Selected Risk Factors,Human Papillomavirus Infection and the P53 Codon 72 Polymorphism in Patients with Squamous Intraepithelial Lesions in Northeastern Thailand

Risk factors for cervical squamous intraepithelial lesions (SIL) including human papillomavirus (HPV) infection ‍and the p53 codon 72 polymorphism were investigated in a case-control study with 103 cases and 105 controls in ‍Northeastern Thailand. Increased risk for SIL was observed for age at menarche (odds ratio (OR) = 2.2; p<0.005), ‍age at the first sexual intercourse (OR=2.4; p<0.05), number of sexual partners (OR=2.7; p<0.005) and partners’ ‍smoking history (OR=2.3-3.2; p<0.01). Prevalence of malignant type of HPV infection in the control and SIL groups ‍was 18.1% and 60.2%, respectively. HPV infection significantly increased risk for SIL 6.8-fold (p<0.001). HPV-16 ‍infection was the commonest (31 out of 62 carriers) in SIL patients and highly associated with risk. The p53 codon 72 ‍polymorphism was not identified as a genetic risk for SIL in this study, as demonstrated in Thai cervical cancer. ‍Therefore, to prevent cervical neoplasia or HPV infection, inclusion of knowledge on sexual behavior and effects of ‍smoking into public health programs is important and, at the same time, a nation-wide screening scheme for cervical ‍abnormalities including HPV-typing is a high priority in Thailand.     

Sexual behaviour and smoking as determinants of cervical HPV infection and of CIN3 among those infected: a case-control study nested within the Manchester cohort

To distinguish risk factors for acquisition of cervical human papillomavirus (HPV) infection from the determinants of neoplasia among infected individuals we have conducted a three-arm case-control study nested within a large population-based cohort of women (the Manchester cohort) screened for HPV at entry using L1 consensus primer PCR. The study includes 181 HPV-positive controls who did not develop high-grade cervical intraepithelial neoplasia (CIN3) during follow-up, 203 HPV-negative controls, and 199 HPV-positive cases with histologically confirmed CIN3. Detailed information on sexual, reproductive and gynaecological history, oral contraceptive use and smoking was obtained at face-to-face interview. There was a striking division between risk factors for infection and those predictive of disease. Comparing the HPV-positive against the HPV-negative controls, the only risk factors for infection were number of sexual partners (OR for six or more = 3.89; 95% Cl = 1.99-7.62), a relatively recent new sexual relationship (OR for a new partner within the previous 2 years = 4.17; 95% Cl = 2.13-8.33), and a history of previous miscarriage (OR = 2.59; 95% Cl = 1.28-5.21). The determinants of CIN3 among infected women were, in contrast, early age at first intercourse (OR for 16 years old or less = 3.23; 95% Cl = 1.33-7.69), a long time since starting a new sexual relationship (OR for 6 years or more = 4.94; 95% Cl = 2.51-9.71), and cigarette smoking, with strong evidence for a dose- response (OR for current smoking habit 20+ per day = 2.57; 95% Cl = 1.49-4.45). Oral contraceptive use was not significantly associated with either HPV infection or CIN3.     

