• endometrial cancer;
  • occupation;
  • silica;
  • silk;
  • textile



A case-cohort study was conducted to investigate associations between occupational exposures and endometrial cancer nested within a large cohort of textile workers in Shanghai, China.


The study included 176 incident endometrial cancer cases diagnosed from 1989 to 1998 and a randomly-selected age-stratified reference subcohort (n = 3,061). Study subjects' complete work histories were linked to a job-exposure matrix developed specifically for the textile industry to assess occupational exposures. Hazard ratios (HR) and 95% confidence intervals were calculated using Cox proportional hazards modeling adapted for the case-cohort design, adjusting for age at menarche and a composite variable of gravidity and parity.


An increased risk of endometrial cancer was detected among women who had worked for ≥10 years in silk production (HR = 3.8, 95% CI 1.2–11.8) and had exposure to silk dust (HR = 1.7, 95% CI 0.9–3.4). Albeit with few exposed women (two cases and eight subcohort women), there was a 7.4-fold increased risk associated with ≥10 years of silica dust exposure (95% CI 1.4–39.7).


The findings suggest that some textile industry exposures might play a role in endometrial carcinoma and should be further replicated in other occupational settings. Am. J. Ind. Med. 51:673–679, 2008. Published 2008 Wiley-Liss, Inc.