Title: Pilot Project A: Pilot Case-Comparison Study of Insulin Resistance, Adiponectin and Endometrial Cancer in Puerto Rico CO-LEADERS: MDACC - Karen H. Lu, M.D., Associate Professor, Gynecologic Oncology UPRCCC - Guillermo Tortolero-Luna, M.D., Ph.D., Director, Cancer Control and Population Sciences Program ABSTRACT Cancer of the uterine corpus is the most common gynecologic malignancy in the United States, with 40,100 new cases and 7,470 cancer-related deaths estimated for 2008. Similarly, in Puerto Rico endometrial cancer is the most common gynecologic malignancy, and the third leading cause of cancer in women behind breast and colorectal cancer. In the year 2003, there were 321 new cases of endometrial cancer reported to the Puerto Rico Cancer Registry, accounting for 6% of all cancers in women. Recent observations suggest that new pathways need to be considered, including evidence for a possible role of insulin and the insulin-like growth factor system. We will conduct a case-comparison hospital-based pilot study to assess the role of insulin resistance and adiponectin, a biomarker of insulin resistance, as risk factors for endometrial cancer among Puerto Rican women. One hundred women (21 years and older) with a newly diagnosed, histplogically confirmed primary endometrial cancer will be selected at the Gynecologic Oncology clinic of the Department of Obstetrics and Gynecology at the University of Puerto Rico Medical Science Campus (UPR-MSC) and compared to 100 women selected among attendees to two Obstetrics and Gynecology clinics at the UPRMSC. Participants will undergo a face-to-face interview in which the following is collected: demographic information, smoking and drinking habits, weight history, personal and family medical history, reproductive and menstrual history, history of contraception and hormone replacement therapy, history of infertility, and levels of physical activity. In addition, women will undergo anthropometric measurements and collection of blood samples for measurements of insulin resistance. Insulin resistance (IR) will be measured using the quantitative insulin sensitivity check index (QUICKI). In addition, serum adiponectin levels, which correlate with insulin resistance, will be measured using a commercially available quantitative sandwich enzyme-linked immunoassay (ELISA). Univariate and multivariate unconditional logistic regression models will be used to assess the association of endometrial cancer with insulin resistance and serum adiponectin. The odds ratio (OR) and its 95% confidence intervals will be used to estimate the strength of the association between IR and other factors of interest and endometrial cancer.
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