title: Reproductive cancer risk factors among Alaska Native women: the Alaska Education and Research Towards Health (EARTH) Study.
abstract: BACKGROUND
  The purpose of this study was to provide estimates for the prevalence of reproductive cancer risk factors among Alaska Native (AN) women who enrolled in the Alaska Education and Research Towards Health (EARTH) Study from 2004 to 2006.
  
  
  METHODS
  A total of 2,315 AN women 18 years or older completed reproductive health questions as part of a comprehensive health history questionnaire. The reproductive health section included menstrual status (age at menarche and menopause), pregnancy and live birth history, use of hormonal contraception, hormone replacement therapy, and history of hysterectomy and/or oophorectomy.
  
  
  RESULTS
  A total of 463 (20%) of women experienced menarche before age 12 with a decline in mean age at menarche by age cohort. More than 86% had been pregnant (mean number of pregnancies, 3.8; mean number of live births, 2.9). More than one half of women (58%) had their first live birth between the ages of 18 and 24. Almost 28% of participants had completed menopause, of whom 24% completed menopause after age 52. Fewer than half (43%) reported ever using hormone replacement therapy. Almost two thirds (62%) reported ever using oral contraceptives, and fewer reported ever using birth control shots (30%) or implants (10%).
  
  
  CONCLUSIONS
  This study is unique in reporting reproductive health factors among a large group of AN women. These data show that AN women have selective protective factors for reproductive cancers, including low nulliparity rates, low use of menopausal estrogens, and common use of contraceptive hormones. However, analysis by age cohorts indicates decreasing age at menarche that might increase the risk for reproductive cancers among AN women in the future.
authors.affiliation: Alaska Native Tribal Health Consortium, Anchorage, Alaska 99508, USA. dredwood@anthc.org
authors.forename: Diana G
authors.initials: DG
authors.lastname: Redwood
authors.forename: Anne P
authors.initials: AP
authors.lastname: Lanier
authors.forename: Janet M
authors.initials: JM
authors.lastname: Johnston
authors.forename: Neil
authors.initials: N
authors.lastname: Murphy
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Murtaugh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000413:Alaska / Q000453:epidemiology; D001943:Breast Neoplasms / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005260:Female; D005833:Genital Neoplasms, Female / Q000208:ethnology*; D006801:Humans; D007198:Indians, North American; D008572:Menarche / Q000208:ethnology; D008593:Menopause / Q000208:ethnology; D008875:Middle Aged; D011159:Population Surveillance; D011247:Pregnancy; D015995:Prevalence; D060728:Reproductive Health / Q000208:ethnology*; D017584:Reproductive History; D012307:Risk Factors; D057566:Self Report; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult