Metabolic risk factors and cervical cancer in the metabolic syndrome and cancer project (Me–Can)

BackgroundLittle is known about the association between metabolic risk factors and cervical cancer carcinogenesis.Material and methodsDuring mean follow-up of 11 years of the Me–Can cohort (N = 288,834) 425 invasive cervical cancer cases were diagnosed. Hazard ratios (HRs) were estimated by the use of Cox proportional hazards regression models for quintiles and standardized z-scores (with a mean of 0 and a SD of 1) of BMI, blood pressure, glucose, cholesterol, triglycerides and MetS score. Risk estimates were corrected for random error in the measurements.ResultsBMI (per 1SD increment) was associated with 12%, increase of cervical cancer risk, blood pressure with 25% and triglycerides with 39%, respectively. In models including all metabolic factors, the associations for blood pressure and triglycerides persisted. The metabolic syndrome (MetS) score was associated with 26% increased corrected risk of cervical cancer. Triglycerides were stronger associated with squamous cell carcinoma (HR 1.48; 95% CI, 1.20–1.83) than with adenocarcinoma (0.92, 0.54–1.56). Among older women cholesterol (50–70 years 1.34; 1.00–1.81), triglycerides (50–70 years 1.49, 1.03–2.16 and ≥ 70 years 1.54, 1.09–2.19) and glucose (≥ 70 years 1.87, 1.13–3.11) were associated with increased cervical cancer risk.ConclusionThe presence of obesity, elevated blood pressure and triglycerides were associated with increased risk of cervical cancer.

► Elevated BMI, blood pressure and triglycerides levels are associated with increased cervical cancer risk.
► A combined score of the MetS is associated with increased cervical cancer risk.
► Associations of metabolic factors differ by histological subtype of cervical cancer.