Polycystic ovarian disease as a risk factor for endometrial carcinoma : A hospital based case control study

Abstract

To determine any association between polycystic ovarian syndrome (PCOS) and the subsequent development of endometrial cancer in Sri Lankan women. Hospital-based casecontrol study of known patients with endometrial carcinoma being followed up at Cancer Institute Maharagama and controls who were free of cancer accessed at well woman clinic, Castle Street Hospital for Women and Cancer Institute. The method of sampling was based on convenience. A single interviewer administered questionnaire was applied to obtain data on features suggestive of PCOS during their reproductive years and also demographic details of those with endometrial cancer. PCOS as a risk factor for the subsequent development of endometrial cancer was evaluated using odds ratio and appropriate tests of significance. The study group consisted of 71(33 percent } cases and 144(67 percent } controls. Mean age of endometrial cancer patients at diagnosis was 57.2±9.4 years; their average age at menarche was 13 years (range 11-17) and 14(19.7 percent } were nulliparous. The endometrial cancer group had 19(26.8 percent } with established type 2 diabetes and 21(29.65 percent } with treated hypertension. Categorization by current age had 11 cases ~ 50 years of age and 60 cases 50 years of age. PCOS as determined by the questionnaire was observed in 4(36 percent } cases ~ 50 years of age vs. 7(11,6 percent } cases 50 years of age, p=0.018. :A cohort of women with endometrial cancer attending Cancer Institute revealed they were more obese than normal women, had type 2 diabetes and hypertension at a prevalence rate of 26.8 percent and 29.65 percent respectively. Overall the probable PCOS and development of endometrial cancer was not significant. However PCOS was seen in a greater proportion of endometrial cancer patients whose diagnosis of cancer had been made at or below the age of 50 years in comparison to those whose diagnosis had been made after the age of 50 years