Rong Shoude, Chen Wen, Wu Lingying, Zhang Xun, Shen Guihua, Liu Yunyuan, Zhao Fanghui, Ma Junfei, Qiao Youlin
Department of Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2002 Jan;36(1):41-3.
To investigate the risk factors for cervical cancer in the areas of high incidence, and provide evidence for current intervention of cervical cancer.
In the areas of Xiangyuan County, Shanxi Provicne with high incidence of cervical cancer, 1 997 women were interviewed using a questionnaire, including baseline information, menstrual, marital and pregnancy histories, sexual behavior, health habits, contraception, medical history and family history of cancer, etc., after its screening with six kinds of methods. All subjects, including 84 cases with pathological diagnosis of greater than cINI, and 1 784 cases with pathological diagnosis of normal, were tested for high-risk HPV.
The overall rates of HPV infection were 20.8% (415/1 997) in high-risk subjects, 97.7% and 14.2% in the cases and control groups, respectively. Univariate analysis showed that risk factors with statistical significance included high-risk HPV infection, age at first sexual intercourse, history of pregnancy and abortion, the number of sexual partners and family history of cancer. Analysis with non-conditional logistic regression model revealed high-risk HPV infection, multiple sexual partners and family history of cancer associated obviously with occurrence of cervical cancer. In addition, there was significantly positive relationship between HPV infection, which increased with the number of sexual partners, and extramarital sexual activity both in males or females.
The main risk factor for cervical cancer in this region was high-risk HPV infection, which related to sexual behavior, hygienic habits during menstruation and puerperium. It was particularly important to detect and treat precancerous lesions and to implement behavior modification. In addition, further research on genetic susceptibility was suggested.
探讨宫颈癌高发地区的危险因素，为当前宫颈癌的干预提供依据。
在山西省襄垣县宫颈癌高发地区，采用六种方法对1997名妇女进行筛查后，使用问卷进行访谈，内容包括基线信息、月经史、婚姻史、妊娠史、性行为、健康习惯、避孕情况、病史及癌症家族史等。对所有受试者，包括84例病理诊断大于CINI的病例和1784例病理诊断正常的病例，进行高危型HPV检测。
高危人群中HPV总体感染率为20.8%（415/1997），病例组和对照组分别为97.7%和14.2%。单因素分析显示，具有统计学意义的危险因素包括高危型HPV感染、初次性交年龄、妊娠与流产史、性伴侣数量及癌症家族史。非条件logistic回归模型分析显示，高危型HPV感染、多个性伴侣及癌症家族史与宫颈癌发生明显相关。此外，HPV感染与男性或女性的婚外性活动均呈显著正相关，且随着性伴侣数量的增加而升高。
该地区宫颈癌的主要危险因素为高危型HPV感染，其与性行为、经期及产褥期卫生习惯有关。检测和治疗癌前病变以及进行行为改变尤为重要。此外，建议进一步开展遗传易感性研究。
