OBJECTIVE:This study was undertaken to identify and quantify risk factors for endometrial cancer among young women. STUDY DESIGN: This case-control study included all Danish women <50 years old who had endometrial cancer diagnosed during the period 1987 to 1994. A total of 237 case patients and 538 population control subjects matched with the case patients for age and residence were included in the analysis. RESULTS: Women with a family history of endometrial cancer had an odds ratio for endometrial cancer of 2.1 (95% confidence interval, 1.1-3.8)). Completion of 1 term pregnancy implied an odds ratio of 0.6 (95% confidence interval, 0.3-1.1). The risk of endometrial cancer decreased significantly with increasing age at first birth and with the number of induced abortions. Use of oral contraceptives for 1 to 5 years decreased the risk of endometrial cancer (odds ratio, 0.2; 95% confidence interval, 0.1-0.3). The odds ratio for endometrial cancer among women who received hormone replacement therapy for 1 to 5 years was 3.1 (95% confidence interval, 1.4-7.0). Body mass index was not demonstrated to be an independent risk factor in this study. The protective impacts of the different exposures (risk factors) can be expressed as etiologic fractions, which indicate how much each exposure reduces the occurrence of endometrial cancer compared with a situation without the existence of that particular exposure. These fractions were as follows: oral contraceptive use for ≥1 year, -45%; 2 term pregnancies, -88%; age ≥30 y when giving birth for the first time, -38%; and a history of incomplete pregnancy, -16%. Key words: Case-control study, endometrial cancer, etiologic fraction, premenopausal, risk factor Endometrial cancer is a rare disease among premenopausal women. Seven percent of endometrial cancer occurs in women <50 years old. In the same age group about 300 curettage procedures and an equal number of endometrial biopsies are performed for every single diagnosis of endometrial cancer. When the physical complications attendant with these invasive procedures and the socioeconomic consequences of curettage as a screening procedure are considered, the question arises as to whether it is appropriate to carry out this number of intrauterine procedures in fertile women to find so few cases of endometrial malignancy.If young women at an increased risk for development of endometrial cancer could be identified, a selection of women among whom the need to undergo curettage was greater might be realized. Consequently, the number of curettage procedures performed in this age group could be reduced.Several studies have identified risk factors of endometrial cancer among older women, such as overweight status, estrogen replacement therapy, nulliparity, infertility, diabetes mellitus, and hypertension. 1-8 However, these risk factors are not necessarily relevant for endometrial cancer among young women. Only a few studies have focused on risk factors for endometrial cancer among premenopausal women (Table I). To identify and quantif...

In an attempt to clarify the correlation between the spread of a local anesthetic and a radiographic contrast medium in the epidural space, a lumbar epidural catheter was inserted in 21 cancer patients. In group I, 10 patients, a single dose of bupivacaine 0.5%, 8 ml, was injected. The epidural block was evaluated by assessing loss of pin-prick sensation. The following day a contrast medium, iohexol 180 mg I/ml, 1.2 ml, was injected and the position of the catheter determined. A second dose of iohexol 180 mg I/ml, 8 ml, was injected and epidurograms were taken. The vertebral spread was measured in cephalad and caudad directions from the catheter tip. Group II, 11 patients, underwent the same procedures as group I with the exception of the volumes injected. On the first day they were given bupivacaine 0.5%, 16 ml, and on the second day iohexol 180 mg I/ml, 1.2 ml by 16 ml. In both groups the position of the patients was supine and the speed of injection standardized. In group I there was no statistically significant correlation between the spread of contrast medium and the extension of the epidural block either in the cephalad or in the caudad direction. In group II there was a statistically significant correlation in both the cephalad and caudad direction. It is concluded that epidurography can provide an estimate of the epidural block, but cannot predict the exact segmental distribution of the block.