Duncan M E, Pelzer A, Tibaux G, Mehari L
Department of Bacteriology, University of Edinburgh, Scotland.
Int Surg. 1993 Apr-Jun;78(2):134-40.
Cervical cancer is the most prevalent cancer of women in Ethiopia and sexually transmitted diseases are highly prevalent in the country. In order to establish a possible cause and effect relationship between sexually transmitted diseases and cervical cancer, likely etiological socio-economic factors for these two conditions have been analysed. While residence, income, age at first coitus, age, number of sexual partners, marital status/profession and duration of sexual life affect both conditions, there is a significant difference between the most important factors in the etiology of the separate conditions. Serological testing shows a high prevalence of gonorrhea, which was used as a marker of STD. Women with gonococcal antibodies had evidence of increased exposure to other STD; there was no such correlation for cervical cancer. Our results indicate that STD per se is unlikely to be a primary cause of CC in Ethiopia. It appears probable that the etiology of CC in Ethiopia is multifactorial. Early exposure of the immature cervical epithelium to STD, the trauma of repeated childbirth, and multiple sexual partners in women whose defence factors are impaired by chronic malnutrition, add up to a major medico-socio-economic factor. The evidence presented here suggests that CC in Ethiopia is not so much the result of a sexually transmitted disease, but a sociosexual disease.
宫颈癌是埃塞俄比亚女性中最常见的癌症，性传播疾病在该国也极为普遍。为了确定性传播疾病与宫颈癌之间可能存在的因果关系，对这两种疾病可能的病因社会经济因素进行了分析。虽然居住情况、收入、首次性交年龄、年龄、性伴侣数量、婚姻状况/职业以及性生活时长对这两种疾病都有影响，但在这两种疾病病因的最重要因素之间存在显著差异。血清学检测显示淋病患病率很高，淋病被用作性传播疾病的一个指标。有淋球菌抗体的女性有证据表明接触其他性传播疾病的机会增加；而宫颈癌不存在这种相关性。我们的结果表明，在埃塞俄比亚，性传播疾病本身不太可能是宫颈癌的主要病因。埃塞俄比亚宫颈癌的病因似乎是多因素的。未成熟的宫颈上皮过早接触性传播疾病、多次分娩造成的创伤，以及慢性营养不良削弱了防御因素的女性中的多个性伴侣，共同构成了一个主要的医学 - 社会经济因素。这里提供的证据表明，埃塞俄比亚的宫颈癌与其说是性传播疾病的结果，不如说是一种社会性性疾病。
