical use for 8 years for the treatment of advanced hormone-sensitive breast cancer and the adjuvant treatment of early breast cancer. More than 350,000 patient treatment years have accumulated, sufficient to allow evaluation of its longer-term safety profile in comparison with tamoxifen and, where possible, with raloxifene and aromatase inhibitors. We reviewed all preclinical and clinical safety data from 1978 to 2004 and comparative clinical safety data between October 1995 and the end of 2004. Secondary endometrial cancer incidence was lower with toremifene than with tamoxifen and was similar to that with raloxifene. It is speculated that toremifene may unmask existing endometrial tumors rather than induce new events. The risk of stroke, pulmonary embolism, and cataract may be lower with toremifene than with tamoxifen and the risk of pulmonary embolism and deep vein thrombosis lower than with raloxifene. Beneficial estrogen agonistic effects were equivalent to those of tamoxifen regarding bone mineral density and superior regarding lipid profiles.
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PMID:Toremifene: an evaluation of its safety profile. 1628 4

Tamoxifen and raloxifene are both selective estrogen receptor modulators (SERMs). The medicines can block estrogen mediated breast cancer growth and development but will also maintain bone density in postmenopausal women and lower circulating cholesterol. Tamoxifen has remained the antihormonal therapy of choice for the treatment of ER positive breast cancer for the last 30 years. However, although adjuvant tamoxifen produces profound increases in disease-free and overall survival in patients with ER positive breast cancer, concerns about drug resistance, blood clots and endometrial cancer have resulted in a change to the use of aromatase inhibitors for the treatment of postmenopausal women. Nevertheless, tamoxifen remains the antihormonal treatment of choice for premenopausal women with ER positive breast cancer and for risk reduction in premenopausal women who are at high risk for developing breast cancer. The risk of endometrial cancer and thromboembolic disorders during tamoxifen therapy is not elevated in premenopausal women. It is important to note that aromatase inhibitors or raloxifene should not be used in premenopausal women. Raloxifene is used to prevent osteoporosis in postmenopausal women and, unlike tamoxifen, does not increase the risk of endometrial cancer. However, raloxifene does reduce breast cancer risk by 50-70% in both low risk and high risk postmenopausal women. Comparisons of raloxifene with tamoxifen show equal efficacy as a chemopreventive for breast cancer but there is a reduction in thromboembolic disorders, fewer endometrial cancers, hysterectomies, cataracts and cataract surgeries in women taking raloxifene. Overall, SERMs continue to fulfill their promise as appropriate medicines that target specific populations for the treatment and prevention of breast cancer.
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PMID:SERMs for the treatment and prevention of breast cancer. 1744 Aug 19

Breast cancer risk factor analysis allows the identification of women at very high risk for the future development of breast cancer. Many of the known risk factors are either not modifiable or are not reasonably modifiable because of social implications or other potential health benefits (eg, those associated with hormone replacement therapy). Thus, effective strategies to decrease the risk of breast cancer are needed. The recent demonstration that the use of tamoxifen for 5 years decreases the future risk of breast cancer by approximately 49% provides the opportunity for a risk-reduction intervention. Women taking tamoxifen must be monitored for the occurrence of well-defined toxicities, including hot flashes and, more rarely, endometrial carcinoma, thromboembolic disease, and cataract formation. Strategies are available for the management of tamoxifen toxicity. In special circumstances, such as in carriers of BRCA1 or BRCA2 mutations, the risk of future breast cancer is very high, and the performance of a bilateral prophylactic mastectomy may be considered. Women considering bilateral prophylactic mastectomy should undergo multidisciplinary consultation so that they may make a fully informed decision. The panel strongly encourages patients and health care providers to participate in clinical trials to test new strategies for decreasing the risk of breast cancer. Only through the accumulated experience gained from well-designed, prospective clinical trials will additional advances in the reduction of breast cancer risk be realized.
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PMID:Breast Cancer Risk Reduction Clinical Practice Guidelines in Oncology. 1976 86