Kjaer S K, Dahl C, Engholm G, Bock J E, Lynge E, Jensen O M
Danish Cancer Registry, Danish Cancer Society, Copenhagen.
Cancer Causes Control. 1992 Jul;3(4):339-48. doi: 10.1007/BF00146887.
Sexual, reproductive and venereal risk factors for cervical neoplasia were investigated in a population-based case-control study of 586 women with histologically verified, cervical squamous-cell carcinoma in situ, and 59 women with invasive squamous-cell cervical cancer, diagnosed from 1985 to 1986 in Copenhagen. Cases were identified from the computerized Danish Cancer Registry. An age-stratified control group (n = 614) was drawn at random from the female population in the study area by means of the Danish Central Population Register. A structured questionnaire was mailed to cases as well as controls. Increasing number of sexual partners exerted a significant effect on the risk both for carcinoma in situ, and invasive cancer, independently of age at first intercourse and other potential confounders. Conversely, the association with early age at first intercourse became statistically insignificant after allowance for other risk factors, although an increasing risk was still observed with decreasing age at sexual debut. Early age at first episode with genital warts was a significant risk factor for carcinoma in situ, perhaps indicating a possible increased susceptibility of the cervix epithelium during adolescence. A history of genital warts was a good predictor of risk for carcinoma in situ, whereas a history of previous gonorrhea was associated with an increased risk for invasive carcinoma. Women with multiple births had a significantly increased adjusted risk, especially for carcinoma in situ, although some association was also observed with invasive cervical cancer. The study supports the hypothesis of cervical neoplasia being a sexually transmitted disease, and that carcinoma in situ and invasive cervical carcinoma, to a high degree, have similar patterns of risk factors.
在一项基于人群的病例对照研究中，对586例经组织学证实为宫颈原位鳞状细胞癌的女性和59例浸润性宫颈鳞状细胞癌的女性的性、生殖和性病风险因素进行了调查。这些病例于1985年至1986年在哥本哈根被诊断出来。病例是从丹麦癌症登记处的计算机记录中识别出来的。通过丹麦中央人口登记处，从研究区域的女性人群中随机抽取了一个年龄分层的对照组（n = 614）。向病例组和对照组邮寄了一份结构化问卷。性伴侣数量的增加对原位癌和浸润癌的风险均有显著影响，且不受首次性交年龄及其他潜在混杂因素的影响。相反，在考虑了其他风险因素后，与首次性交年龄早的关联在统计学上变得不显著，尽管随着首次性行为年龄的降低，风险仍在增加。首次出现尖锐湿疣的年龄早是原位癌的一个显著风险因素，这可能表明青春期宫颈上皮的易感性可能增加。尖锐湿疣病史是原位癌风险的一个良好预测指标，而既往淋病病史与浸润癌风险增加有关。多产女性的调整后风险显著增加，尤其是原位癌，尽管也观察到与浸润性宫颈癌有一定关联。该研究支持宫颈癌是一种性传播疾病的假说，并且原位癌和浸润性宫颈癌在很大程度上具有相似的风险因素模式。
