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Associations between Smoking, Screening, and Death Caused by Cervical Cancer in Korean Women
Nemekhee Odongua,채영문,김미란,윤지은,지선하 연세대학교의과대학 2007 Yonsei medical journal Vol.48 No.2
Purpose: Cervical cancer is a major women's health problem in the world today. The purpose of this study was to estimate the incidence and mortality rates and to investigate risk factors for cervical cancer in Korean women. Materials and Methods: Reproductive factors, cigarette smoking, as well as the risk of incidence and death from cervical cancer were examined in a 12-year prospective cohort study of 475,398 Korean women aged 30 to 95 years who received health insurance from the National Health Insurance Corporation and who had a medical evaluation in 1992. Relative risks (RR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazards model after adjusting for age, body mass index, cigarette smoking, alcohol use, menarche, parity, and Papanicolaou test status. Results: This study showed that the RR of death due to cervical cancer among current smokers was two times higher compared with non- smokers (RR=2.00; 95% CI, 1.23-2.91). In addition, the RR of death due to cervical cancer among all women who smoked ≥10 cigarettes/day was 2.4 times higher than the RR among women that had never smoked. More interestingly, those who had never been screened by Papanicolaou smears had twice the risk of death due to cervical cancer (RR =2.00; 95% CI, 1.37-1.81). Conclusion: Our prospective study concluded that current smokers had an increased risk of death due to cervical cancer. We suggest that the target age group for cervical cancer screening tests be reconsidered and should begin as early as possible.
Chang, Hoo Sun,Odongua, Nemekhee,Ohrr, Heechoul,Sull, Jae Woong,Nam, Chung Mo The North American Menopause Society 2011 Menopause Vol.18 No.11
OBJECTIVE:: The relationship between reproductive factors and the risk of mortality from cardiovascular disease in postmenopausal women is unclear. In this study, we aimed to investigate this relationship in Korean postmenopausal women. METHODS:: Subcohort analysis was carried out using the data of 3,257 postmenopausal women (age, ≥55 y at study entry) from the Kangwha Cohort Study who were followed up from 1985 until 2005. Cox proportional hazards models were used to evaluate the associations between reproductive factors and cardiovascular disease mortality. RESULTS:: The risk of cardiovascular mortality in women who were 20 to 22 years old at first childbirth was 26% lower (95% CI, 0.60-0.92) than that in women younger than 20 years at first childbirth, after adjustment for age at entry, body mass index, hypertension, drinking, smoking, education, and occupation. Early first childbirth was associated with increased cardiovascular disease mortality (P trend = 0.036). The risk of coronary heart disease mortality was 51% lower in women who were 17 to 18 years old at menarche (95% CI, 0.25-0.95) than that in women who were younger than 17 years at menarche. CONCLUSIONS:: An inverse relationship between age at first childbirth and the risk of cardiovascular disease mortality exists. In addition, early menarche may be a reproductive risk factor for coronary heart disease mortality.
Yi, Sang-Wook,Odongua, Nemekhee,Nam, Chung Mo,Sull, Jae Woong,Ohrr, Heechoul Ovid Technologies Wolters Kluwer -American Heart A 2009 Stroke Vol.40 No.11
<P>BACKGROUND AND PURPOSE: The association between body mass index and mortality caused by subtypes of stroke among postmenopausal women in terms of smoking status and age at menopause remains controversial. METHODS: The data were derived from a cohort study of 3321 with 17.8 years of follow-up (1985 to 2002). Hazard ratios (HRs) and 95% CIs for strokes as related to body mass index were estimated by Cox proportional hazard models adjusted for age, hypertension, smoking, drinking, occupation, education, self-reported health, and age at menopause. A stratified analysis was conducted by age at menopause and smoking status. RESULTS: The obese group (body mass index >or=27.5 kg/m(2)) had higher risks of total stroke mortality (HR, 1.59; 95% CI, 1.05 to 2.42) and hemorrhagic stroke mortality (HR, 2.91; 95% CI, 1.37 to 6.19) than the normal weight group (18.5<or= body mass index <23.0). Among ever smokers, the obese group showed significantly increased risks of total stroke mortality (HR, 2.33; 95% CI, 1.00 to 5.43) and ischemic stroke mortality (HR, 7.21; 95% CI, 1.18 to 44.3). Obesity had more effect on stroke mortality among women who experienced menopause at age <50 than women with age >or=50. For the obese group of the former, the HR of total stroke was 2.04 (95% CI, 1.25 to 3.34) and that of hemorrhagic stroke 6.46 (95% CI, 2.42 to 17.25). CONCLUSIONS: In this prospective study, obesity raised the risks of total stroke mortality and hemorrhagic stroke mortality among Korean menopausal women. It was more evident with women who experienced menopause at age <50. The obese group of ever smokers was at an increased risk of ischemic stroke mortality.</P>