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  • Title: An epidemiologic study of ovarian cancer. Part 11: Oral contraceptive use and menstrual events.
    Author: Badawy YA, Bayoumi DM.
    Journal: J Egypt Public Health Assoc; 1992; 67(5-6):579-91. PubMed ID: 1294683.
    Abstract:
    This work was conducted to investigate the potential risk factors which may contribute to the development of ovarian cancer. A retrospective analysis was adopted where 52 ovarian cancer cases and an equal number of a control group were obtained from the Western region of Saudi Arabia. This case-control study confirms that oral contraceptive use protects against the onset of ovarian cancer and that the decrease in the risk of the development of this disease is also directly related to the duration of use. Additionally, the study revealed a positive association between both age at menopause and hot flashes and the relative risk of ovarian cancer. On the contrary, age at menarche and premenstrual tension have been shown in this study to have no role as a risk factor in the development of ovarian cancer. A retrospective analysis was carried out on 52 ovarian cancer cases and an equal number of controls from the Western region of Saudi Arabia. Only 30.77% of cases as compared with 55.77% of the controls used oral contraceptives, but also only 31.25% of cases compared with 72.42% of controls were longterm users (or= 5 years). 26.92% of women had their menarche before age of 12, 63.46% between 12 and 14, and 9.62% at age 15 years or over. In the control group the corresponding percentages were 46.15%, 42.3%, and 11.54%, respectively. Of the 22 postmenopausal cases, 18.18% had their menopause before age 45, 45.46% between 45 and 49 and 36.36% at age 50 years or over. However, among the 16 postmenopausal controls, 56.25% had their menopause before the age of 45, 31.25% between 45 and 49, and only 12.51% at age 50 years or over. 48.48% of all cases experienced premenstrual tension compared with only 38.46% of controls. In addition, 72.73% of postmenopausal cases reported hot flashes vs. only 31.25% of postmenopausal controls. The estimated relative risk of oral contraceptive use, as compared with nonuse, was found to be 0.4 (60% protection); this was statistically significant by the Chi-square test. The relative risk of disease development decreased with the duration of oral contraceptive use: it was found to be 0.9 (0.3-2.5) for women reporting oral contraceptive use of less than 5 years and 0.2 (01-0.5) for 5 years or more. although the relative risk of women whose menarche occurred below 12 years as compared with 15 years or over was above unity (1.8) and the relative risk associated with having, as opposed to not having premenstrual tension, followed the same trend with a value of 1.5. Compared with women whose menopause between 45 and 49 years or earlier, the relative risk was 4.5 for menopause between 45 and 49 years and 9.0 for menopause at 50 years or above. Similarly, hot flashes were significantly more often encountered among cases than controls and the relative risk was 5.9 with a 95% confidence interval of 1.4-24.0.
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