Evidence map›Paper›PMID 31614036›Full record

ArticleUltrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology2020

Serial endometrial thickness and risk of non-endometrial hormone-dependent cancers in postmenopausal women in UK Collaborative Trial of Ovarian Cancer Screening.

M Burnell, A Gentry-Maharaj, C Glazer, C Karpinskyj, A Ryan, S Apostolidou, J Kalsi, M Parmar, S Campbell, I Jacobs and 1 more

Open access · hybridAbstract readEvaluation StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 4 countries.

M BurnellMRC CTU, Institute of Clinical Trials and Methodology, University College London, London, UK.ORCID 0000-0002-2632-1545
A Gentry-MaharajMRC CTU, Institute of Clinical Trials and Methodology, University College London, London, UK.
C GlazerDepartment of Occupational and Environmental Medicine, Frederiksberg-Bispebjerg University Hospital, Copenhagen, NV, Denmark.
C KarpinskyjMRC CTU, Institute of Clinical Trials and Methodology, University College London, London, UK.
A RyanMRC CTU, Institute of Clinical Trials and Methodology, University College London, London, UK.
S ApostolidouMRC CTU, Institute of Clinical Trials and Methodology, University College London, London, UK.
J KalsiDepartment of Women's Cancer, Institute for Women's Health, University College London, London, UK.
M ParmarMRC CTU, Institute of Clinical Trials and Methodology, University College London, London, UK.
S CampbellCreate Fertility, London, UK.
I JacobsDepartment of Women's Cancer, Institute for Women's Health, University College London, London, UK.
U MenonMRC CTU, Institute of Clinical Trials and Methodology, University College London, London, UK.ORCID 0000-0003-3708-1732
MRC Clinical Trials Unit at UCL · GBCREATe Centre · GBFrederiksberg Hospital · DKLondon Women's Clinic · GBUNSW Sydney · AU

Funding

Department of Health HTA/16/46/01Medical Research Council G0801228Medical Research Council G9901012Medical Research Council MC_UU_12023/20Medical Research Council MC_UU_12023/28
6 · The paper itself

Abstract

objectiveEstrogen is a well-established risk factor for various cancers. It causes endometrial proliferation, which is assessed routinely as endometrial thickness (ET) using transvaginal ultrasound (TVS). Only one previous study, restricted to endometrial and breast cancer, has considered ET and the risk of non-endometrial cancer. The aim of this study was to explore the association between baseline and serial ET measurements and nine non-endometrial hormone-sensitive cancers, in postmenopausal women, using contemporary statistical methodology that attempts to minimize the biases typical of endogenous serial data.

methodsThis was a cohort study nested within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). In the ultrasound arm of UKCTOCS, 50639 postmenopausal women, aged 50-74, underwent annual TVS examination, of whom 38 105 had a valid ET measurement, no prior hysterectomy and complete covariate data, and were included in this study. All women were followed up through linkage to national cancer registries. The effect of ET on the risk of six estrogen-dependent cancers (breast, ovarian, colorectal, bladder, lung and pancreatic) was assessed using joint models for longitudinal biomarker and time-to-event data, and Cox models were used to assess the association between baseline ET measurement and these six cancers in addition to liver cancer, gastric cancer and non-Hodgkin's lymphoma (NHL). All models were adjusted for current hormone-replacement therapy (HRT) use, body mass index, age at last menstrual period, parity and oral contraceptive pill use.

resultsThe 38 105 included women had a combined total of 267 567 (median, 8; interquartile range, 5-9) valid ET measurements. During a combined total of 407 838 (median, 10.9) years of follow-up, 1398 breast, 351 endometrial, 381 lung, 495 colorectal, 222 ovarian, 94 pancreatic, 79 bladder, 62 gastric, 38 liver cancers and 52 NHLs were registered. Using joint models, a doubling of ET increased significantly the risk of breast (hazard ratio (HR), 1.21; 95% CI, 1.09-1.36; P = 0.001), ovarian (HR, 1.39; 95% CI, 1.06-1.82; P = 0.018) and lung (HR, 1.25; 95% CI, 1.02-1.54; P = 0.036) cancers. There were no statistically significant associations between ET and the remaining six cancers.

conclusionPostmenopausal women with high/increasing ET on TVS are at increased risk of breast, ovarian and lung cancer. It is important that clinicians are aware of these risks, as TVS is a common investigation. © 2019 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

Indexed as

PostmenopauseAgedBreast NeoplasmsEarly Detection of CancerEndometrial HyperplasiaEndometriumEstrogensFemaleHumansInformation Storage and RetrievalLung NeoplasmsMiddle AgedNeoplasmsOvarian NeoplasmsRandomized Controlled Trials as TopicRegistriesEstrogensbreast cancercancer biomarkercumulative estrogenendometrial thicknessjoint modelslung cancerovarian cancertransvaginal ultrasound

Identifiers

PMID31614036
PMCPMC7496247
OpenAlexW2980968995

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.