Estrogen exposure and bladder cancer risk in Egyptian women

Wolpert, Beverly J.; Amr, Sania; Ezzat, Sameera; Saleh, Doa’a; Gouda, Iman; Loay, Iman; Hifnawy, Tamer; Mikhail, Nabiel N.; Abdel-Hamid, Mohamed; Zhan, Min; Zheng, Yun-Ling; Squibb, Katherine; Abdel-Aziz, Mohamed A.; Zaghloul, Mohamed; Khaled, Hussein; Loffredo, Christopher A.

doi:10.1016/j.maturitas.2010.07.014

« Previous Next »Maturitas
Volume 67, Issue 4 , Pages 353-357, December 2010

Estrogen exposure and bladder cancer risk in Egyptian women

Beverly J. Wolpert
- Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Corresponding author at: 660 West Redwood Street, 133a Howard Hall, Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA. Tel.: +1 410 706 1466; fax: +1 410 706 4255.
Sania Amr
- Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
Sameera Ezzat
- Menoufiya University, Egypt
Doa’a Saleh
- University of Cairo, Egypt
Iman Gouda
- National Cancer Institute, Cairo, Egypt
Iman Loay
- National Cancer Institute, Cairo, Egypt
Tamer Hifnawy
- Beni Suif University, Egypt
Nabiel N. Mikhail
- Assiut University, Egypt
Mohamed Abdel-Hamid
- Minia University, Egypt
Min Zhan
- Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
Yun-Ling Zheng
- Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA
Katherine Squibb
- Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
Mohamed A. Abdel-Aziz
- Assiut University, Egypt
Mohamed Zaghloul
- National Cancer Institute, Cairo, Egypt
Hussein Khaled
- National Cancer Institute, Cairo, Egypt
Christopher A. Loffredo
- Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA

Received 22 May 2010; received in revised form 22 July 2010; accepted 24 July 2010. published online 11 August 2010.

Abstract

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 (<45y) and older age at first pregnancy (>18y) 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.

Conclusion

Our data suggest that early estrogen exposure, or the relative lack of it, plays a role in urinary bladder carcinoma development among Egyptian women.

Abbreviations: AOR, adjusted odds ratio, CI, confidence interval, p-y, person-years, SCC, squamous cell carcinoma, UOR, unadjusted odds ratio, UC, urothelial [cell] carcinoma