Risk factors for cervical intraepithelial neoplasia and cervical cancer in Chinese women: large study in Jiexiu, Shanxi Province, China

Abstract

We aimed to investigate the risk factors for cervical intraepithelial neoplasia (CIN) in Jiexiu, Shanxi Province, China. Twenty thousand eligible married women (age: 18-65 years) were administered with a questionnaire on potential risk factors for CIN and underwent liquid based Pap test. All women with abnormal cytological results underwent colposcopy with biopsy. Based on the biopsy pathology results, women were then assigned to either study group (with CIN) or control group (negative for histological results and volunteered to participate in the follow up study). The women in both study group and control group underwent vaginal microflora detection and dietary survey. The potential risk factors were analyzed by using ordinal logistic regression. Among the 20,000 women ne 1,438 women (7.19%) had cytologic abnormalities and 410 (2.05%) women were diagnosed histologically with CIN lesions, including 317 (1.58%) with CIN1, 93 (0.50%) with CIN2/3and 11 (55/100,000) with squamous cell carcinoma (SCC). The average daily dietary folate intake was significantly lower in the study group (344.61±153.07μg) than in the control group (371.50±166.58μg; P<0.001). Multivariate analysis demonstrated that age of 56-65 years, farming as the husband's occupation, unwashing the vulva after sexual intercourse, and low self-reported folate intake were positively associated with CIN development and might have contribution to the increased CIN incidence in this population. These findings may provide help to develop the strategies to reduce the risk of cervical cancer in China.

Effects of exposure to polycyclic aromatic hydrocarbons combined with high‐risk human papillomavirus infection on cervical intraepithelial neoplasia: A population study in Shanxi Province, China

“…Atypical squamous cells of undetermined significance and above were considered as TCT positive. All cases with atypical squamous cells of undetermined significance and above and 10% of cases with the negative results were further reviewed blindly by a senior cytopathology physician for quality control …”

“…If the diagnoses were discordant between the two pathologists, the cases would be reviewed by the third senior pathologist. The three pathologists would review the cases together to arrive a consensus diagnosis for some difficult or equivocal cases . In addition, we performed immunohistochemical detection of p16 and Ki‐67 to assist the pathological diagnosis.…”

“…Development of cervical cancer is a long‐term process with multiple stages. Although a persistent human papillomavirus (HPV) infection, especially high‐risk human papillomavirus (HR‐HPV) infection, is necessarily a causal factor in cervical carcinogenesis, not all women infected with HPV develop cervical cancer, indicating that other factors are involved in cervical carcinogenesis along with HPV . In recent years, an increase in industrial production has resulted in increased environmental pollution, which has become more and more serious.…”

“…Although a persistent human papillomavirus (HPV) infection, especially high-risk human papillomavirus (HR-HPV) infection, is necessarily a causal factor in cervical carcinogenesis, [9][10][11] not all women infected with HPV develop cervical cancer, indicating that other factors are involved in cervical carcinogenesis along with HPV. 12,13 In recent years, an increase in industrial production has resulted in increased environmental pollution, which has become more and more serious. Polycyclic aromatic hydrocarbons (PAHs), a major environmental pollutant, are widely exposed to the population and have a carcinogenic property.…”

Diagnostic Yield and Performance of a Large Population-Based Cervical Cancer Screening Program in High-Risk Rural China

“…Latest cervical cancer statistical studies have shown that more than 85% of cervical cancer patient in Shanxi Province had never received proper screening and presented at late stage. As a result, the incidence and mortality of cervical cancer women living in Shanxi Province are 10-fold higher than that of other regions in China [9,10] . To date, little if any information is available concerning cervical cancer screening performance and diagnostic yield in this region [9][10][11][12] .…”