BJOG Release: Study Finds Higher Incidence Of Gynaecological Cancers In Urban Areas

New research to be published in BJOG: An International Journal of Obstetrics and Gynaecology has found a higher incidence of gynaecological cancers (uterine, ovarian and cervical cancer) in urban areas of Egypt, as compared to rural areas. The incidence of uterine cancer among urban women was six times higher than that of rural women. The study suggests that women in urban areas may have a higher exposure to environmental xenoestrogens (industrially made compounds that have an oestrogenic activity), which may increase the risk of developing hormone-related cancers.


Cancers specific to female organs such as the breasts and uterus, are associated with higher long term exposure to estrogen. Numerous studies around the world have shown that environmental xenoestrogen presence and exposure is higher in urban areas.


Previous research has shown a three to four times higher urban incidence of breast cancer and estrogen receptor positive breast cancer. In this study, the researchers investigated the urban-rural incidences of gynaecological cancers (uterine, ovarian and cervical cancer) to see if they demonstrate the same trend.


The researchers analysed data from the Gharbiah Cancer Registry for the 4-year period of 1999-2002. The study population consisted of all women diagnosed with uterine, ovarian and cervical cancer in the Gharbiah Province of Egypt during this time.


The key findings indicate that the incidence of all three cancers (uterine, ovarian and cervical cancer) was higher in urban areas. The most striking finding was the almost six times higher incidence of uterine cancer among urban women. The researchers found a gradient of increasing urban-rural differences 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 increased the urban-rural difference by almost 70% (the urban-rural difference increased by 146% when only hormonal cancers were considered).


Lead author, Dr. Amr Soliman, Associate Professor of Epidemiology at the University of Michigan School of Public Health, said "In this population, there is no significant urban-rural difference among women with respect to other risk factors for uterine and breast cancer, healthcare access, and behaviour. There is also very low use of hormonal pills or therapy among Egyptian women. The higher exposure of urban women to man-made chemicals in the environment that act as hormones is the probable risk factor."


Prof. Philip Steer, BJOG editor-in-chief, said "This study adds to a growing body of literature demonstrating the impact of environmental chemicals on human health. The findings suggest that urban women have a much higher exposure to hormonal agents that increase the risk of them developing hormone-dependent cancers. Further research is warranted to confirm and investigate in more detail the association between xenoestrogens and hormone-related cancers.


Notes


BJOG: An International Journal of Obstetrics and Gynaecology is owned by the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially independent and published monthly by Wiley-Blackwell. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. Please quote 'BJOG' or 'BJOG: An International Journal of Obstetrics and Gynaecology' when referring to the journal and include the website: bjog as a hidden link online.


Reference


Dey S, Hablas A, Seifeldin I, Ismail K, Ramadan M, El-Hamzawy H, Wilson M, Banerjee M, B|offetta P, Hartford J, Merajver S, Soliman A. Urban-rural differences of gynaecological malignancies in Egypt (1999-2002). BJOG 2009; DOI: 10.1111/j.1471-0528.2009.02447.x.

Source
Royal College of Obstetricians and Gynaecologists