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Open Access 01-12-2019 | Obesity | Research article

Risk factors for endometrial carcinoma among postmenopausal women in Sri Lanka: a case control study

Authors: Withanage Iresha udayangani Jayawickcrama, Chrishantha Abeysena

Published in: BMC Public Health | Issue 1/2019

Abstract

Background

Endometrial carcinoma burden is on the rise globally. The objective of this study was to determine the risk factors for endometrial carcinoma among postmenopausal women in Western province in Sri Lanka.

Methods

A case control study was conducted recruiting 83 incident cases of endometrial carcinoma and 332 unmatched hospital controls from all the secondary and tertiary care hospitals in the province using consecutive sampling technique. A case was defined as a postmenopausal woman who had been residing in the province for at least a period of 1 year, diagnosed to have endometrial carcinoma with histological confirmation within 3 months of the initiation of data collection of the study. Data were collected using validated interviewer administered questionnaire. Risk factor were identified through multiple logistic regression and results were expressed as adjusted odds ratios (AOR) and 95% confidence intervals (CI).

Results

The independent risk factors of endometrial carcinoma are having family history of any type of cancer among first degree relative (AOR = 12.6; 95% CI:5.14–30.9), generalized obesity (BMI ≥25 kg/m²) (AOR = 11.85; 95% CI:5.12–27.4), never conceived (AOR = 3.84; 95% CI:1.37–10.7), age at menarche ≤11 years (AOR = 4.07; 95% CI:1.16–14.2), age > 55 years (AOR = 4.69; 95% CI:2.16–10.2), monthly family income of ≤20,000 Rupees (AOR = 2.65; 95% CI:1.31–5.39), sub-optimal consumption of deep fried food (AOR = 0.17; 95% CI:0.06–0.46), and low level household activities (AOR = 2.82; 95% CI:1.34–5.92).

Conclusions

There were eight independent risk factors of endometrial carcinoma specific for Sri Lankan postmenopausal women identified. Some modifiable risk factors such as generalized obesity, sub-optimal dietary practices and low level physical activities need to be addressed at primary prevention level.

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Bohiltea R, Furtunescu F, Dosius M, Cîrstoiu M, Radoi V, Baroș A, Bohîlțea LC. Evaluation of endometrial cancer epidemiology in Romania. J Med Life. 2015;8(2):218–25.PubMedPubMedCentral

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebel M, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):359–86. https://doi.org/10.1002/ijc.29210 PMID:25220842.CrossRef

American Cancer Society. Cancer Facts & Figures 2012 [internet]. Atlanta: American Cancer Society; 2015. Available from https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2012.html

Lai JC, Weng C, Huang S, Huang N, Chou Y, Wang C, Wang K. Incidence and lifetime risk of uterine corpus cancer in Taiwanese women from 1991 to 2010. Taiwan J Obstet Gynecol. 2017;56(1):68–72. https://doi.org/10.1016/j.tjog.2015.09.010.CrossRefPubMed

National Cancer Control Programme. Cancer incidence data 2010. Sri Lanka: National Cancer Control Programme; 2016. Available from http://nccp.health.gov.lk/images/PDF_PUBLICATIONS/Cancer_Incidence_Data_2010.pdf

Parslov M, Lidegaard O, Klintorp S, Pedersen B, Jønsson L, Eriksen PS, Ottesen B. Risk factors among young women with endometrial cancer: a Danish case-control study. Am J Obstet Gynecol. 2000;182(1):23–9.CrossRef

Bittoni MA, Fisher JL, Fowler JM, Maxwell GL, Paskett ED. Assessment of the effects of severe obesity and lifestyle risk factors on stage of endometrial cancer. Cancer Epidemiol Biomark Prev. 2013;22(1):76–81. https://doi.org/10.1158/1055-9965.EPI-12-0843.CrossRef

Inoue M, Okayama A, Fujith M, Enomata T, Tanizawa O, Ueshima H. A case control study on risk factors for uterine cancer in Japan. Jpn J Cancer Res. 1994;85(4):346–50.CrossRef

Census and Statistics. Population Survey Report. Sri Lanka: Department of Census and Statistics; 2012. Available from http://www.statistics.gov.lk/PopHouSat/CPH2011/Pages/Activities/Reports/FinalReport/FinalReportE.pdf

10.

