title: Risk factors in women 40 years of age and younger with endometrial carcinoma.
abstract: OBJECTIVE
  To identify and compare risk factors among endometrial cancer patients ≤40 years of age, postmenopausal women with the same malignancy and women ≤40 years without malignancy.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  Athens University, department of obstetrics and gynecology of a tertiary hospital serving a mainly urban population.
  
  
  METHODS
  Endometrial cancer patients ≤40 years (study group, n = 40), postmenopausal women with the same malignancy (positive controls, n = 40) and women ≤40 (negative controls, n = 40) without endometrial cancer.
  
  
  METHODS
  Clinical history, treatment and follow-up of patients were evaluated. Factors studied included age, histology, stage, grade, lymphovascular space involvement, body mass index (BMI), cytology, lymph node status, parity, smoking, family history, hypertension recurrence and survival.
  
  
  METHODS
  Differences in risk factors and characteristics.
  
  
  RESULTS
  Nulliparity, smoking and hypertension were significantly related with endometrial cancer in the study group compared to positive controls (p = 0.001, p < 0.01 and p < 0.001, respectively). BMI >30 significantly characterized patients in the study group compared to negative controls (p = 0.006). Finally, irregular menstruation and family history of cancer were observed more often in the study group compared to both control groups. Stage, grade, myometrial invasion, lymphovascular space involvement and lymph node status were comparable between the study and positive control groups.
  
  
  CONCLUSIONS
  Nulliparity, obesity, unstable menstruation, smoking and cancer in the family are strongly correlated with endometrial cancer risk in women ≤40 years.
authors.affiliation: 1st Department of Obstetrics and Gynecology, Alexandra General Hospital, University of Athens, Athens, Greece. mariaasimos@yahoo.com
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Haidopoulos
authors.forename: Maria
authors.initials: M
authors.lastname: Simou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Akrivos
authors.forename: Alexandros
authors.initials: A
authors.lastname: Rodolakis
authors.forename: Georgios
authors.initials: G
authors.lastname: Vlachos
authors.forename: Stelios
authors.initials: S
authors.lastname: Fotiou
authors.forename: Maria
authors.initials: M
authors.lastname: Sotiropoulou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Thomakos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Biliatis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Protopappas
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult