Lazcano-Ponce E C, Hernández-Avila M, López-Carrillo L, Alonso de Ruíz P, Torres-Lobatón A, González-Lira G, Romieu I
Centro de Investigaciones en Salud Pública, Instituto Nacional de Salud Pública de Cuernavaca, Morelos, México.
Rev Invest Clin. 1995 Sep-Oct;47(5):377-85.
Uterine cervical cancer is one of the principal public health problems in Mexico. The national mortality rate for cervical cancer in 1991 is estimated at 9.5 per 100,000 women, representing 4,194 deaths. In the period from August 1990 to December 1992, a case-control study was carried out that included 630 cases of histologically confirmed cervical cancer in eight Mexico City hospitals (two for people with no social security cover, four of the social security system and two private). As controls, 1,005 women were chosen from a random sampling of houses in the Mexico City metropolitan area. The main cervical cancer risk factors found in this study, adjusted for a multivariate model, were multiple normals births (with five births OR of 1.93 and 95% C.I. of 1.22-2.73) and a history of two or more sex partners (the OR with four or more sex partners was 5.56 and a C.I. of 2.3-13.4). In addition, there was an estimated lower risk of disease related to starting a sex life after 25 years of age (OR 0.41 with C.I. of 0.25-0.69) and to having cesareans as compared versus one normal birth (OR 0.28 and C.I. of 0.13-0.61). The information obtained is relevant since it identifies Mexican women with a high-risk of developing cervical cancer which can be used in planning programs for the early detection of cancer in this population.
子宫颈癌是墨西哥主要的公共卫生问题之一。据估计，1991年全国子宫颈癌死亡率为每10万名女性中有9.5人，死亡人数达4194人。在1990年8月至1992年12月期间，开展了一项病例对照研究，该研究纳入了墨西哥城八家医院经组织学确诊的630例子宫颈癌病例（两家针对无社会保障覆盖人群的医院、四家社会保障系统医院和两家私立医院）。作为对照，从墨西哥城大都市区的房屋随机抽样中选取了1005名女性。在该研究中发现的主要子宫颈癌风险因素，经多变量模型调整后，为多次正常分娩（五次分娩的比值比为1.93，95%置信区间为1.22 - 2.73）以及有两个或更多性伴侣的病史（有四个或更多性伴侣的比值比为5.56，置信区间为2.3 - 13.4）。此外，估计25岁后开始性生活以及与一次正常分娩相比进行剖宫产的疾病风险较低（比值比分别为0.41，置信区间为0.25 - 0.69；比值比为0.28，置信区间为0.13 - 0.61）。所获得的信息具有相关性，因为它识别出了患子宫颈癌风险较高的墨西哥女性，可用于规划该人群癌症早期检测项目。
