Risk factors for hyperplasia-associated versus atrophy-associated endometrial carcinoma

OBJECTIVE: Endometrial cancer can be divided into atrophy-associated and hy perplasia-associated subtypes. it has been suggested that these subtypes ha ve different pathologic features and prognoses. This preliminary study expl ores whether these subtypes are associated with different risk factors. STUDY DESIGN: Hysterectomies performed in cases of endometrial carcinoma wi th evaluable benign endometrium on routine processing were reviewed, and cl inical data were abstracted from medical records. Forty-eight subjects with atrophy-associated and 28 subjects with hyperplasia-associated cancers wer e studied. RESULTS: We found younger age, higher weight, absence of cigarette smoking, and earlier menarche in subjects with hyperplasia-related cancers. CONCLUSIONS: Our findings support the idea that hyperplasia-associated endo metrial cancer is estrogen-related but also suggest that atrophy-associated cases may result from a different causal pathway. Epidemiologic studies ma y yield more precise and accurate measures of association if atrophy-associ ated and hyperplasia-associated endometrial cancers are considered separate ly.