Thesis: Impact of the childhood environment on adult reproductive behaviours and later life risk of endometrial cancer in Western Australian women
Endometrial cancer risk is influenced by reproductive behaviours, including parity and breastfeeding, and timing of life history events such as age at menarche and menopause. One potential mechanism by which altered reproductive strategies may influence endometrial cancer risk is through exposure to reproductive hormones. Current theory suggests that high lifetime exposure to oestrogen, unopposed by progesterone, increases endometrial cancer risk; here we suggest that progesterone deficiency itself may also play a significant role. Additionally, given that reproductive profile variables are themselves influenced by early childhood conditions, we hypothesise that endometrial cancer risk may be influenced by the childhood psychosocial environment as mediated through changes to adolescent and adult reproductive behaviours and hormone exposures. Investigating reproductive cancers, including endometrial cancer, using a life history approach may help to increase understanding of why these cancers occur and potentially help implementation of early detection and screening processes in the future.
Why my research is important
Endometrial cancer is the most common gynaecological cancer affecting women in Australia. The peak age-specific incidence occurs in post-menopausal women between the ages of 75 and 79 years. It is also common to have at least one adverse childhood event; 55% of women, and 53.5% of adults over the age of 50 years report experiencing at least one childhood exposure. Adverse childhood experiences influence reproductive parameters in adulthood, and reproductive characteristics influence risk of endometrial cancer. Therefore, it is important to investigate if there is a relationship between the childhood environment and endometrial cancer risk, mediated through reproductive behaviours in adulthood. This research may help target 'at-risk' women for early screening in future.