Natphopsuk Sitakan, Settheetham-Ishida Wannapa, Sinawat Supat, Pientong Chamsai, Yuenyao Pissamai, Ishida Takafumi
Department of Physiology, Khon Kaen University, Khon Kaen, Thailand.
Asian Pac J Cancer Prev. 2012;13(11):5489-95. doi: 10.7314/apjcp.2012.13.11.5489.
Cervical cancer is a serious public health problem in Thailand. We investigated possible risk factors for cervical cancer including HPV infection, p53 polymorphism, smoking and reproductive history among women in Northeast Thailand using a case control study with 177 cases and age-matched controls. Among the HPV carriers, a significantly increased risk for cervical cancer with an OR of 36.97 (p<0.001) and an adjusted OR of 38.07 (p<0.001) were observed. Early age at first sexual exposure, and multiple sexual partners increased the risk of cervical cancer with ORs ranging between 1.73-2.78 (p<0.05). The interval between menarche and first sexual intercourse<6 years resulted in a significant increase in the risk for cervical cancer with ORs ranging between 3.32-4.09 and the respective adjusted OR range for the 4-5 and 2-3 year-old groups were 4.09 and 2.92. A higher risk was observed among subjects whose partner had smoking habits, whether currently or formerly; with respective ORs of 3.36 (p<0.001) and 2.17 (p<0.05); and respective adjusted ORs of 2.90 (p<0.05) and 3.55 (p<0.05). Other smoking characteristics of the partners including smoking duration≥20 years, number of cigarettes smokes≥20 pack-years and exposure time of the subject to passive smoking≥5 hrs per day were found to be statistically significant risks for cervical cancer with adjusted ORs of 3.75, 4.04 and 11.8, respectively. Our data suggest that the risk of cervical cancer in Thai women is substantially associated with smoking characteristics of the partner(s), the interval between menarche and first sexual intercourse as well as some other aspects of sexual behavior.
宫颈癌在泰国是一个严重的公共卫生问题。我们采用病例对照研究，以177例病例及年龄匹配的对照，调查了泰国东北部女性宫颈癌的可能危险因素，包括人乳头瘤病毒（HPV）感染、p53基因多态性、吸烟及生殖史。在HPV携带者中，观察到患宫颈癌的风险显著增加，比值比（OR）为36.97（p<0.001），调整后的OR为38.07（p<0.001）。首次性接触年龄早及多个性伴侣会增加患宫颈癌的风险，OR值在1.73至2.78之间（p<0.05）。月经初潮与首次性交的间隔<6年会导致患宫颈癌的风险显著增加，OR值在3.32至4.09之间，4至5岁组和2至3岁组各自调整后的OR范围分别为4.09和2.92。伴侣有吸烟习惯（无论目前还是既往）的受试者患癌风险更高；各自的OR值分别为3.36（p<0.001）和2.17（p<0.05）；各自调整后的OR值分别为2.90（p<0.05）和3.55（p<0.05）。伴侣的其他吸烟特征，包括吸烟时长≥20年、吸烟量≥20包年以及受试者被动吸烟暴露时间≥5小时/天，被发现是宫颈癌的统计学显著危险因素，调整后的OR值分别为3.75、4.04和11.8。我们的数据表明，泰国女性患宫颈癌的风险与伴侣的吸烟特征、月经初潮与首次性交的间隔以及性行为的其他一些方面密切相关。
