Biswas L N, Manna B, Maiti P K, Sengupta S
Department of Radiotherapy and Oncology, NRS Medical College, Calcutta, India.
Int J Epidemiol. 1997 Jun;26(3):491-5. doi: 10.1093/ije/26.3.491.
The association between sexual behaviour and cervical cancer is well established. Despite a high incidence of cervical cancer in India, its role has not been widely investigated in Indian women among whom the rate of sexual promiscuity is known to be very low. A hospital-based case-control study was carried out to investigate the role of sexual risk factors in cervical cancer among rural Indian women.
A case-control design was used in which a total of 268 subjects, comprising 134 women with invasive cervical cancer as cases and 134 control women were studied. A multiple logistic regression model was used to analyse the data.
The risk factors found to be associated with cervical cancer were early age at first coitus, extramarital sex partners of women and the time interval since first exposure. In a multiple logistic regression model, independent effects were observed for early age at first coitus, showing maximum risk in women who reported their first intercourse at < 12 years of age, compared to that of women at > or = 18 years (odds ratio [OR] = 3.5. 95% confidence interval [CI]: 1.1-10.9). Increased risk was also seen for women who had extramarital sex relationships (OR = 5.5, 95% CI: 1.5-19.5). The significant effect of early age at first coitus persisted after adjustment for latency period which also showed its independent risk association with cervical cancer in the multivariate analysis.
These findings confirm the association between early age at first coitus and cervical cancer in women with a low rate of sexual promiscuity and define the role of these risk factors in cervical carcinogenesis among rural Indian women.
性行为与宫颈癌之间的关联已得到充分证实。尽管印度宫颈癌发病率很高，但其在印度女性中的作用尚未得到广泛研究，而印度女性的性乱交率已知非常低。开展了一项基于医院的病例对照研究，以调查性风险因素在印度农村女性宫颈癌中的作用。
采用病例对照设计，共研究了268名受试者，其中包括134名浸润性宫颈癌女性作为病例，以及134名对照女性。使用多元逻辑回归模型分析数据。
发现与宫颈癌相关的风险因素包括首次性交年龄早、女性的婚外性伴侣以及首次暴露后的时间间隔。在多元逻辑回归模型中，观察到首次性交年龄早的独立影响，报告首次性交年龄<12岁的女性与≥18岁的女性相比风险最大（比值比[OR]=3.5，95%置信区间[CI]：1.1-10.9）。有婚外性关系的女性风险也增加（OR=5.5，95%CI：1.5-19.5）。在对潜伏期进行调整后，首次性交年龄早的显著影响仍然存在，潜伏期在多变量分析中也显示出与宫颈癌的独立风险关联。
这些发现证实了性乱交率低的女性中首次性交年龄早与宫颈癌之间的关联，并确定了这些风险因素在印度农村女性宫颈癌发生中的作用。
