Investigation of reproductive risk factors for endometrial cancer development among women aged 45-75 years in Yerevan, Armenia: A Case-Control study

Abstract

Objectives: Endometrial cancer is one of the most common gynecologic cancers worldwide. The current study identified the reproductive risk factors of endometrial cancer among 45-75 years old women in Yerevan, Armenia and developed recommendations for early prevention of the disease. Methods: The study utilized a case-control study design. Cases were patients aged 45-75 years with clinically and hystologically confirmed diagnosis of endometrial cancer who were registered at the National Oncology Center of Armenia from 2000 to 2006 (n=177). Controls were “healthy” women aged 45-75 years residing in Yerevan recruited through Random Digit Dialing (n=232). An interviewer-administered structured questionnaire was used during the telephone interviews with both cases and controls. Results: Cases and controls were significantly different in several factors. According to the multiple logistic regression analyses, getting older than 55 years was associated with 2.5 times (OR=2.5, 95% CI 1.3-4.7) and 65 years with more than 9 times (OR=9.0, 95% CI 4.3-18.8) increased risk of endometrial cancer as compared to the younger age women (45-54 years). Older age at the onset of menarche (over 14 years old) was associated with threefold elevated risk of endometrial cancer. Gravidity was associated with a considerable risk reduction for endometrial cancer development (OR =0.1, 95% CI 0.03-0.38). Compared with normal weight women (BMI=19-24.9 kg/m2 ), obese women (BMI >30.0 kg/m2 ) had approximately 7.5 times higher risk of endometrial cancer. Oral contraceptive use and intrauterine device use was very low in this population while very high proportion of women experienced at least one induced abortion in their lifetime. iii Conclusion: Older age, older age at the onset of menarche, obesity, and nulliparity were independent risk factors of endometrial cancer development. Based on the results it has been suggested to promote actively the concept of maternity and gravidity, healthy lifestyle and weight control, as well as family planning and particularly modern methods on contraception among Armenian female community.