Higher incidence of gynaecological cancers in urban areas, Egypt.
Article Type: Brief article
Subject: Genital cancer (Statistics)
Genital cancer (Demographic aspects)
Hormone therapy (Complications and side effects)
Breast cancer (Statistics)
Breast cancer (Demographic aspects)
Pub Date: 05/01/2010
Publication: Name: Reproductive Health Matters Publisher: Reproductive Health Matters Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2010 Reproductive Health Matters ISSN: 0968-8080
Issue: Date: May, 2010 Source Volume: 18 Source Issue: 35
Topic: Event Code: 680 Labor Distribution by Employer
Geographic: Geographic Scope: Egypt Geographic Code: 7EGYP Egypt
Accession Number: 236247752
Full Text: Cancers specific to female reproductive organs such as the breast, uterus and ovary, are associated with higher long-term exposure to oestrogen, and numerous studies have shown that environmental xenoestrogen presence and exposure is higher in urban areas. Previous research showed a three to four times higher urban incidence of breast cancer and oestrogen receptorpositive breast cancers in the Gharbiah Province of Egypt. This study investigated the urban-rural incidences of gynaecological cancers to see if they demonstrated the same trend, using data on all women diagnosed with uterine, ovarian and cervical cancer taken from the Gharbiah Cancer Registry from 1999-2002. Incidence of all three cancers was higher in urban areas. Uterine cancer showed the highest urban-rural incidence rate ratio with a six times higher incidence among urban women (IRR = 6.07, 95% CI 4.17-8.85). There was an increasing gradient of urban-rural incidence for all female cancers. Cancers such as leukaemia (which are mainly genetically determined) had the lowest urban-rural difference, followed by that seen for all non-hormonally-related cancers. The inclusion of cancers that are largely hormonally dependent, e.g. breast and uterus, increased the urban-rural difference by almost 70% (the urban-rural difference increased by 146% when only hormone-dependent cancers were considered). In this population, there is no significant urban-rural difference in other risk factors for uterine and breast cancer such as fertility rate, health care access, and behaviour. There is also very low use of hormonal contraception. The higher exposure of urban women to environmental oestrogenic compounds may increase the risk of developing hormone-related cancers. (1)

(1.) Dey S, Hablas A, Seifeldin IA, et al. Urban-rural differences of gynaecological malignancies in Egypt (1999-2002). BJOG 2010;117(3):348-55.
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