Bjørge T, Engeland A, Tretli S, Weiderpass E. Body size in relation to cancer of the uterine corpus in 1 million Norwegian women. Int J Cancer. 2006;120:378–83. https://doi.org/10.1002/ijc.22260.CrossRef

11.

Katulanda P, Jayawardena MAR, Sheriff MHR, Constantine GR, Matthews DR. Prevalence of overweight and obesity in Sri Lankan adults. Obes Rev. 2010;11(11):751–6. https://doi.org/10.1111/j.1467-789X.2010.00746.x.CrossRefPubMed

12.

Kumari PBVR. Risk factors and risk assessment of breast cancer among women in the district of Colombo. Colombo: Post Graduate Institute of Medicine, University of Colombo; 2013.

13.

Kroll M, Swanson J, Vincent TJ, Draper GJ. Childhood cancer and magnetic fields from high-voltage power lines in England and Wales: a case-control study. Br J Cancer. 2010;103(7):1122–7. https://doi.org/10.1038/sj.bjc.6605795.CrossRefPubMedPubMedCentral

14.

Savitz DA, Philips A, Carroll MO, Henshaw D. Adult cancers near high-voltage power lines. J Epidemol. 2013;24(5):782–3. https://doi.org/10.1097/EDE.0b013e31829f3cb3.CrossRef

15.

Chakraborty C. Determination of safe distance limit from Cellular Base station radiation exposure using SAR analysis. Int J Comput Appl. 2013;55:18–22.

16.

Mahalingaiah S, Hart JE, Laden F, Terry KL, Boynton-Jarrett R, Aschengrau A, Missmer SA. Adult air pollution exposure and risk of uterine leiomyoma in the nurses’ health study II. Epidemiology. 2014;25(5):682–8. https://doi.org/10.1097/EDE.0000000000000126.CrossRefPubMedPubMedCentral

17.

Rosato V, Zucchetto A, Bosetti C, Maso LD, Montella M, Pelucchi C, Vecchia CL. Metabolic syndrome and endometrial cancer risk. Ann Oncol. 2011;22:884–9. https://doi.org/10.1093/annonc/mdq464.CrossRefPubMed

18.

Obermair A, Youlden DR, Young JP, Lindor NM, Baron JA, Newcomb P, Jenkins MA. Risk of endometrial cancer for women diagnosed with HNPCC-related colorectal carcinoma. Int J Cancer. 2010;127(11):2678–84. https://doi.org/10.1002/ijc.25501.CrossRefPubMedPubMedCentral

19.

Cook LS, Nelson HE, Stidley CA, Dong Y, Round PJ, Amankwah EK, Friedenreich CM. Endometrial cancer and a family history of cancer. Gynecol Oncol. 2013;130(2):334–9. https://doi.org/10.1016/j.ygyno.2013.04.053.CrossRefPubMedPubMedCentral

20.

Olson JE, Sellers TA, Anderson KE, Folsom AR. Does a family history of cancer increase the risk for postmenopausal endometrial carcinoma. J Cancer. 1999;85(11):2444–9 Available from http://www.ncbi.nlm.nih.gov/pubmed/10357416.CrossRef

21.

Xu WH, Xiang YB, Zheng W, Zhang X, Ruan ZX, Cheng JR, Shu XO. Weight history and risk of endometrial cancer among Chinese women. Int J Epidemiol. 2006;35(1):159–66. https://doi.org/10.1093/ije/dyi223.CrossRefPubMed

22.

Gao Y, Dai X, Chen L, Lee AC, Tong M, Wise M, Chen Q. Body mass index is positively associated with endometrial cancer in Chinese women, especially prior to menopause. J Cancer. 2016;7(9):1169–73. https://doi.org/10.7150/jca.15037.CrossRefPubMedPubMedCentral

23.

Xu WH, Xiang YB, Ruan ZX, Zheng W, Cheng JR, Dai Q, Shu XO. (2004). Menstrual and reproductive factors and endometrial cancer risk: results from a population-based case-control study in urban Shanghai. Int J Cancer. 2004;108(4):613–9. https://doi.org/10.1002/ijc.11598.CrossRefPubMed

24.

