Age at menarche by birth cohort: A pooled analysis of half a million women in Asia

Sarah K Abe¹, Marisa Nishio², Hsi-Lan Huang², Chi Yan Leung², Md Rashedul Islam³, Md Shafiur Rahman⁴, Eiko Saito⁵, Aesun Shin⁶, Melissa A Merritt⁷, Ji-Yeob Choi⁸, Ryoko Katagiri⁹, Zahra Mohammadi¹⁰, Xiao-Ou Shu¹¹, Kenji Wakai¹², Norie Sawada¹³, Yuki Ideno¹⁴, Akiko Tamakoshi¹⁵, Wei Jie Seow¹⁶, Woon-Puay Koh¹⁷, Ritsu Sakata¹⁸, Atsushi Hozawa¹⁹, Jeongseon Kim²⁰, Chisato Nagata²¹, Yumi Sugawara¹⁹, Sue K Park²², Sun-Seog Kweon²³, Fereidoun Azizi²⁴, Reza Malekzadeh²⁵, Foong-Ming Moy²⁶, Farhad Pourfarzi²⁷, Yu-Tang Gao²⁸, Yoko Kubo¹², Mayo Hirabayashi², Kazue Nagai¹⁴, Takashi Kimura¹⁵, Jian-Min Yuan²⁹, Seiki Kanemura¹⁹, Keiko Wada²¹, Daehee Kang⁶, Min-Ho Shin²³, Davood Khalili³⁰, Hossein Poustchi¹⁰, Abbas Rezaianzadeh³¹, Fariborz Mansour-Ghanaei³², Farid Najafi³³, Iraj Mohebbi³⁴, Paolo Boffetta³⁵, Jung Eun Lee³⁶, Keitaro Matsuo³⁷, Nathaniel Rothman³⁸, You-Lin Qiao³⁹, Wei Zheng¹¹, Manami Inoue²

Affiliations

¹ Division of Prevention, National Cancer Center Institute for Cancer Control, Japan. Electronic address: saabe@ncc.go.jp.
² Division of Prevention, National Cancer Center Institute for Cancer Control, Japan.
³ Division of Prevention, National Cancer Center Institute for Cancer Control, Japan; Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Japan.
⁴ Division of Prevention, National Cancer Center Institute for Cancer Control, Japan; Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan.
⁵ Sustainable Society Design Center Graduate School of Frontier Sciences the University of Tokyo, Japan.
⁶ Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
⁷ The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia.
⁸ Cancer Research Institute, Seoul National University, Seoul, Republic of Korea; Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea.
⁹ Graduate School of Informatics, Faculty of Informatics, Chiba University, Japan.
¹⁰ Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
¹¹ Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States.
¹² Department of Preventive Medicine, Nagoya University School of Medicine, Nagoya, Japan.
¹³ Division of Cohort Research, National Cancer Center Institute for Cancer Control, Japan.
¹⁴ Gunma University Center for Food Science and Wellness, Maebashi, Japan.
¹⁵ Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan.
¹⁶ Saw Swee Hock School of Public Health and Department of Medicine, National University of Singapore and National University Health System, Singapore.
¹⁷ Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A∗STAR), Singapore.
¹⁸ Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan.
¹⁹ Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan.
²⁰ Graduate School of Cancer Science and Policy, National Cancer Center, Seoul, Republic of Korea.
²¹ Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
²² Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
²³ Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
²⁴ Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
²⁵ Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
²⁶ Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
²⁷ Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
²⁸ Department of Epidemiology, Shanghai Cancer Institute, China; Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
²⁹ Cancer Epidemiology and Prevention Program, University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, Pittsburgh, PA, United States; Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.
³⁰ Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³¹ Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
³² Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
³³ Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
³⁴ Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran.
³⁵ Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, United States; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
³⁶ Department of Food and Nutrition, Seoul National University, Republic of Korea.
³⁷ Division Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
³⁸ Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, United States.
³⁹ School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

PMID: 39368404
PMCID: PMC11602349
DOI: 10.1016/j.puhe.2024.09.020

Age at menarche by birth cohort: A pooled analysis of half a million women in Asia

Sarah K Abe et al. Public Health. 2024 Dec.