高危型HPV持续感染在宫颈病变中的分布及其影响因素分析

目的 探讨高危型人乳头瘤病毒(HPV)持续感染在宫颈病变中的分布及其影响因素.方法 选取1388例液基细胞学检查异常者进行宫颈病理组织学检查,同时进行高危型HPV检测并随访,分析不同类型HPV感染的分布情况,以及患者的年龄、性伴侣及宫颈病变的家族史情况.结果 1388例患者中,272例为宫颈炎,936例为宫颈上皮内瘤变(CIN),180例为宫颈癌;宫颈炎患者高危型HPV持续感染率为0.74％,低于其他宫颈病变患者(P﹤0.05).222例高危型HPV持续感染患者中,HPV16、HPV18和HPV58的比例分别为53.60％、22.97％和10.36％;宫颈病变患者中高危型HPV检出较多的亚型分别为HPV16、HPV18和HPV58.初次性行为年龄﹤20岁、性伴侣≥2个和有宫颈癌家族史的患者,其高危型HPV持续感染率分别为21.96％、22.94％和21.20％,高于初次性行为年龄≥20岁、性伴侣1个和无宫颈癌家族史患者的13.33％、13.30％和15.2％(P﹤0.05);合并生殖道炎症的患者,其高危型HPV持续感染率为19.17％,高于无生殖道炎症的患者(P﹤0.05).Logistic回归分析结果显示:初次性行为年龄是高危型HPV持续感染的保护因素(OR=0.576,95％CI:0.576～0.817);性伴侣数量(OR=2.188,95％CI:1.647～2.907)和生殖道炎症(OR=1.904,95％CI:1.214～2.986)是高危型HPV持续感染的危险因素.结论 高危型HPV持续感染主要以HPV16、HPV18和HPV58为主,其不仅与宫颈病变有关,还与患者的初次性行为年龄、性伴侣数量和生殖道炎症有一定的关系.     

Multiple Sexual Partners as a Potential Independent Risk Factor for Cervical Cancer: a Meta-analysis of Epidemiological Studies

It’s known that having multiple sexual partners is one of the risk factors of human papillomavirus (HPV)infection which is a major cause of cervical cancer. However, it is not clear whether the number of sexual partnersis an independent risk factor for cervical cancer. We identified relevant studies by searching the databases ofMEDLINE, PubMed and ScienceDirect published in English from January 1980 to January 2014. We analyzedthose studies by combining the study-specific odds ratios (ORs) using random-effects models. Forty-one studieswere included in this meta-analysis. We observed that the number of sexual partners was associated with theoccurrence of non-malignant cervical disease (OR=1.82, 95%CI 1.63-2.00) and invasive cervical carcinoma(OR=1.77, 95%CI 1.50-2.05). Subgroup analyses revealed that the association remained significant aftercontrolling for HPV infection (OR=1.52, 95%CI 1.21-1.83 for non-malignant disease; OR=1.53, 95%CI 1.30-1.76 for invasive cervical carcinoma). We found that there was a non-linear relation of the number of sexualpartners with both non-malignant cervical disease and invasive cervical carcinoma. The risk of both malignantand non-malignant disease is relatively stable in women with more than 4-7 sexual partners. Furthermore, thefrequency-risk of disease remained significant after controlling for HPV infection.The study suggested thath aving multiple sexual partners, with or without HPV infection, is a potential risk factor of cervical cancer.     

Risk Factors for Cervical Cancer in Northeastern Thailand: Detailed Analyses of Sexual and Smoking Behavior

Cervical cancer is a serious public health problem in Thailand. We investigated possible risk factors forcervical cancer including HPV infection, p53 polymorphism, smoking and reproductive history among womenin Northeast Thailand using a case control study with 177 cases and age-matched controls. Among the HPVcarriers, a significantly increased risk for cervical cancer with an OR of 36.97 (p<0.001) and an adjusted OR of38.07 (p<0.001) were observed. Early age at first sexual exposure, and multiple sexual partners increased therisk of cervical cancer with ORs ranging between 1.73-2.78 (p<0.05). The interval between menarche and firstsexual intercourse <6 years resulted in a significant increase in the risk for cervical cancer with ORs rangingbetween 3.32-4.09 and the respective adjusted OR range for the 4-5 and 2-3 year-old groups were 4.09 and 2.92.A higher risk was observed among subjects whose partner had smoking habits, whether currently or formerly;with respective ORs of 3.36 (p<0.001) and 2.17 (p<0.05); and respective adjusted ORs of 2.90 (p<0.05) and 3.55(p<0.05). Other smoking characteristics of the partners including smoking duration ≥ 20 years, number ofcigarettes smokes ≥ 20 pack-years and exposure time of the subject to passive smoking ≥ 5 hrs per day were foundto be statistically significant risks for cervical cancer with adjusted ORs of 3.75, 4.04 and 11.8, respectively. Ourdata suggest that the risk of cervical cancer in Thai women is substantially associated with smoking characteristicsof the partner(s), the interval between menarche and first sexual intercourse as well as some other aspects ofsexual behavior.     