Salazar-Martinez E, Lazcano-Ponce E, Sanchez-Zamorano LM, Gonzalez-Lira G. Escudero-DE los Rios P, Hernandez-Avila M. dietary factors and endometrial cancer risk. Results of a case-control study in Mexico. Int J Gynecol Cancer. 2005;15(5):938–45. https://doi.org/10.1111/j.1525-1438.2005.00253.CrossRefPubMed

25.

Cui X, Rosner B, Willett WC, Hankinson SE. Dietary fat, fibre, and carbohydrate intake in relation to risk of endometrial cancer. Cancer Epidemiol Biomark Prev. 2011;1089:978. https://doi.org/10.1158/1055-9965.EPI-10-1089.CrossRef

26.

Canchola AJ, Lace JV, Bernstein L, Horn-Ross PL. Dietary patterns and endometrial cancer risk in the California teachers study cohort. Cancer Causes Control. 2015;26(4):627–34. https://doi.org/10.1007/s10552-015-0552-1.CrossRefPubMedPubMedCentral

27.

Merritt M, Tzoulaki I, Tworoger SS, De Vivo I, Hankinson SE, Fernandes J, Dahm CC. Investigation of dietary factors and endometrial cancer risk using a nutrient-wide association study approach in the EPIC and Nurses’ health study (NHS) and NHSII. Cancer Epidemiol Biomark Prev. 2015;24(2):466–71. https://doi.org/10.1158/1055-9965.EPI-14-0970.CrossRef

28.

Schouten LJ, Goldbohm RA, Van Den Brandt PA. Anthropometry, physical activity, and endometrial cancer risk: results from the Netherlands cohort study. J Natl Cancer Inst. 2004;96(21):1635–8.CrossRef

29.

Friedenreich CM, Cook LS, Magliocco AM, Duggan MA, Courneya KS. Case–control study of lifetime total physical activity and endometrial cancer risk. Cancer Causes Control. 2010;21(7):1105–16. https://doi.org/10.1007/s10552-010-9538-1.CrossRefPubMedPubMedCentral

30.

Creasman WT. Endometrial cancer: incidence, prognostic factors, diagnosis, and treatment. Semin Oncol. 1997;24:1–140.

31.

Heidary F, Rahimi A, Gharebaghi R. Poverty as a risk factor in human cancers. Iran J Public Health. 2013;42(3):341–3.PubMedPubMedCentral

32.

Karageorgi S, Hankinson SE, Kraft P, De Vivo I. Reproductive factors and postmenopausal hormone use in relation to endometrial cancer risk in the Nurses' health study cohort 1976–2004. Int J Cancer. 2010;126(1):208–16. https://doi.org/10.1002/ijc.24672.CrossRefPubMedPubMedCentral

33.

Terry P, Baron JA, Weiderpass E, Yuen J, Lichtenstein P, Nyren O. Lifestyle and endometrial cancer risk: a cohort study from the Swedish twin registry. Int J Cancer. 1999;82:38–42.CrossRef

34.

Friberg E, Mantzoros CS, Wolk A. Diabetes and risk of endometrial cancer: a population-based prospective cohort study. Cancer Epidemiol Biomark Prev. 2007;16(2):276–80. https://doi.org/10.1158/1055-9965.EPI-06-0751.CrossRef

35.

Friberg E, Orsini N, Mantzoros CS, Wolk A. Diabetes mellitus and risk of endometrial cancer: a meta-analysis. Diabetologia. 2007;50(7):1365–74. https://doi.org/10.1007/s00125-007-0681-5.CrossRefPubMed

36.

American Cancer Society. Cancer Facts & Figures 2015. Atlanta: American Cancer Society; 2015. Available from https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2015/cancer-facts-and-figures-2015.pdf

Title: Risk factors for endometrial carcinoma among postmenopausal women in Sri Lanka: a case control study
Authors: Withanage Iresha udayangani Jayawickcrama
Chrishantha Abeysena
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Obesity
Obesity
Endometrial Cancer
Endometrial Cancer
Published in: BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-019-7757-2

At a glance: The STEP trials

Springer Medicine

Risk factors for endometrial carcinoma among postmenopausal women in Sri Lanka: a case control study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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