Risk factors for endometrial cancer: An umbrella review of the literature.
Olivia Raglan,Olivia Raglan,Ilkka Kalliala,Ilkka Kalliala,Georgios Markozannes,Sofia Cividini,Marc J. Gunter,Jaya Nautiyal,Hani Gabra,Evangelos Paraskevaidis,Pierre Martin-Hirsch,Kostas Tsilidis,Kostas Tsilidis,Maria Kyrgiou,Maria Kyrgiou +14 more
TLDR
Of many proposed risk factors, only three had strong association without hints of bias, and Identification of genuine risk factors associated with endometrial cancer may assist in developing targeted prevention strategies for women at high risk.Abstract:
Although many risk factors could have causal association with endometrial cancer, they are also prone to residual confounding or other biases which could lead to over- or underestimation. This umbrella review evaluates the strength and validity of evidence pertaining risk factors for endometrial cancer. Systematic reviews or meta-analyses of observational studies evaluating the association between non-genetic risk factors and risk of developing or dying from endometrial cancer were identified from inception to April 2018 using PubMed, the Cochrane database and manual reference screening. Evidence was graded strong, highly suggestive, suggestive or weak based on statistical significance of random-effects summary estimate, largest study included, number of cases, between-study heterogeneity, 95% prediction intervals, small study effects, excess significance bias and sensitivity analysis with credibility ceilings. We identified 171 meta-analyses investigating associations between 53 risk factors and endometrial cancer incidence and mortality. Risk factors were categorised: anthropometric indices, dietary intake, physical activity, medical conditions, hormonal therapy use, biochemical markers, gynaecological history and smoking. Of 127 meta-analyses including cohort studies, three associations were graded with strong evidence. Body mass index and waist-to-hip ratio were associated with increased cancer risk in premenopausal women (RR per 5 kg/m2 1.49; CI 1.39-1.61) and for total endometrial cancer (RR per 0.1unit 1.21; CI 1.13-1.29), respectively. Parity reduced risk of disease (RR 0.66, CI 0.60-0.74). Of many proposed risk factors, only three had strong association without hints of bias. Identification of genuine risk factors associated with endometrial cancer may assist in developing targeted prevention strategies for women at high risk.read more
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Endometrial cancer
TL;DR: In this paper , the authors proposed minimally invasive surgical staging and sentinel-lymph-node biopsy for endometrial cancer, which provides a low morbidity alternative to historical surgical management without compromising oncological outcomes.
Journal ArticleDOI
Estrogen Signaling in Endometrial Cancer: a Key Oncogenic Pathway with Several Open Questions
Adriana C. Rodriguez,Zannel Blanchard,Zannel Blanchard,Kathryn A. Maurer,Kathryn A. Maurer,Jason Gertz,Jason Gertz +6 more
TL;DR: The evidence for the importance of estrogen signaling in endometrial cancer, details of the endometricrial cancer-specific actions of ER, and open questions surrounding estrogen signaling are discussed.
Journal ArticleDOI
Association of Antidepressant Use With Adverse Health Outcomes: A Systematic Umbrella Review
Elena Dragioti,Elena Dragioti,Marco Solmi,Marco Solmi,Angela Favaro,Paolo Fusar-Poli,Paolo Fusar-Poli,Paolo Fusar-Poli,Paola Dazzan,Paola Dazzan,Trevor Thompson,Brendon Stubbs,Brendon Stubbs,Joseph Firth,Joseph Firth,Joseph Firth,Michele Fornaro,D Tsartsalis,André F. Carvalho,Eduard Vieta,Philip McGuire,Allan H. Young,Allan H. Young,Jae Il Shin,Christoph U. Correll,Evangelos Evangelou,Evangelos Evangelou +26 more
TL;DR: It is suggested that most putative adverse health outcomes associated with antidepressant use may not be supported by convincing evidence, and confounding by indication may alter the few associations with convincing evidence.
Journal ArticleDOI
Endometrial cancer
Emma J Crosbie,Sarah Kitson,Jessica N. McAlpine,Asima Mukhopadhyay,Melanie E Powell,Naveena Singh +5 more
Journal ArticleDOI
Factors Associated With Loneliness: An Umbrella Review Of Observational Studies
Marco Solmi,Nicola Veronese,Daiana Galvano,Angela Favaro,Edoardo G Ostinelli,Vania Noventa,Elisa Favaretto,Florina Tudor,Matilde Finessi,Jae Il Shin,Lee Smith,Ai Koyanagi,Alberto Cester,Francesco Bolzetta,Antonino Cotroneo,Stefania Maggi,Jacopo Demurtas,Diego De Leo,Marco Trabucchi +18 more
TL;DR: This work is the first meta-evidence synthesis showing that highly suggestive and significant evidence supports the association between loneliness and adverse mental and physical health outcomes.
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