Kjaer S K, Engholm G, Dahl C, Bock J E
Danish Cancer Society, Division for Cancer Epidemiology, Copenhagen, Denmark.
Eur J Cancer Prev. 1996 Oct;5(5):359-65. doi: 10.1097/00008469-199610000-00008.
The role of smoking and other risk factors for cervical neoplasia was investigated in a population-based case-control study of 586 women with histologically verified cervical squamous-cell carcinoma in situ (CIS), and 59 women with invasive squamous-cell cervical cancer from Copenhagen. Controls were randomly selected from the general female population using the computerized Danish Central Population Register. After adjustment for a variety of confounding variables, which were all significantly associated with CIS risk and included age, number of partners, proportion of sexually active life without barrier contraceptive use, years with intra-uterine devices, number of births, and age at first episode of genital warts (as a proxy measure for human papillomavirus exposure), current cigarette smoking was found to be significantly associated with CIS [adjusted relative risk (RR) = 2.4; 95% confidence interval (CI): 1.7-3.4]. Ex-smokers had a lower, but still significantly increased risk (RR = 1.6; 95% CI: 1.0-2.7). A dose-response relationship was present, especially for number of cigarettes smoked per day. In contrast, the crude estimates showed a weak association between invasive cervical cancer and smoking, which however disappeared after confounder control. The results of the present study support the hypothesis implicating smoking as a risk factor for CIS.
在一项基于人群的病例对照研究中，对586例经组织学证实为宫颈原位鳞状细胞癌（CIS）的女性和59例来自哥本哈根的浸润性宫颈鳞状细胞癌女性，研究了吸烟及其他宫颈癌前病变风险因素的作用。使用丹麦中央人口计算机登记系统从一般女性人群中随机选取对照。在对各种混杂变量进行调整后（这些变量均与CIS风险显著相关，包括年龄、性伴侣数量、无屏障避孕措施的性活跃生活比例、使用宫内节育器的年限、生育次数以及初次出现尖锐湿疣的年龄（作为人乳头瘤病毒暴露的替代指标）），发现当前吸烟与CIS显著相关[调整后相对风险（RR）=2.4；95%置信区间（CI）：1.7 - 3.4]。已戒烟者的风险较低，但仍显著增加（RR = 1.6；95% CI：1.0 - 2.7）。存在剂量反应关系，尤其是每天吸烟的数量。相比之下，粗略估计显示浸润性宫颈癌与吸烟之间存在微弱关联，但在控制混杂因素后这种关联消失。本研究结果支持吸烟是CIS风险因素这一假说。