Cervical Cancer Prevention and Early Detection; The Role of Nurse and Midwives

Worldwide 31% of cancers in women are in the breast or uterine cervix. Cancer of the uterine cervix is one of the ‍leading causes of cancer death among women. The estimated new cancer cervix cases per year is 500.000 of which ‍79% occur in the developing countries, where it is consistently the leading cancer and there are in excess of 233.000 ‍deaths from the disease. The major risk factors for cervical cancer include early age at first intercourse, multiple ‍sexual partners, low socioeconomic status, HSV, HPV infection, cigarette smoking and extended use of oral ‍contraceptives. Well organized and applied public education and mass screening programmes can substantially ‍reduce the mortality from cervical cancer and the incidence of invasive disease in the population. Women who are ‍health conscious are more likely to have used screening services (mammogram, pap-smear test) and performed ‍breast-self examination and genital hygiene. There are both opportunities and burdens for nurses and midwives ‍working in primary health care settings. This is a prime example of a role of public education in cancer prevention ‍with reference to population-based cancer screening programs. ‍     

Incidence and risk factors of papillomavirus infection and cervical dysplasia in sexually active adolescent girls

A cytological examination of 425 sexually active females aged 13-17 established cervical HPV infection incidence at 30.3 +/- 2.2% while that of cervical dysplasia--4.5 +/- 1.0%. The risk factors for HPV infection included low education and income level (p < 0.05), number of sexual partners exceeding three (p < 0.05), poor hygienic standards of woman (p < 0.05) and those of partner (p < 0.001) and smoking of more than 5 cigarettes per day (p < 0.001). The risk factors of cervical epithelial dysplasia were number of partners of 5 or more (p < 0.001), poor hygienic standards of male partner (p < 0.001) and smoking of 10 cigarettes and more per day (p < 0.001), etc.     

Determinants of genital human papillomavirus infection in young women.

Carcinoma of the cervix has several well-established epidemiologic risk factors, including multiple sexual partners and early age at first intercourse. Human papillomavirus (HPV) infection appears to have an etiologic role in the development of cervical neoplasia, but evidence linking HPV infection to known risk factors for cervical cancer has been inconsistent. The lack of expected correlations may be due to the inaccuracy of HPV assays previously used. A polymerase chain reaction DNA amplification method for the detection of HPV was used to investigate the determinants of genital HPV infection in a cross-sectional sample of 467 women attending a university health service. In contrast to studies using less accurate detection methods, the risk factors for HPV infection found here were consistent with those for cervical neoplasia. The risk of HPV infection was strongly and independently associated with increasing numbers of sexual partners in a lifetime, use of oral contraceptives, younger age, and black race. Age at first intercourse, smoking, and history of a prior sexually transmitted disease were correlated with, but not independently predictive of, HPV infection. These results demonstrate that the key risk factors for cervical carcinoma are strongly associated with genital HPV infection. This correlation suggests that HPV has an etiologic role in cervical neoplasia and reaffirms the sexual route of HPV transmission.     

Human Papilloma Infection in Northeastern Thai-women

This study aimed to investigate the histological outcome of cervix with human papillomavirus (HPV) infectionand the association of risk factors with cervical intraepithelial neoplasia (CIN) and invasive cervical carcinoma(ICC) development in Northeast Thai women. The study population (n=210) comprised 71 cases of normal cervix, 71cases of CIN and 68 cases of ICC. The histological outcome of HPV infection was determined for 9.5% of the studypopulation. Increased risk factors for CIN were observed for more than one partner (odds ratio (OR)=3.75, p<0.05),history of sexually transmitted disease (STD) (OR=2.28, p<0.05), menarche under 14 years of age (OR=0.31, p<0.05)and partners’ smoking history (OR=3.98, p<0.01). Increased risk for ICC was observed for those with a history ofSTDs (OR=0.14, p<0.01) and multiparity (OR=2.53, p<0.01). Age at first sexual intercourse was not a risk factor inthis study population. Further studies with HPV-DNA tests should more precisely quantify the risks.     

