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Case control study of cervical cancer in Herrera Province, Republic of Panama
Author(s) -
Reeves William C.,
Brinton Louise A.,
Brenes Maria M.,
Quiroz Evelia,
Rawls William M.,
De Britton Rosa C.
Publication year - 1985
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.2910360110
Subject(s) - panama , cervical cancer , cancer , medicine , gynecology , geography , biology , ecology
A previous survey found the average annual age‐adjusted incidence of cervical cancer in Herrera Province, Panama, to be 79/100, 000, exceeding any other reported world rate. In an effort to clarify the reasons for this excessive occurrence, a case‐control study was conducted among patients diagnosed between 1974‐1980. Sixty‐six percent of cervical cancer patients from Herrera Province were alive and were contacted by the study team; of these 91% were successfully interviewed and provided serum specimens. The total study encompassed 156/169 surviving patients and 309 age‐neighborhood matched controls. Sexual promiscuity was uncommon, but it exerted a major effect, with those reporting 4 or more life‐time sex partners being at a 4‐fold excess risk compared to those reporting only one partner. First intercourse at a young age was common (21% began sexual activity prior to age 16) but it failed to alter risk once number of partners was taken into account. Oral contraceptive use was associated with a 2‐fold excess risk and this was not substantially affected by controlling for sexual parameters. Thirty‐three percent of the study subjects had anti‐herpes‐simplex type‐2 antibody as measured by both neutralization and radioimmunoassays. Although results of the neutralization test were not predictive of risk, women with a radioimmunoassay indicative of HSV‐2 infection were at a 40% excess risk for cervical cancer after adjustment for sexual characteristics.