La Vecchia C, Franceschi S, Decarli A, Fasoli M, Gentile A, Parazzini F, Regallo M
Cancer. 1986 Aug 15;58(4):935-41. doi: 10.1002/1097-0142(19860815)58:4<935::aid-cncr2820580422>3.0.co;2-o.
The relation between major indicators of sexual habits (age at first intercourse and total number of sexual partners), history of selected venereal diseases, and cervical neoplasia was investigated using data from a case-control study of 206 cases of cervical intraepithelial neoplasia compared with 206 age-matched outpatient controls, and of 327 cases of invasive cancer compared with 327 control subjects in hospital for acute conditions unrelated to any of the established or suspected risk factors for cervical cancer. The relative risks increased with decreasing age at first intercourse and increasing number of sexual partners both for intraepithelial and for invasive cancers. The effects of these two variables were independent, since they were only marginally affected by reciprocal adjustment, or by allowance for several other identified potential distorting factors. The negative association with age at first intercourse was particularly strong in the case of invasive cancers, with risk estimates over five-fold elevated for women reporting their first intercourse before age 18 compared with those aged over 22 years. This relation might be discussed in terms of multistage models of carcinogenesis, which predict that the incidence of epithelial carcinomas is a function of duration of exposure. In fact, when age was allowed for, the relative risks of cervical neoplasia were positively and strongly related with the total duration of the interval between age at diagnosis/interview and age at first intercourse. Clinical histories of several sexually transmitted diseases were positively associated with the risk of intraepithelial neoplasia. In particular, genital warts were reported by nine cases but no control subject. No such association, however, emerged for invasive carcinomas. Thus, the current findings confirm that, although intraepithelial neoplasia and invasive cervical cancer appear to share several important epidemiological features, the specific (infectious) agents implicated in dysplastic lesions probably differ to some extent from those causing invasive cancer.
利用一项病例对照研究的数据，对性行为习惯的主要指标（首次性交年龄和性伴侣总数）、特定性病病史与宫颈肿瘤形成之间的关系进行了调查。该研究中，206例宫颈上皮内瘤变病例与206名年龄匹配的门诊对照进行比较，327例浸润癌病例与327名因与任何已确定或疑似宫颈癌危险因素无关的急性病住院的对照受试者进行比较。对于上皮内癌和浸润癌，相对风险均随着首次性交年龄的降低和性伴侣数量的增加而升高。这两个变量的影响是独立的，因为它们仅在相互调整或考虑其他几个已确定的潜在干扰因素时受到轻微影响。首次性交年龄与浸润癌的负相关尤为强烈，报告首次性交年龄在18岁之前的女性与22岁以上女性相比，风险估计值高出五倍以上。这种关系可以根据致癌作用的多阶段模型来讨论，该模型预测上皮癌的发病率是暴露持续时间的函数。事实上，在考虑年龄因素后，宫颈肿瘤形成的相对风险与诊断/访谈年龄和首次性交年龄之间间隔的总持续时间呈正相关且相关性很强。几种性传播疾病的临床病史与上皮内瘤变的风险呈正相关。特别是，9例病例报告有尖锐湿疣，而对照受试者中无人报告。然而，浸润癌未出现这种关联。因此，目前的研究结果证实，尽管上皮内瘤变和浸润性宫颈癌似乎具有几个重要的流行病学特征，但发育异常病变中涉及的特定（感染性）病原体可能在一定程度上与导致浸润癌的病原体不同。
