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Original article Changes in metabolic syndrome and risk of breast and endometrial cancers according to menopause
Thi Xuan Mai Tran2orcid , Soyeoun Kim3orcid , Boyoung Park1orcid
Epidemiol Health 2023;e2023049
DOI: https://doi.org/10.4178/epih.e2023049 [Accepted]
Published online: May 1, 2023
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1Graduate School of Public Health, Hanyang University, Korea, Seoul, Korea
2Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea, Seoul, Korea
3Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea, Seoul, Korea
Corresponding author:  Boyoung Park,
Email: hayejine@hanmail.net
Received: 20 January 2023   • Revised: 3 April 2023   • Accepted: 12 April 2023
Full Article

Abstract

Objectives
This study investigated how changes in metabolic syndrome (MetS) are associated with the subsequent risk of breast and endometrial cancer according to menopausal status.
Methods
This cohort study, using data from the National Health Insurance Service database, included women aged ≥40 years who underwent 2 biennial cancer screenings (2009–2010 and 2011–2012) and were followed up until 2020. Participants were grouped into MetS-free, MetS-recovery, MetS-development, and MetS-persistent groups. Menopausal status (premenopausal, perimenopausal, and postmenopausal) was assessed at 2 screenings. Cox proportional hazard regression was used to assess the association between MetS changes and cancer risk.
Results
In 3,031,980 women, breast and endometrial cancers were detected in 39,184 and 4,298, respectively. Compared with the MetS-free group, those who recovered, developed, or had persistent MetS showed an increased risk of breast cancer, with adjusted hazard ratios (aHRs) of 1.05, 1.05, and 1.11, respectively (p<0.005). MetS persistence was associated with an increased risk of breast cancer in postmenopausal women (aHR=1.12, 95% CI, 1.08–1.16) but not in premenopausal or perimenopausal women. MetS persistence was associated with an increased risk of endometrial cancer in premenopausal, perimenopausal, and postmenopausal women, with aHRs of 1.41 (95% CI, 1.17–1.70), 1.59 (95% CI, 1.19–2.12), and 1.47 (95% CI, 1.32–1.63), respectively.
Conclusions
Increased breast cancer risk was associated with recovered, developed, and persistent MetS in postmenopausal women. Meanwhile, increased endometrial cancer risk was found in obese women who recovered from MetS or persistently had MetS, regardless of menopausal status, when compared to MetS-free women.

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