Sociodemographic predictors of endometrial cancer mortality in South Africa (1997 to 2015): a case-control study

Abstract

South Africa is currently undergoing epidemiological and health transition that may impact on the risk factors of endometrial cancer mortality. We evaluated the sociodemographic characteristics of women that died from endometrial cancer in South Africa from 1997 to 2015. An unmatched case control study was conducted to compare the sociodemographic characteristic of women that died from endometrial cancer cases (n = 3,955) with the characteristics of women that died from other cancers (controls, n = 66,202) using the population-based mortality data from Statistics South Africa. Unconditional binary logistic regression modelling was conducted. The Mean age of women that died from endometrial cancer was 66.7 ± 11.9 years. The odds of death from endometrial cancer among women aged ≥50 years was about 4-fold as compared to women younger than 50 years (AOR = 3.98 95% CI: 3.14 − 5.03; p value: <.001). Conversely, high school leavers (AOR = 0.79 95% CI: 0.66 − 0.94; p value: .009), smokers (AOR= 0.53 95% CI: 0.43 − 0.65; p value: <.001), and divorced women (AOR= 0.73 95% CI: 0.59 − 0.89; p value: .002) had lesser odds of endometrial cancer mortality. This study provides information to guide Public Health control program on endometrial cancer in South Africa. Impact statement What is already known on this subject? The prevalence of endometrial cancer is increasing in low and middle income countries. After the abolition of Apartheid in South Africa, the country commenced a multi-racial government that provided socio-economic empowerment to the majority of the country. Thus, South Africa is currently undergoing epidemiological and health transition that may impact on the risks of endometrial cancer in the country. What do the result of the study add? This study is the first in South Africa to evaluate the sociodemographic characteristics of women that died from endometrial cancer using a large population-based data. Age, educational status, smoking status are some identified risk factors of mortality from endometrial cancer in South Africa What are the implications of these findings for clinical practice and/or further research? The highlighted risk factors that are associated with endometrial mortality will help in guiding health policies that will help reduce the prevalence of endometrial cancer. The study recommends a targeted national prevention program for endometrial cancer as the burden appears to be worsening with each passing year.