Acs J, Hildesheim A, Reeves W C, Brenes M, Brinton L, Lavery C, de la Guardia M E, Godoy J, Rawls W E
Department of Pathology, McMaster University, Hamilton, Ontario, Canada.
Cancer Res. 1989 Oct 15;49(20):5725-9.
A population-based national cancer registry has documented strikingly different regional incidence rates of cervical cancer in the Republic of Panama. Such regional differences in disease rates could represent regional differences in the occurrence of risk factors, in particular, human genital papillomaviruses (HPV). This study enrolled newly diagnosed invasive cancer patients in the Republic of Panama over an 18-mo period. Behavioral risk factors were measured by interviewing cases and matched controls. In addition, DNA extracted from biopsies of the cancers was tested for HPV sequences. Early age at first coitus, multiple pregnancies, and nonparticipation in Pap smear screening programs were significant risk factors for cervical cancer in this population. These factors and low levels of education occurred more frequently among women residing in regions with higher cancer rates than women residing in the region with lower cancer rates. HPV DNA was detected most frequently (70%) among cases from the region with the lowest cancer rate (30 of 100,000) and least frequent (54%) among cases where the cancer rate was the highest (51 of 100,000). The observations suggest that risk factors other than HPV contribute to the differences in cervical cancer rates among women residing in various regions of Panama.
一项基于人群的国家癌症登记系统记录了巴拿马共和国宫颈癌区域发病率存在显著差异。疾病发病率的这种区域差异可能代表了危险因素发生情况的区域差异，尤其是人类乳头瘤病毒（HPV）。本研究在18个月期间纳入了巴拿马共和国新诊断的浸润性癌症患者。通过对病例和匹配对照进行访谈来测量行为危险因素。此外，对癌症活检提取的DNA进行HPV序列检测。首次性交年龄早、多次怀孕以及未参加巴氏涂片筛查项目是该人群患宫颈癌的重要危险因素。与癌症发病率较低地区的女性相比，这些因素以及低教育水平在癌症发病率较高地区的女性中更为常见。在癌症发病率最低地区（每10万人中有30例）的病例中，HPV DNA检测频率最高（70%），而在癌症发病率最高地区（每10万人中有51例）的病例中检测频率最低（54%）。这些观察结果表明，除HPV外的其他危险因素导致了巴拿马不同地区女性宫颈癌发病率的差异。
