埃塞俄比亚亚的斯亚贝巴宫颈癌筛查女性中与宫颈癌前病变相关的因素：一项病例对照研究。
Factors associated with cervical precancerous lesions among women screened for cervical cancer in Addis Ababa, Ethiopia: A case control study.
作者信息
Teame Hirut, Addissie Adamu, Ayele Wondimu, Hirpa Selamawit, Gebremariam Alem, Gebreheat Gdiom, Jemal Ahmedin
机构信息
Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia.
School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
出版信息
PLoS One. 2018 Jan 19;13(1):e0191506. doi: 10.1371/journal.pone.0191506. eCollection 2018.
BACKGROUND
Cervical cancer is the second most prevalent cancer among women in the developing countries including Ethiopia. Precancerous lesions can be developed and risk to the development of cervical cancer over time. Early identification of the precancerous lesion and its risk factor is paramount in preventing cervical cancer. However, the determinants of cervical precancerous lesions are not well documented in Ethiopia. Therefore, this study is conducted to determine factors associated with cervical precancerous lesion among women screened for cervical cancer.
METHODS
A hospital-based unmatched case-control study was conducted in selected health facilities in Addis Ababa from March to April 2016. Data were collected from 114 cases and 229 controls using an interviewer-administered questionnaire, entered to Epi Info version 7, and exported to SPSS version 20 for analysis. Odds ratios with its 95% confidence intervals and two-tailed P-value were calculated. Variables with P-value ≤ 0.2 in the bivariate analysis were included in the multivariate logistic regression model.
RESULTS
Women aged 40-49 years had 2.4-fold higher odds of precancerous lesions compared to those aged 30-39 (Adjusted Odds Ratio = 2.4, 95% Confidence Interval: 1.27-4.54). Women having history of sexually transmitted infections were significantly associated with cervical precancerous lesion compared to their counterparts (Adjusted Odds Ratio = 3.20, 95% Confidence Interval: 1.26-8.10). Similarly, those women who had two or more lifetime sexual partners (Adjusted Odds Ratio = 2.17 95% Confidence Interval: 1.01-4.67), and women whose husbands had two or more lifetime sexual partners (Adjusted Odds Ratio = 3.03, 95% Confidence Interval: 1.25, 7.33) had higher odds of cervical precancerous lesions.
CONCLUSIONS
Older age, history of multiple sexual partners and sexual transmitted infections were associated with increased risk of precancerous lesion. Therefore, women with higher risk of precancerous lesions should be encouraged to be screened more frequently for cervical cancer.
背景
宫颈癌是包括埃塞俄比亚在内的发展中国家女性中第二大常见癌症。癌前病变可能会发展，随着时间的推移有患宫颈癌的风险。早期识别癌前病变及其危险因素对于预防宫颈癌至关重要。然而，在埃塞俄比亚，宫颈癌前病变的决定因素尚无充分记录。因此，本研究旨在确定接受宫颈癌筛查的女性中与宫颈癌前病变相关的因素。
方法
2016年3月至4月，在亚的斯亚贝巴的选定卫生机构进行了一项基于医院的非匹配病例对照研究。使用访谈式问卷从114例病例和229例对照中收集数据，录入Epi Info 7版本，并导出到SPSS 20版本进行分析。计算比值比及其95%置信区间和双侧P值。在双变量分析中P值≤0.2的变量纳入多变量逻辑回归模型。
结果
40 - 49岁的女性患癌前病变的几率是30 - 39岁女性的2.4倍（调整后的比值比 = 2.4，95%置信区间：1.27 - 4.54）。有性传播感染史的女性与没有此类病史的女性相比，与宫颈癌前病变显著相关（调整后的比值比 = 3.20，95%置信区间：1.26 - 8.10）。同样，有两个或更多终身性伴侣的女性（调整后的比值比 = 2.17，95%置信区间：1.01 - 4.67）以及丈夫有两个或更多终身性伴侣的女性（调整后的比值比 = 3.03，95%置信区间：1.25，7.33）患宫颈癌前病变的几率更高。
结论
年龄较大、有多个性伴侣史和性传播感染与癌前病变风险增加有关。因此，应鼓励癌前病变风险较高的女性更频繁地进行宫颈癌筛查。
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