Smoking, diet, pregnancy and oral contraceptive use as risk factors for cervical intra-epithelial neoplasia in relation to human papillomavirus infection

Smoking, nutrition, parity and oral contraceptive use have been reported as major environmental risk factors for cervical cancer. After the discovery of the very strong link between human papillomavirus (HPV) infection and cervical cancer, it is unclear whether the association of these environmental factors with cervical cancer reflect secondary associations attributable to confounding by HPV, if they are independent risk factors or whether they may act as cofactors to HPV infection in cervical carcinogenesis. To investigate this issue, we performed a population-based case-control study in the Vasterbotten county of Northern Sweden of 137 women with high-grade cervical intra-epithelial neoplasia (CIN 2-3) and 253 healthy age-matched women. The women answered a 94-item questionnaire on diet, smoking, oral contraceptive use and sexual history and donated specimens for diagnosis of present HPV infection (nested polymerase chain reaction on cervical brush samples) and for past or present HPV infections (HPV seropositivity). The previously described protective effects of dietary micronutrients were not detected. Pregnancy appeared to be a risk factor in the multivariate analysis (P < 0.0001). Prolonged oral contraceptive use and sexual history were associated with CIN 2-3 in univariate analysis, but these associations lost significance after taking HPV into account. Smoking was associated with CIN 2-3 (odds ratio (OR) 2.6, 95% confidence interval (CI) 1.7-4.0), the effect was dose-dependent (P = 0.002) and the smoking-associated risk was not affected by adjusting for HPV, neither when adjusting for HPV DNA (OR 2.5, CI 1.3-4.9) nor when adjusting for HPV seropositivity (OR 3.0, CI 1.9-4.7). In conclusion, after taking HPV into account, smoking appeared to be the most significant environmental risk factor for cervical neoplasia.     

Early Experience of Sexual Intercourse - A Risk Factor for Cervical Cancer Requiring Specific Intervention for Teenagers

There is consensus that the main risk factor for cervical cancer development is persistent infection with high-risk ‍group human papilloma viruses (HPVs), together with smoking, and reproductive history. Since sexual behaviour ‍determines exposure to HPVs and the adolescent period may be particularly important in this regard it is of interest ‍to consider behavioural determinants of teenagers. In one survey conducted in Khon Kaen, Thailand, some 62% ‍percent of male and 19.3 % of female respondents aged 13-15 years reported having experienced sexual desire, and ‍19.1% of male and 4.7 % of female respondents admitted to sexual intercourse. The possibility that this might ‍impact on HPV infection rates, with added risk due to the physical trauma associated with pregancy and illegal ‍abortions, indicates that more attention needs to education of early teens, not only for avoidance of HIV and AIDS, ‍but also for prevention of cervical cancer.     

Epidemiological evidence of cervical intraepithelial neoplasia without the presence of human papillomavirus.

The aim of this paper was to provide epidemiological evidence to support the notion that cervical intraepithelial neoplasia (CIN) without human papillomavirus (HPV) is a true entity. If a diagnosis of HPV-negative cervical neoplasia is erroneous, one would not expect there to be any differences in risk factors between HPV-positive and HPV-negative patients. Patients at a gynaecological outpatient clinic of a university hospital [a total of 265 consecutive women with dyskaryotic cervical smears who were subsequently diagnosed with CIN I (n=37), CIN II (n=48) or CIN III (n=180)] completed a structured questionnaire regarding smoking habits and sexual history. Analysis of an endocervical swab for Chlamydia trachomatis, analysis of a cervical scrape for HPV, and morphological examination of cervical biopsy specimens were also performed. HPV was found in 205 (77.4%) out of the 265 women. Univariate analysis showed that current age (P=0.02), current smoking behaviour (P=0.002) and the number of sexual partners (P=0.02) were significantly associated with the presence of HPV. Age at first sexual intercourse, a past history of venereal disease or genital warts, and current infection with Chlamydia trachomatis were not associated with the presence of HPV. Using multivariate logistic regression analysis, the number of sexual partners and current smoking behaviour showed an independent significant association with HPV. HPV-negative and HPV-positive CIN patients differ with respect to the risk factors for HPV. These findings suggest that HPV-negative CIN is a separate true entity.     

Contribution of epigenetic risk factors but not p53 codon 72 polymorphism to the development of cervical cancer in Northeastern Thailand

Relationships between cervical cancer and risk factors were investigated in Northeastern Thailand. Cases (n=90) with squamous cell cervical cancer (SCCA) and age matched healthy controls (n=100) were recruited. The p53 codon 72 polymorphism, proline and arginine allele, was studied by the polymerase chain reaction-restriction fragment length polymorphism. There was no significant difference in the allele and the genotype distribution between the SCCA and the control groups (P>0.05). Significant difference was observed in the number of sexual partners (P<0.003), age at the first sexual intercourse (P<0.03) and number of parities (P<0.006). After adjusted by age and p53 genotype, significant difference was still observed in the number of sexual partners (P=0.017). The partners' smoking increased the risk to develop SCCA. Increased odds ratios were observed when the partner had smoking history both at present (3.31; P<0.003) and in the past (3.36; P<0.003). The p53 polymorphism itself may not be a risk factor for cervical cancer in Northeastern Thailand. Much attention should be paid to the presence of other risk factors such as sexual behaviors and smoking habits in the prevention of cervical cancer in this region.     

Association of oral contraceptive use and human papillomaviruses in invasive cervical cancers

In a study of 197 cases of histologically confirmed invasive cervical cancer, 61% of biopsies were positive for human papillomavirus (HPV) DNA by Southern or dot-blot hybridization. An association between detection of HPV DNA and oral contraceptive use was observed when HPV-positive and -negative cases were compared. Women reporting recent or long-term (greater than 4 yrs) oral contraceptive use were at 2.3 and 2.9-fold increased risks of HPV positivity, respectively. An increased risk of HPV positivity was also associated with formal education and with urban residence, while long-term smoking was negatively associated with HPV detection. A non-significant trend of increasing risk of HPV positivity with increasing number of sexual partners of the women and of the male partners of monogamous women was observed. Detection of HPV DNA was not associated with other cervical cancer risk factors examined, including age at first coitus, number of pregnancies, and Pap smear screening history. Our findings suggest either an interaction between HPV infection and oral contraceptive use in the genesis of cervical cancer or an increased expression of HPV genome in neoplasms of oral contraceptive users. These observations also support a multifactorial model of cervical cancer causation.     

Risk factors for cervical cancer in Colombia and Spain.

A population-based case-control study of cervical cancer was conducted in Spain and Colombia to assess the relationship between cervical cancer and exposure to human papillomavirus (HPV), selected aspects of sexual and reproductive behaviour, use of oral contraceptives, screening practices and smoking. The study included 436 cases of histologically confirmed squamous-cell carcinoma and 387 age-stratified controls randomly selected from the general population that generated the cases. The presence of HPV DNA in cervical scrapes was assessed by PCR-based methods and was the strongest risk factor (OR = 23.8; 13.4-42.0). Risk estimates for any other factor were only slightly modified after adjusting for HPV status. Among women found positive for HPV DNA, only the use of oral contraceptives was a risk factor for cervical cancer (OR = 6.5; 1.3-31.4 for ever vs. never use). Patients with cervical cancer who were HPV DNA-negative retained most of the established epidemiological features of this disease. This suggests that some instances of HPV infection went undetected or that other sexually transmitted factor(s) contribute to the causation of cervical cancer. Early age at first intercourse (OR = 4.3; 2.1-9.0 for age < 16 vs. 24+) and early age at first birth (OR = 5.0; 1.8-14.2 for age < 16 vs. 24+) were associated with increased risk of cervical cancer; these effects were independent of one another. Low educational level was a risk factor (OR = 2.5; 1.6-3.9). Number of sexual partners was in our study a surrogate for HPV infection. Smoking and parity after age 24 were weakly and inconsistently associated with the risk of cervical cancer. Previous screening (OR = 0.7; 0.5-1.0) and ever having undergone a Caesarean section (OR = 0.4; 0.2-0.8) were protective factors.     

A Population-based Case-control Study of Risk Factors and Genetic Polymorphisms of ALDH2 and P4502E1 for Hepatocellular Carcinoma in Nagoya,Japan

A population-based case-control study was carried out to investigate risk factors for hepatocellular carcinoma ‍(HCC) in Nagoya, Japan, including hepatitis virus infections, drinking and smoking habits and genetic polymorphisms ‍in aldehyde dehydrogenase2 (ALDH2) and cytochrome P4502E1 (CYP2E1). A total of 84 patients with HCC and 84 ‍sex, age and residence pair-matched controls were recruited for this study. By univariate analysis, hepatitis B virus ‍(HBV) (OR=5.14; 95%CI=2.29-11.6) and hepatitis C virus (HCV)(OR=32.00; 95%CI=7.83-130.7) infections, having ‍a history of blood transfusion (OR=5.25; 95%CI=1.80-15.29), and habitual smoking (OR=2.36; 95%CI=1.17-4.78) ‍were significantly linked to cases; by multivariate analysis, HCV infection (OR=23.5; 95%CI=5.07-108.9) and habitual ‍smoking (OR=5.41; 95%CI=1.10-26.70) were still associated with a significantly increased risk. The c1/c1 genotype ‍of CYP2E1 (odds ratio [OR]= 0.45; 95% confidence interval [CI]=0.21-0.99), detected by Pstl and Rsal digestion was ‍significantly more prevalent in the control group, while 1-1 genotype of ALDH2 (OR=1.24; 95%CI=0.70-2.20) did ‍not demonstrate variation. There were no statistically significant interactions between habitual smoking/drinking ‍and genetic polymorphisms of ALDH2/P4502E1 with reference to HCC development. These findings suggest that ‍viruses, especially HCV infection, and habitual smoking are major independent risk factors, while genetic ‍polymorphisms of ALDH2 and CYP2E1 have only limited contribution to the risk of HCC in Nagoya, Japan.     

Human Papillomavirus Infection and Risk Determinants for Squamous Intraepithelial Lesion and Cervical Cancer in Japan

A case control design was used to investigate human papillomavirus (HPV) prevalence and risk factors associated with development of cervical squamous intraepithelial lesion (SIL) and cervical cancer (CC) in Japan, One hundred and twenty-three women with histologically confirmed SIL or CC were compared to a control group of 778 cytologically normal women. With the use of a polymerase chain reaction (FCR)-hased method for detection of low-risk (types 6 and 11) and high-risk (types 16, 18, 31, 33, 35, 52 and 58) HPVs, a high prevalence of HPV infection was observed in smokers among the controls. Logistic regression analysis demonstrated that high-risk HPV infection was the most significant risk determinant for LSIL (OR=9.4, 95% CI=4.5–19), HSIL (OR=77, 95% CI=28–217) and CC (OR=97, 95% CI=35–269). It also showed that unmarried women, women married for 5 to 19 years and smokers represented high risk groups for SIL, while smokers and women with a history of many pregnancies/parities had increased risk for CC. Smoking was the only HPV infection-independent factor for CC, suggesting that smoking may have a carcinogenic effect on the cervix. Since neither history of other cancer nor family cancer history was associated with SIL or CC, genetic factors appear to play little role in cervical carcinogenesis. The risk for cervical neoplasia due to HPV infection increased after marriage in Japan, suggesting a role for husbands as carriers of HPV transmission. Protection from high-risk HPV infection may be of greatest importance for prevention of cervical cancer.     

PCR-detected genital papillomavirus infection: prevalence and association with risk factors for cervical cancer.

