Herrero R, Brinton L A, Reeves W C, Brenes M M, Tenorio F, de Britton R C, Gaitan E, Garcia M, Rawls W E
Unidad Nacional de Cancerologia, Caja Costarricense de Seguro Social, San Jose, Costa Rica.
Cancer. 1990 Jan 15;65(2):380-6. doi: 10.1002/1097-0142(19900115)65:2<380::aid-cncr2820650234>3.0.co;2-9.
A case-control study of 759 women with invasive cervical cancer and 1430 controls in four Latin American countries evaluated risk in relation to sexual behavior, histories of specific venereal diseases, and hygiene practices. Early age at first sexual intercourse and increasing number of sexual partners were associated with significantly increased risks even after adjustment for their mutual effects. Risk increased to a twofold excess among women reporting first intercourse at 14 to 15 years of age compared with 20+ years. The number of steady sexual partners was a more important predictor of risk than the number of nonsteady partners, particularly before age 30, possibly reflecting the need for prolonged or repeated exposures to a transmissible agent, or different methods of protection against sexually transmitted diseases or pregnancy. Reported frequency of intercourse was not generally associated with risk, except among women reporting increased frequencies before 20 years of age. Histories of gonorrhea or crab lice were associated with increased risk, but histories of other venereal diseases were not significant predictors. No consistently increased risks were detected for women reporting specific hygiene or douching habits, except the practice of washing the genitalia infrequently during menstruation. These results provide support for a period of increased susceptibility to carcinogens during adolescence, and suggest that this may be an important determinant of the high incidence of cervical cancer in Latin America.
一项针对拉丁美洲四个国家759名浸润性宫颈癌女性和1430名对照者的病例对照研究，评估了性行为、特定性病病史和卫生习惯与风险的关系。即使在对首次性交年龄和性伴侣数量的相互影响进行调整之后，首次性交年龄较小和性伴侣数量增加仍与风险显著增加相关。与20岁及以上开始首次性交的女性相比，报告在14至15岁开始首次性交的女性风险增加了两倍。稳定的性伴侣数量比不稳定的性伴侣数量是更重要的风险预测因素，尤其是在30岁之前，这可能反映了需要长时间或反复接触可传播病原体，或者采用不同的方法预防性传播疾病或怀孕。除了20岁之前报告性交频率增加的女性外，报告的性交频率一般与风险无关。淋病或阴虱病史与风险增加相关，但其他性病病史不是显著的预测因素。除了在月经期间很少清洗生殖器的习惯外，报告有特定卫生习惯或灌洗习惯的女性未检测到风险持续增加。这些结果支持青春期对致癌物易感性增加的时期，并表明这可能是拉丁美洲宫颈癌高发病率的一个重要决定因素。
