Reproductive factors and risk of cervical cancer by cell type. A prospective study

Kvåle, Gunnar; Heuch, Ivar; Nilssen, Steinar

doi:10.1038/bjc.1988.318

Cited by 24 publications

(12 citation statements)

References 21 publications

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“…Case -case studies have generally found adenocarcinoma to be more strongly associated than squamous cell carcinoma with nulliparity (Tasker and Collins 1974;Korhonen, 1980;Milsom and Friberg 1983;Silcocks et al, 1987), but these studies are difficult to interpret as most of them lack adequate adjustment for potential confounding factors. Previous studies of cervical cancer have found age at first birth to be an independent risk factor for squamous cell , but not for adenocarcinoma (Kvale et al, 1988;Parazzini et al, 1988, Bjorge andKravdal, 1996;Ursin et al, 1996;Munoz et al, 2002;Altekruse et al, 2003).…”

Section: Discussionmentioning

confidence: 98%

“…Altekruse et al (2003) found an inverse relationship between parity and cervical adenocarcinoma risk. No association with parity for either adenocarcinoma or squamous cell carcinoma of the cervix was found in two cohort studies (Kvale et al, 1988;Bjorge and Kravdal, 1996). Case -case studies have generally found adenocarcinoma to be more strongly associated than squamous cell carcinoma with nulliparity (Tasker and Collins 1974;Korhonen, 1980;Milsom and Friberg 1983;Silcocks et al, 1987), but these studies are difficult to interpret as most of them lack adequate adjustment for potential confounding factors.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for adenocarcinoma and squamous cell carcinoma of the cervix in women aged 20–44 years: the UK National Case–Control Study of Cervical Cancer

et al. 2003

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We report results on risk factors for invasive squamous cell and adenocarcinomas of the cervix in women aged 20 -44 years from the UK National Case -Control Study of Cervical Cancer, including 180 women with adenocarcinoma, 391 women with squamous cell carcinoma and 923 population controls. The risk of both squamous cell and adenocarcinoma was strongly related to the lifetime number of sexual partners, and, independently, to age at first intercourse. The risk of both types of cervical cancer increased with increasing duration of use of oral contraceptives, and this effect was most marked in current and recent users of oral contraceptives. The risk of squamous cell carcinoma was associated with high parity and the risk of both squamous cell and adenocarcinoma increased with early age at first birth. Long duration smoking (20 or more years) was associated with a two-fold increase in the risk of squamous cell carcinoma, but smoking was not associated with the risk of adenocarcinoma. Further studies are needed to confirm the suggestion from this and other studies of differences in risk related to smoking between squamous cell and adenocarcinomas of the cervix. Among cancers of the uterine cervix, adenocarcinomas are much less common than squamous cell carcinomas. As for squamous cell carcinoma, human papillomavirus (HPV) infection appears to be a major risk factor for adenocarcinoma of the cervix (Kjaer and Brinton, 1993;Walboomers et al, 1999;Santos et al, 2001;Altekruse et al, 2003), but evidence on other factors that may affect the risk of adenocarcinoma is limited and not entirely consistent (Parazzini and La Vecchia, 1990;Kjaer and Brinton, 1993;Ursin et al, 1994Ursin et al, , 1996Lacey et al, 1999Lacey et al, , 2000Lacey et al, , 2001Madeleine et al, 2001;Altekruse et al, 2003). The question of whether there are substantial differences in the risk factors for adenocarcinomas and squamous cell carcinomas remains unresolved. Few epidemiological studies have been designed specifically to provide a direct comparison between adenocarcinoma and squamous cell carcinoma of the cervix, and most studies of cervical carcinoma have had too few cases of adenocarcinoma to allow full evaluation of the possible risk factors. We present here results from the UK National Case -Control Study of Cervical Cancer, a case -control study of risk factors for invasive cervical cancer in women under 45 years old at diagnosis, with 180 cases of adenocarcinoma (including adenosquamous carcinoma), 391 cases of squamous cell carcinoma and 923 population controls. Information was available for all study subjects on sexual and reproductive factors, cervical screening, body weight, smoking and the use of barrier and hormonal contraceptives. Additional information was collected on HPV serology for a subgroup of subjects, and for this subgroup results have previously been published on the relationship between HPV positivity and risk of cervical cancer (Jha et al, 1993), and on oral contraceptive use as a risk factor for cervical cancer in relati...

