埃塞俄比亚南部宫颈癌筛查女性中癌前宫颈病变的危险因素：病例对照研究。
Risk factors for precancerous cervical lesion among women screened for cervical cancer in south Ethiopia: Unmatched case-control study.
机构信息
College of Medical and Health Sciences, Wollega University, Nekemte, Oromia, Ethiopia.
Postdoctoral Research Fellow, University of Newcastle, Callaghan, Australia.
出版信息
PLoS One. 2021 Jul 15;16(7):e0254663. doi: 10.1371/journal.pone.0254663. eCollection 2021.
BACKGROUND
Nearly 90% of deaths from cervical cancer occur in a low resource setting. In Ethiopia, the magnitude of precancerous cervical lesions ranges from 7% to 28%. Precancerous cervical lesions may progress to cervical cancer. Early screening and treatment of precancerous cervical lesions is a cost-effective way to avert the growth of cervical cancer. However, there has been limited research on risk factors for precancerous cervical lesions in Ethiopia. Therefore, this study aimed to identify risk factors for precancerous cervical lesions among women screened for cervical cancer in south Ethiopia.
METHOD
A facility-based unmatched case-control study was carried out in five health facilities in south Ethiopia between 8 May to 28 September 2018. Interviewer administered questionnaires were used to collect data from 98 cases and 197 controls. Multivariate logistic regression was employed to identify determinants of precancerous cervical lesions.
RESULTS
Women aged 30-39 years (AOR = 2.51, 95% CI: 1.03-6.08), monthly income ≤66 (AOR = 3.51, 95% CI: 1.77-6.97), initiation of first sexual intercourse at age less than or equal to 20 (AOR = 2.39, 95% CI: 1.14-5.47), having more than one lifetime sexual partner (AOR = 4.70, 95% CI: 2.02-10.95), having a partner/ husband with more than one lifetime sexual partner (AOR = 2.98, 95% CI: 1.35-6.65) had higher odds of precancerous cervical lesions.
CONCLUSION AND RECOMMENDATION
Strategies to prevent precancerous cervical lesions should focus on modification of lifestyle and sexual behaviour. The findings of this study highlight several implications for policymakers: targeting older women for cervical cancer screening, addressing inequalities and education relating to risky sexual behaviour may reduce precancerous cervical lesions. Furthermore, future longitudinal studies are needed to assess the awareness of women about cervical cancer screening.
背景
近 90%的宫颈癌死亡发生在资源匮乏的环境中。在埃塞俄比亚，癌前宫颈病变的范围在 7%至 28%之间。癌前宫颈病变可能进展为宫颈癌。早期筛查和治疗癌前宫颈病变是一种具有成本效益的方法，可以避免宫颈癌的发展。然而，在埃塞俄比亚，对癌前宫颈病变的危险因素的研究有限。因此，本研究旨在确定在埃塞俄比亚南部接受宫颈癌筛查的女性中癌前宫颈病变的危险因素。
方法
这是一项在埃塞俄比亚南部的五个卫生机构进行的基于设施的非匹配病例对照研究，时间为 2018 年 5 月 8 日至 9 月 28 日。访谈员使用问卷调查收集了 98 例病例和 197 例对照的数据。采用多变量逻辑回归确定癌前宫颈病变的决定因素。
结果
30-39 岁的女性（AOR=2.51，95%CI：1.03-6.08）、月收入≤66 埃塞俄比亚比尔（AOR=3.51，95%CI：1.77-6.97）、首次性行为发生在 20 岁或以下（AOR=2.39，95%CI：1.14-5.47）、有一个以上的性伴侣（AOR=4.70，95%CI：2.02-10.95）、伴侣/丈夫有一个以上的性伴侣（AOR=2.98，95%CI：1.35-6.65），这些女性患癌前宫颈病变的几率更高。
结论和建议
预防癌前宫颈病变的策略应侧重于生活方式和性行为的改变。本研究的结果强调了对政策制定者的几点启示：针对老年妇女进行宫颈癌筛查，解决不平等和与危险性行为相关的教育问题，可能会降低癌前宫颈病变的发生率。此外，还需要进行未来的纵向研究，以评估妇女对宫颈癌筛查的认识。
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