Castañeda-Iñiguez M S, Toledo-Cisneros R, Aguilera-Delgadillo M
Programa de Prevención y Control del Cáncer Cervicouterino y Mamario, Servicio de Salud, Zacatecas, México.
Salud Publica Mex. 1998 Jul-Aug;40(4):330-8.
To determine the sociodemographic characteristics and the reproductive and sexual behavior of participants in the Cervical Cancer Prevention and Control Program and to identify the risk factors for this neoplasm.
A case control study was performed among participants in the Cervical Cancer Prevention and Control Program in the state of Zacatecas. The cases consisted of all patients diagnosed and corroborated by histopathology with CIN III and invasive carcinoma of the uterine cervix (251) who were referred to the Dysplasia Clinic (within the same program), during 1993-1995. Controls were women randomly selected from the population which participates in this program, who had negative cervical cytology. One control was selected for each case and paired by age and date, simultaneous to the cervical cytology.
Risk of cervical cancer was higher in women with greater number of pregnancies (more than 12 pregnancies) than in women with less than 3 (OR 5.2, CI 95% 2.6-10.5). This is also true of women with greater number of births (12 or more) who have a risk five times higher than women with less than 3. Beginning sexual activity at an early age was associated to the risk of cervical cancer; women who began their sexual activity after the age of 19 had a risk two times lower than those who started before the age of 15. The use of oral contraceptives increased the risk of cervical cancer in relation to the use of non-hormonal contraceptives (OR 1.9, CI 95% 1.3-3.4).
In the present study, the risk factors for cervical cancer in the population participating in the prevention and control program were higher in women with high parity, who began sexual activity at an early age and/or who consumed oral contraceptives.
确定宫颈癌预防与控制项目参与者的社会人口学特征、生殖与性行为，并识别该肿瘤的危险因素。
在萨卡特卡斯州的宫颈癌预防与控制项目参与者中开展了一项病例对照研究。病例包括1993 - 1995年间被组织病理学诊断并确诊为CIN III和子宫颈浸润癌的所有患者（251例），这些患者被转诊至发育异常诊所（同一项目内）。对照是从参与该项目的人群中随机选取的宫颈细胞学检查为阴性的女性。为每个病例选取一名对照，并按年龄和日期配对，与宫颈细胞学检查同时进行。
怀孕次数较多（超过12次怀孕）的女性患宫颈癌的风险高于怀孕次数少于3次的女性（比值比5.2，95%置信区间2.6 - 10.5）。生育次数较多（12次或更多）的女性也是如此，其风险比生育次数少于3次的女性高五倍。过早开始性行为与宫颈癌风险相关；19岁以后开始性行为的女性风险比15岁以前开始的女性低两倍。与使用非激素避孕药相比，使用口服避孕药会增加患宫颈癌的风险（比值比1.9，95%置信区间1.3 - 3.4）。
在本研究中，参与预防与控制项目人群中宫颈癌的危险因素在多产、过早开始性行为和/或使用口服避孕药的女性中更高。