. 2024 Dec:237:130-134.

doi: 10.1016/j.puhe.2024.09.020. Epub 2024 Oct 4.

Authors

Affiliations

¹ Division of Prevention, National Cancer Center Institute for Cancer Control, Japan. Electronic address: saabe@ncc.go.jp.
² Division of Prevention, National Cancer Center Institute for Cancer Control, Japan.
³ Division of Prevention, National Cancer Center Institute for Cancer Control, Japan; Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Japan.
⁴ Division of Prevention, National Cancer Center Institute for Cancer Control, Japan; Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan.
⁵ Sustainable Society Design Center Graduate School of Frontier Sciences the University of Tokyo, Japan.
⁶ Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
⁷ The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia.
⁸ Cancer Research Institute, Seoul National University, Seoul, Republic of Korea; Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea.
⁹ Graduate School of Informatics, Faculty of Informatics, Chiba University, Japan.
¹⁰ Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
¹¹ Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States.
¹² Department of Preventive Medicine, Nagoya University School of Medicine, Nagoya, Japan.
¹³ Division of Cohort Research, National Cancer Center Institute for Cancer Control, Japan.
¹⁴ Gunma University Center for Food Science and Wellness, Maebashi, Japan.
¹⁵ Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan.
¹⁶ Saw Swee Hock School of Public Health and Department of Medicine, National University of Singapore and National University Health System, Singapore.
¹⁷ Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A∗STAR), Singapore.
¹⁸ Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan.
¹⁹ Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan.
²⁰ Graduate School of Cancer Science and Policy, National Cancer Center, Seoul, Republic of Korea.
²¹ Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
²² Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
²³ Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
²⁴ Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
²⁵ Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
²⁶ Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
²⁷ Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
²⁸ Department of Epidemiology, Shanghai Cancer Institute, China; Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
²⁹ Cancer Epidemiology and Prevention Program, University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, Pittsburgh, PA, United States; Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.
³⁰ Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³¹ Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
³² Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
³³ Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
³⁴ Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran.
³⁵ Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, United States; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
³⁶ Department of Food and Nutrition, Seoul National University, Republic of Korea.
³⁷ Division Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
³⁸ Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, United States.
³⁹ School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

PMID: 39368404
PMCID: PMC11602349
DOI: 10.1016/j.puhe.2024.09.020

Abstract

Objectives: To evaluate changes in the age at menarche in Asian populations.

Study design: Retrospective cohort study.

Methods: We included 548,830 women from six countries in Asia. The data were sourced from 20 cohorts participating in the Asia Cohort Consortium (ACC) and two additional cohort studies: Japan Multi-institutional Collaborative Cohorts (J-MICC), and Japan Nurse Health Study (JNHS) with data on age at menarche. Joinpoint regression was used to evaluate changes in age at menarche by birth year and by country.

Results: The study includes data from cohorts in six Asian countries namely, China, Iran, Japan, Korea, Malaysia and Singapore. Birth cohorts ranged from 1873 to 1995. The mean age of menarche was 14.0 years with a standard deviation (SD) of 1.4 years, ranged from 12.6 to 15.5 years. Over 100 years age at menarche showed an overall decrease in all six countries. China showed a mixed pattern of decrease, increase, and subsequent decrease from 1926 to 1960. Iran and Malaysia experienced a sharp decline between about 1985 and 1990, with APC values of -4.48 and -1.24, respectively, while Japan, South Korea, and Singapore exhibited a nearly linear decline since the 1980s, notably with an APC of -3.41 in Singapore from 1993 to 1995.

Conclusions: Overall, we observed a declining age at menarche, while the pace of the change differed by country. Additional long-term observation is needed to examine the contributing factors of differences in trend across Asian countries. The study could serve as a tool to strengthen global health campaigns.

Keywords: Age; Asia; Birth cohort; Menarche.

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Conflict of interest statement

Competing interests

None to declare. The authors have no potential financial, personal or other conflicts of interests.

Figures

**Figure 1.**
Secular changes in age at menarche by country

See this image and copyright information in PMC

References

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Age at menarche by birth cohort: A pooled analysis of half a million women in Asia

Affiliations

Age at menarche by birth cohort: A pooled analysis of half a million women in Asia

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources