Sexual behavior, venereal diseases, hygiene practices, and invasive cervical cancer in a high-risk population

Article Abstract:

Much of the epidemiologic research on cervical cancer has been performed in developed countries where the incidence of this cancer has been on the decline. Latin America still has high rates of invasive cervical cancer, but few studies have been conducted in this part of the world. A study of 759 women with invasive cervical cancer and 1,430 controls was conducted to analyze the contribution of sexual habits to increased risk of cervical cancer. Both early age at first intercourse and the number of sexual partners were significant risk factors. This remained true even when adjustment was made for mutual effects, that is, women with early intercourse are intrinsically more likely to have more partners as well. A two-fold increase in risk was experienced by women having their first intercourse at age 14 or 15 rather than over 20 years of age. The number of steady partners was found to be a more significant risk factor than the number of nonsteady partners. In general, increased frequency of intercourse was not correlated with cervical cancer unless the increase occurred before the age of 20. The picture which emerges is that of increased risk being due to contact with some environmental agent during adolescence. The risk associated with steady partners suggests that repeated exposure might be an important part of the etiology of this disease. There was increased risk associated with a history of gonorrhea or crab lice, but not with syphilis, genital herpes, or venereal warts. No consistently increased risks were associated with hygiene habits, except for the practice of decreased washing during menstruation. Curiously, the frequent washing of the genitals at other times was associated with a slightly increased risk. The factors of early intercourse and numerous partners probably explain much of the increased risk observed in Latin American countries, where early sexual activity is common, and may also explain the increased rates among lower socioeconomic classes in more developed countries. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sexual behavior, Women, Risk factors, Latin America, Women's health, South America

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Mammographic densities and risk of breast cancer

Article Abstract:

Mammography has greatly improved the early detection of breast cancer. However, the interpretation of mammograms is far from straightforward, since breasts differ greatly in their appearance on mammographic images. Breast cancers show up as densities on the image, against the background image cast largely by fatty tissue. However, normal tissues may also cast densities upon the mammographic X-ray films. It may be possible to define features which are predictive of breast cancer, even in breasts which do not yet conclusively show signs of cancer. Using a planimeter, a device which measures areas on a map, picture, or any two-dimensional surface, investigators measured the areas of densities on mammographic images. These measurements were made on mammograms taken prior to diagnosis in 266 cases of breast cancer and 301 control subjects; the observers were unaware of the diagnosis in individual cases. The mammograms studied were taken at least four years prior to the actual diagnosis of cancer; none of the patients had a history of breast cancer prior to their entry into the study. The "standard" was taken to be a breast which showed less than 5 percent of the area covered by densities upon mammographic examination. The results showed that the risk of breast cancer increased with increasing area on the mammogram covered by densities. For densities covering from 5 to 25 percent of the area, the risk of subsequent breast cancer was increased 1.7-fold. When 25 to 45 percent of the area was covered by densities, the risk of breast cancer was increased 2.5 times. From 45 to 64 percent, the risk increase was 3.8 times, and a risk increase of 4.3 times was observed for the patients with 65 percent or more of the breast consisting of densities. The pathologic patterns observed in these images were not as successful in predicting the subsequent development of cancer as was the direct and objective measurement of densities on the mammographic images. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, Breast cancer, Mammography, Predictive value of tests, Predictive value of tests (Medical)

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Human papillomavirus infection and cervical cancer in Latin America

Article Abstract:

The hypothesis associating genital infection by human papillomavirus (HPV) 16 or 18 and cervical cancer is supported by a study of 759 cases of invasive cervical cancer and 1,467 randomly selected controls. The strong association between infection with HPV and cervical cancer persisted even after a number of variables were taken into account: the number of sexual partners, age at first intercourse, number of live births and Pap-smear history.

Analysis, Complications and side effects, Demographic aspects, DNA, Papillomavirus infections

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