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Risk factors for adenocarcinoma and squamous cell carcinoma of the cervix in women aged 20–44 years: the UK National Case–Control Study of Cervical Cancer

et al. 2003

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“…In contrary to the present study others studies shows no association of multiparity with cervical carcinoma. [12][13][14] In the present study Leucorrhoea or discharge per vaginum was the most common symptom. These findings were consistent with those of Rose and Jean, Das and Bhargava, who also found discharge per vaginum, was the commonest symptom in lesions of the cervix.…”

Section: Discussionmentioning

confidence: 99%

VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol’s iodine) as an initial approach with colposcopy as a next screening tool with its positive predictive value in low socioeconomic patients

Paswan¹,

Kumar²,

Jha³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Cervical Cancer is the second most common cancer in women worldwide and India alone contribute the 1/4th of the world’s cases of cervical cancer. In view to this huge burden there was need to establish a feasible screening programme to detect cervical carcinoma at earliest in developing country.Methods: This is a prospective study of 500 women who fulfil the selection criteria. 50 pregnant patients for VIA (Visual inspection with acetic acid), 50 pregnant patients for VILI (Visual inspection with lugol’s iodine) and 400 non-pregnant women for VIA, VILI and colposcopy were enrolled. In positive cases, cervical biopsy with histopathological examination was done. The sensitivity, specificity and positive predictive value of each test were obtained and compared. Chi-square (X2) test was used to test the significance of difference between two proportions of a quantitative data.Results: The sensitivity, specificity, positive predictive value and negative predictive value for VIA (85.1%, 84.1%, 41.7%, 97%), VILI (95.7%, 92.4%, 62.5%, 93.4%) and Colposcopy (83%, 86%, 51.3%, 96.6%) were statistically significant with its histopathological report.Conclusions: In a poor developing country like India where pap smear and colposcopy is not available in low resource setting VIA and VILI can prove a very helpful tool in picking up abnormal looking cervix which can then be confirmed by pap or colposcopy. It will go a long way in reducing the incidence of cervical carcinoma.

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“…Anyway, as our reference group was the entire population with the mean number of 1.5 -1.7 births per woman during the study period (www.stat.fi), the RR estimates might have been larger, when compared to nulliparous women. There are also studies which do not show any role for multiparity in the aetiology of CC or CIN (Rotkin, 1973;Kvale et al, 1988;Cuzick et al, 1996). In those studies, crude RRs of CC were 0.6 -2.3 for women with five or more pregnancies.…”

Section: Discussionmentioning

confidence: 99%

A population-based study on the risk of cervical cancer and cervical intraepithelial neoplasia among grand multiparous women in Finland

et al. 2004

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Previous studies suggest that high parity increases the risk of cervical cancer. We studied the risk of cervical cancer (CC) and cervical intraepithelial neoplasia (CIN3) in a Finnish cohort of grand multiparous (GM) women (at least five children) with low prevalence of sexually transmitted infections (STI). The Finnish Cancer Registry data revealed 220 CC and 178 CIN3 cases among 86 978 GM women. Standardised incidence ratios (SIR) were calculated from the numbers of observed and expected cases. Interval analyses by parity, age at first birth and average birth interval were done using multivariate Poisson regression. Seroprevalence of human papillomavirus (HPV) 16 and Chlamydia trachomatis was tested among 561 GM women and 5703 women with 2 -4 pregnancies. The incidence among GM women was slightly above the national average for squamous cell carcinoma of cervix uteri (SIR 1.21, 95% CI 1.05 -1.40) and CIN3 (1.37, 95% CI 1.17 -1.58), but lower for adenocarcinoma (SIR 0.77, 95% CI 0.52 -1.10). The seroprevalence of HPV16 and Chlamydia trachomatis among GM women was lower than in the reference population, except among those women who had their child under age 19. Age under 20 years at first birth increased the risk of CC and CIN3 especially in premenopausal GM women, while increasing parity had no effect. The small relative risks of CC and CIN3 among GM women in our study as compared to studies from other countries can be explained by the exceptionally low prevalence of STIs in Finnish GM women. The observed SIRs between 1.2 and 1.4 should be interpreted to represent increased risk attributable to grand multiparity. The increased incidence of CC and CIN3 among young GM women suggests causal association to HPV 16 and Chlamydia trachomatis infections.

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Reproductive factors and risk of cervical cancer by cell type. A prospective study

Cited by 24 publications

References 21 publications

Risk factors for adenocarcinoma and squamous cell carcinoma of the cervix in women aged 20–44 years: the UK National Case–Control Study of Cervical Cancer

Risk factors for adenocarcinoma and squamous cell carcinoma of the cervix in women aged 20–44 years: the UK National Case–Control Study of Cervical Cancer

VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol’s iodine) as an initial approach with colposcopy as a next screening tool with its positive predictive value in low socioeconomic patients

A population-based study on the risk of cervical cancer and cervical intraepithelial neoplasia among grand multiparous women in Finland

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