Postmenopausal women who develop endometrial cancer are, on the whole, heavier t

Question

Postmenopausal women who develop endometrial cancer are, on the whole, heavier than women who do not develop the disease. It is believed that higher levels of estrogen contained in fat cells increase the risk of this disease for heavier women. One might also ask if hormone replacement therapy (estrogen taken at the time of menopause) would also increase the risk of endometrial cancer. Below are odds ratios from one study looking at both estrogen replacement therapy and heavy weight as risk factors for endometrial cancer. Which of the following statements best describes the results of this study?

Weight is a confounder of the association between estrogen replacement therapy and endometrial cancer.

Heavy weight is a mediator between estrogen replacement therapy and endometrial cancer.

Weight interacts with the effect of estrogen replacement therapy on endometrial cancer.

Heavy weight and estrogen replacement therapy are independent risk factors for endometrial cancer.

None of the above.

A.

Weight is a confounder of the association between estrogen replacement therapy and endometrial cancer.

B.

Heavy weight is a mediator between estrogen replacement therapy and endometrial cancer.

C.

Weight interacts with the effect of estrogen replacement therapy on endometrial cancer.

D.

Heavy weight and estrogen replacement therapy are independent risk factors for endometrial cancer.

E.

None of the above.

Exposure Odds Ratios Comparing Those with and Without Endometrial Cancer on Two Exposures Crude Stratified Stratified Stratified Among the Light Weight) Among the Moderate Weight Among the Heavy Weight) 2.17 5.00 2.75 1.30 Replacement Therapy (compared to no Replacement Therapy) Crude Stratified Stratified (Among those without Estrogen Replacement Therapy) (Among those with Estrogen Replacement Therapy) Heavy Weight Light Weight) 2. 1.19

Explanation / Answer

In odd ratio formula,

there are three outcome either odd ratio =1,<1or >1. If odd ratio is equal to one then there is no difference between exposure and non exposure. If it is >1 then positive association of exposure on the person and if less than one then it has negative association of exposure on the person. Here most of the values of Odd ratios are greater than one. Hence option (c) is true as other options seem are not true according to the odd ratio values.

Like weight is not a basic casuse of this disease as per the data so option (A) is wrong

second option "Heavy weight is a mediator between estrogen replacement therapy and endometrial cancer is not true" as heavy weight odd ratio is minimum then all the ratio for estrogen replacement therapy. So this is wrong.

Fourth option is wrong because we cannot say anything about independency of any risk factor if all the odd ratio values are greater than 1

So option (c) is more suitable than all the options.

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