Estrogen exposure and bladder cancer risk in Egyptian women.
OBJECTIVE
To examine associations between reproductive history and urinary bladder cancer in Egyptian women.


METHODS
We used questionnaire data from an ongoing, multicenter case-control study in Egypt. Controls were matched on age and residence area. This analysis focused on female cases with confirmed urothelial (UC) and squamous cell (SCC) carcinoma of the bladder.


RESULTS
We recruited 779 women (540 controls, 239 cases; >98.0% nonsmokers). Younger age at menopause (<45 y) and older age at first pregnancy (>18 y) were factors significantly associated with increased risk of bladder cancer, even after adjusting for schistosomiasis history and other covariates in the multivariable logistic model; adjusted odds ratio and 95% confidence intervals were 1.98 (1.41, 2.77) and 6.26 (3.46, 11.34), respectively. On the other hand, multiple pregnancies or use of oral contraceptives were associated with decreased odds of having bladder cancer. Similar associations were observed with UC and SCC when analyzed separately; however, the magnitude of association with SCC was lower than with UC.


CONCLUSIONS
Our data suggest that early estrogen exposure, or the relative lack of it, plays a role in urinary bladder carcinoma development among Egyptian women.
Wolpert
Beverly J
BJ
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA. bwolpert@epi.umaryland.edu
Amr
Sania
S
Ezzat
Sameera
S
Saleh
Doa'a
D
Gouda
Iman
I
Loay
Iman
I
Hifnawy
Tamer
T
Mikhail
Nabiel N
NN
Abdel-Hamid
Mohamed
M
Zhan
Min
M
Zheng
Yun-Ling
YL
Squibb
Katherine
K
Abdel-Aziz
Mohamed A
MA
Zaghloul
Mohamed
M
Khaled
Hussein
H
Loffredo
Christopher A
CA
D000367:Age Factors; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D016022:Case-Control Studies; D003276:Contraceptives, Oral / Q000009:adverse effects; D004534:Egypt; D004967:Estrogens / Q000009:adverse effects / Q000378:metabolism*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008572:Menarche; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D011272:Pregnancy, Multiple; D017584:Reproductive History; D012307:Risk Factors; D011795:Surveys and Questionnaires; D001749:Urinary Bladder Neoplasms / Q000209:etiology*
D003276:Contraceptives, Oral; D004967:Estrogens
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