In an investigation conducted in student health clinic patients, the polymerase chain reaction was used to detect human papillomavirus (HPV) DNA, thereby allowing measurement of the prevalence of HPV infection and study of the association between HPV infection and risk factors for cervical cancer. Of 159 women eligible to participate, 105 (66%) provided a specimen of cervical cells for HPV typing, and also answered an interviewer-administered questionnaire which sought information on risk factors for cervical cancer. Nucleic acid extracted from cervical cells was screened with primers for HPV types 6, 11, 16, 18, 33 and with an HPV Consensus primer. Overall, the prevalence of HPV infection was 18.1%, while for HPV-6/11 it was 2.9% and for HPV-16/18 it was 10.5%. There were statistically significant increases in risk of HPV infection with a history of ever having smoked cigarettes (overall, and for HPV-16 alone) and with a history of usually having sexual intercourse during menstrual periods (overall, but not for HPV-16), and these associations were independent of the effects of age at first sexual intercourse and number of sexual partners. The latter 2 variables, as well as the total number of occasions of sexual intercourse, a history of anal intercourse, and a history of ever having used oral contraceptives, were not associated with statistically significant alterations in risk of HPV infection.     

Risk Factors for Cervical Cancer in Rural Areas of Wuhan China: a Matched Case-control Study

Cervical cancer is a serious public health problem in developing countries. We investigated possible riskfactors for cervical cancer in rural areas of Wuhan China using a matched case-control study with 33 womendiagnosed with cervical cancer and 132 healthy women selected from the same area as matched controls. Aquestionnaire, which included questions about general demography conditions, environmental and geneticfactors, the first sexual intercourse, first marriage age, age at first pregnancy, pregnancy first child’s age, femalepersonal health history, social psychological factors, dietary habits, smoking and alcohol status and other livinghabits was presented to all participants. At the same time, HPV infection of every participant was examined inlaboratory testing. Results showed HPV infection (P<0.000, OR=23.4) and pregnancy first child’s age (P<0.000,OR=13.1) to be risk factors for cervical cancer. Menopause (P=0.003, OR=0.073) was a protective factor againstcervical cancer. However, there was no indication of associations of environmental (drinking water, insecticide,disinfectant) genetic (cancer family history), or life-style factors (smoking status, alcohol status, physical training,sleep quality), including dietary habits (intake of fruit and vegetable, meat, fried food, bean products and pickledfood) or social psychological factors with cervical cancer. The results suggest that the risk of cervical cancer inChinese rural women may be associated with HPV infection, menopause and the pregnancy first child’s age.     

Risk Factors for Esophageal Cancer: a Case-control Study in South-western China

Esophageal cancer is a crucial cancer in China. Yanting in Sichuan Province was a key area with highest esophageal ‍cancer mortality in China, but little evidence on esophageal cancer risk factors has been reported for this area and ‍the etiology remains unclear. To clarify risk factors, a 1:1 matched case-control study was conducted. Totals of 185 ‍eligible esophageal cancer patients and 185 healthy residents matched for sex and age were recruited. Conditional ‍logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for possible risk/ ‍protective factors. All ORs were adjusted by family history of esophageal cancer and occupation, and then further ‍adjusted by other possible confounding factors. Our results showed that smoking and alcohol drinking were risk ‍factors for esophageal cancer with dose-response. The ORs (95% CI) compared with never smokers and drinkers ‍were 4.06 (1.55-10.6) and 2.49 (1.06-5.85), respectively. The OR was further increased to 8.86 (95%CI, 3.82-20.5) for ‍both smoking and drinking in combination. Eating food rapidly (OR=5.84, 95%CI, 2.05-16.7), drinking shallow ‍ground water (OR=4.18, 95%CI, 1.30-13.4) and frequent intake of picked vegetables (OR=2.12, 95%CI, 1.00-4.49) ‍appeared to increase the risk, while frequent intake of fresh fruit (OR=0.42, 95%CI, 0.19-0.89), fresh vegetables ‍(OR= 0.62, 95%CI, 0.32-1.17) and eggs (OR=0.59, 95%CI, 0.25-1.39) decreased the risk. In conclusion, smoking and ‍alcohol drinking are common in Yanting and main contributors to esophageal cancer. Consumption of fresh fruit ‍and eggs are not common and high consumption of these two foods as well as fresh vegetables may decrease the risk ‍of esophageal cancer in this area. In addition, drinking shallow ground water and eating food rapidly, as well as ‍frequent intake of pickled vegetables, are also factors increasing the risk. ‍ ‍