Epidemiology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr., Research Triangle Park, NC, 27709, USA.
Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Sci Rep. 2021 Jul 21;11(1):14836. doi: 10.1038/s41598-021-94447-3.
While human papillomavirus is the primary cause of cervical cancer, other factors may influence susceptibility and response to the virus. Candidates include douching and talcum powder applied in the genital area. We used Cox proportional hazards models to estimate confounder-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) in the Sister Study (2003-2009), a US cohort of women aged 35-74. We considered pre-baseline (n = 523) and incident (n = 31) cervical cancers. Douching at ages 10-13 was positively associated with pre-baseline cervical cancer (HR 1.32, 95% CI 0.86-2.03), though the association was not statistically significant. We did not observe an association between adolescent talc use and pre-baseline cervical cancer (HR 0.95, 95% CI 0.76-1.19). Douching in the year before enrollment was positively associated with incident cervical cancer (HR 2.56, 95% CI 1.10-5.99). The association between recent genital talc use and incident cervical cancer was positive, but not statistically significant (HR 1.79, 95% CI 0.78-4.11). The observed positive association between douching and incident cervical cancer is consistent with previous retrospective case-control studies. In the first study to examine genital talc use and cervical cancer, we did not see evidence of an association.
虽然人乳头瘤病毒是宫颈癌的主要病因，但其他因素也可能影响对病毒的易感性和反应。候选因素包括阴道冲洗和在生殖器部位使用滑石粉。我们使用 Cox 比例风险模型，在 2003-2009 年的美国姐妹研究（Sister Study）中，对年龄在 35-74 岁的女性队列进行了混杂因素调整后的危险比（HR）和 95%置信区间（CI）的估计。我们考虑了基线前（n=523）和发病（n=31）宫颈癌。10-13 岁时阴道冲洗与基线前宫颈癌呈正相关（HR 1.32，95%CI 0.86-2.03），尽管这种关联没有统计学意义。我们没有观察到青少年时期使用滑石粉与基线前宫颈癌之间存在关联（HR 0.95，95%CI 0.76-1.19）。入组前一年阴道冲洗与发病宫颈癌呈正相关（HR 2.56，95%CI 1.10-5.99）。最近生殖器部位使用滑石粉与发病宫颈癌之间的关联呈阳性，但无统计学意义（HR 1.79，95%CI 0.78-4.11）。与之前的回顾性病例对照研究一致，我们观察到阴道冲洗与发病宫颈癌之间呈正相关。在第一项研究中，我们没有发现生殖器部位使用滑石粉与宫颈癌之间存在关联的证据。
