Seventeen studies (4 cohort and 13 case-control) in the Epidemiology of Endometrial Cancer Consortium (E2C2) that collected information on age at last birth or age at last pregnancy were included in the pooled analysis ( 3, 11вЂ“ 27). The large number of cases and controls also allowed us to evaluate associations by tumor subtype. In the present study, we combined individual-level data from 17 epidemiologic studies and performed a pooled analysis of 8,671 endometrial cancer cases and 16,562 controls to examine how age at last birth affects the risk of endometrial cancer and how this is influenced by other risk factors for the disease. Later age at last birth (в‰Ґ35 years of age) is associated with a lower risk of endometrial cancer ( 2вЂ“ 10), but whether the association is independent of the number of births or other known risk factors (e.g., obesity, exogenous hormone use) requires clarification.

Most epidemiologic studies have observed that nulliparity is associated with an elevated risk of endometrial cancer, whereas an increasing number of births is associated with a reduction in risk ( 1). Pregnancy results in large changes in endogenous estrogen and progesterone levels, and for this reason it is plausible that pregnancy influences the incidence of endometrial cancer. In this large pooled analysis, late age at last birth was independently associated with a reduced risk of endometrial cancer, and the reduced risk persisted for many years.Д®xposure of the endometrium to estrogen вЂњunopposedвЂќ by progesterone is a common cause of endometrial cancer ( 1). No effect modification was observed by body mass index, parity, or exogenous hormone use. The protective association was similar across the different age-at-diagnosis groups and for the 2 major tumor histologic subtypes (type I and type II).

Women who last gave birth at 40 years of age or older had a 44% decreased risk compared with women who had their last birth under the age of 25 years (95% confidence interval: 47, 66). The pooled odds ratio per 5-year increase in age at last birth was 0.87 (95% confidence interval: 0.85, 0.90). After adjustment for known risk factors, endometrial cancer risk declined with increasing age at last birth ( P trend < 0.0001). A total of 8,671 cases of endometrial cancer and 16,562 controls were included in the analysis. Individual-level data from 4 cohort and 13 case-control studies in the Epidemiology of Endometrial Cancer Consortium were pooled. Childbearing at an older age has been associated with a lower risk of endometrial cancer, but whether the association is independent of the number of births or other factors remains unclear.

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