Becker T M, Wheeler C M, McGough N S, Parmenter C A, Stidley C A, Jamison S F, Jordan S W
University of New Mexico, School of Medicine, Albuquerque 87131.
Cancer Epidemiol Biomarkers Prev. 1994 Mar;3(2):113-9.
To assess smoking-related and other risk factors for high-grade cervical dysplasia in southwestern Hispanic and non-Hispanic white women in New Mexico, we conducted a clinic-based case-control study among attendees at university-affiliated gynecology clinics. We collected data on cigarette use, sexual behavior, past and current sexually transmitted diseases, hygienic practices, contraception, and diet. For both ethnic groups combined, after adjustment for the effects of human papillomavirus, sexual behavior, and other risk factors, cigarette smoking at the time of diagnosis was associated with high-grade dysplasia (odds ratio, 1.7; 95% confidence limits, 1.0-2.8). In contrast, former smoking was not associated with cervical dysplasia (odds ratio 0.9; 95% confidence limits, 0.5-1.5). Analyses showed dose-response relationships for the amount of cigarettes smoked per day and for cumulative exposure (pack-years of use) in association with cervical dysplasia. Although our study lacked the power to show statistically significant ethnic differences in smoking-related risks for dysplasia, smoking at the time of diagnosis, high pack-years of use, and smoking at the time of menarche were associated with dysplasia only for non-Hispanic white versus Hispanic women. Our data support hypotheses that implicate cigarette use as an etiological factor in the development of high-grade cervical dysplasia and suggest ethnic differences in risks for dysplasia among women attending the same clinics.
为评估新墨西哥州西南部西班牙裔和非西班牙裔白人女性中与吸烟相关的及其他高级别宫颈发育异常的风险因素，我们在大学附属医院妇科诊所的就诊者中开展了一项基于诊所的病例对照研究。我们收集了关于吸烟情况、性行为、既往及当前性传播疾病、卫生习惯、避孕措施和饮食的数据。对于合并的两个种族群体，在对人乳头瘤病毒、性行为及其他风险因素的影响进行调整后，诊断时吸烟与高级别发育异常相关（比值比为1.7；95%置信区间为1.0 - 2.8）。相比之下，既往吸烟与宫颈发育异常无关（比值比为0.9；95%置信区间为0.5 - 1.5）。分析显示，每日吸烟量及累积暴露量（吸烟包年数）与宫颈发育异常之间存在剂量反应关系。尽管我们的研究没有足够的效力显示发育异常的吸烟相关风险存在统计学上的显著种族差异，但仅在非西班牙裔白人女性与西班牙裔女性相比时，诊断时吸烟、高吸烟包年数及初潮时吸烟与发育异常相关。我们的数据支持将吸烟作为高级别宫颈发育异常病因因素的假说，并提示在同一诊所就诊的女性中发育异常风险存在种族差异。
