| الوصف: |
Introduction. There is a lack of research on endometriosis from the Eastern Mediterranean region and a complete absence of data from Northern Cyprus. It is unknown whether regional-specific factors effect endometriosis presentation and if risk factors differ. Methods. The Cyprus Women’s Health (COHERE) Initiative is a cross-sectional study of 7,646 women living in Northern Cyprus. Baseline recruitment involved completing an expanded version of the World Endometriosis Research Foundation Endometriosis and Phenome Biobanking Harmonisation Project (WERF-EPHect) questionnaire, including validated tools. Clinical data was obtained from ultrasound scans attended by 668 women and information on diet was obtained from 513 women who completed a validated Food-Frequency-Questionnaire (FFQ). Associations with endometriosis were compared to a pain symptomatic and a pain asymptomatic control group. Results. Prevalence of endometriosis was 5.4% (95%Confidence Interval:4.9%-5.9%; n=410), including 15 incident cases identified during the clinical visit. Average age of endometriosis symptom onset was 25.9-years despite average age of first pain occurring at 16.2-years, giving a diagnostic delay of 9.3-years. Compared to asymptomatic controls, endometriosis cases were more likely to report anxiety and migraines (Odds Ratio=1.56; 95%CI:1.03-2.38 and OR=1.39; 95%CI:1.06-1.83, respectively). Physical health-related-quality-of-life was impaired in endometriosis cases compared to symptomatic controls (p=0.034). There was no significant difference in economic burden between endometriosis cases and symptomatic controls (Int $9,864; 95%CI: $8,812-$10,917 vs Int $10,917; 95%CI: $10,004-$10,855, respectively). Average cost for endometriosis cases peaked between 26-35-years-of-age and decreased after age 36 but remained high across the life-course for symptomatic controls. Participants with endometriosis were more likely to report reproductive, allergic, metabolic/obesity-related and cardiovascular diseases. Women who were iron deficient and vitamin-D deficient were more likely to report to have endometriosis compared to asymptomatic controls (OR:1.70; 95%CI:1.37-2.12 and OR:2.04; 95%CI:1.37-3.02, respectively). Discussion. For the first time, the epidemiology of endometriosis in Northern Cyprus has been investigated and presented, suggesting that burden of endometriosis is high in this population and the awareness is low. There are multiple opportunities to improve care for endometriosis patients and the findings on iron and vitamin-D deficiency may be unique risk factors for the region, warranting further investigation. |
