Multiple multiparity is a negative prognostic factor for endometrial cancer in Poland.

BACKGROUND: Nulliparity is one of the most important reproductive risk factors for endometrial cancer. It is still discussed whether multiparity implies a more favorable course of the disease and higher overall survival rates. The aim of the study was to analyze the effect of parity on the overall survival of endometrial cancer patients in Poland. MATERIAL AND METHOD: A retrospective analysis of parity on survival rates was performed in 810 women treated surgically for endometrial cancer in a single referential center of gynecological oncology. RESULTS: Higher parity was shown to be associated with significantly lower survival rates (p=0.03). Parity turned out to be an independent prognostic factor of survival (HR 1.9). Multiple multiparous women were older at the time of surgery, more often presented with deep myometrial infiltration and with involvement of the cervical stroma and had higher clinical stages of the cancer (only according to FIGO 1988 classification). The group of multiple multiparous women was characterized by significantly lower recurrence rates. Multiple multiparous women significantly more often presented with lower educational level, more often were diagnosed with comorbidities and a history of other malignancies, while breast cancer and colon cancer were of lesser evidence in multiple multiparous endometrial cancer patients. CONCLUSION: Multiparity turns out to be an unfavorable prognostic factor of survival in Polish women. Unfavorable prognosis in endometrial cancer patients in this group is associated with interactions between risk factors and negative prognostic factors, i.e. the conditions of tumor growth, rather than with the nulliparity itself.

Sexual behavior and contraception among young Polish women.

OBJECTIVE: To analyze sexual behavior and the use of contraception among young women in Poland. DESIGN: Cross-sectional study. POPULATION: 1,478 young women in higher (78.9%) and secondary (21.1%) education. SETTING: Gdansk region in Poland. METHODS: The data were gathered between September and December 2008 by the use of a questionnaire prepared for the purpose of this study, completed anonymously and in person by the young women. RESULTS: Sexual activity had been initiated by 67.2% of the women studied at a mean age of 18.7 years (±1.97). Assessment was made of changes in their contraceptive practice between the time of sexual initiation and later sexual activity. Since their first experience of intercourse 67.0% did not change their contraceptive methods. As many as 40.1% continued using either low effective methods or no contraception. Early sexual initiation was linked to a significantly lower likelihood of highly effective contraception, more frequent unprotected sexual intercourse and more sexual partners (p < 0.05). Over half of women assigned to a 'high-risk' group with regard to the chance of unintended pregnancy and sexually transmitted infection, declared that their behavior did not carry any risk, similar (p > 0.05) to those who did not have a history of hazardous behavior. CONCLUSION: Sexual behavior differentiates Polish women from the women in Western Europe. Despite the welcome tendency toward choosing reliable contraceptives, use of appropriate contraception is still insufficient.

Nutrition and pregnancy after bariatric surgery.

Obesity is an escalating problem in all age groups and it is observed to be more common in females than males. About 25% of women meet the criteria of obesity and one-third of them are in the reproductive age. Because morbid obesity requiring surgical treatment is observed with increasing frequency, surgeons and gynecologists are undergoing new challenges. It is not only a matter of women's health and their quality of life but also proper development of the fetus, which should be a concern during bariatric treatment. Therefore complex perinatal care has to be provided for morbid obesity patients. The paper reviews pregnancy and fertility issues in bariatric surgery patients.

The use of emergency contraception in young Polish women.

BACKGROUND: The aim of this work was to assess the frequency of use of emergency contraception (EC) and the factors that influence young women in Poland to choose this method of contraception. METHODS: The study included 1,154 randomly chosen young women of whom 843 were students of the four largest universities and 311 were pupils aged 18 and over of six randomly chosen secondary schools in the Gdansk region of Poland. A diagnostic review was made by means of a survey based on an anonymous self-administered questionnaire, that was handed directly to the respondents. The factors affecting EC choice were assessed. The characteristics of women who used EC and those who did not were described and compared. RESULTS: The mean age of the respondents was 21.692.10. In a group of young sexually active women EC was used by only 14%, and among these the frequency with which it had been used varied from once to eight times. The students who most often turned to the EC were from institutions of higher education, came from large cities, and did not have a steady partner. Women in Poland have a general familiarity with the possibility of using EC, but there is insufficient exact knowledge of the way it works, as evidenced by the high proportion of women (68.3%) who regarded the EC as a means of early termination of pregnancy. CONCLUSIONS: EC is not routinely employed in Poland. Thus there is a need for thorough and comprehensive sexual education which covers EC.