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Socioeconomic Distribution of Cervical Cancer, in Relation to Early Marriage and Pregnancy

Frank Edward Lundin (Jr.)Cyrus C. EricksonDouglas Hamilton Sprunt

出版	U.S. Department of Health, Education, and Welfare, Public Health Service, 1965
URL	http://books.google.com.hk/books?id=CfLlZyIhVSoC&hl=&source=gbs_api
EBook	FULL_PUBLIC_DOMAIN

註釋A case-control study based on data from the vaginal cytologic survey of Memphis, Tennessee, which reached all levels of the city, is used to relate the etiology of cervical cancer to socioeconomic status, age at 1st marriage, and age at 1st pregnancy. Because evidence suggests that the epidemiologic distribution of squamous cell carcinoma differs from that of adenocarcinoma, cases are limited to the squamous type (SCC). Because of the different racial incidence of SCC and other types of cervical cancer, all data are presented separately by race. Among never-married white women, 6.5 cases of SCC would be statistically expected; 0 were found. Among never-married black women 3.5 would be expected; 1 was found. For intraepithelial carcinoma (IC) 10.4 cases would be expected for whites and 5 were found; 6.6 expected for nonwhite , 3 found. Among married whites, cases of SCC and IC were roughly the same as expected but age at marriage under age 18, expected cases of SCC were 25.8, observed were 48; expected IC was 34.9, observed was 66. (p=.001 for SCC and p=.0001 for IC). Among nonwhites, expected SCC for women married under 18 was 38.0 observed was 37; expected IC 38.4, observed 36. The expected and observed cases gradually came into agreement until age at 1st marriage reached 25+. Then for whites expected SCC was 25.1 and observed was 14; for nonwhites expected SCC was 12.3 and observed was 7. For IC, expected for whites was 27.7, observed 17 and for nonwhite 6.6 expected and 10 observed. For white women similar figures showed age at 1st pregnancy and socioeconomic area of residence are definitely associated with histologically confirmed cases of invasive and intraepithelial carcinoma of the cervix as well as with uncomfirmed cases with suspicious and positive cytologic findings. Early pregnancy and lower categories. For nonwhite women, although age at 1st marriage is not associated with either form of cancer, early pregnancy is associated with invasive cervical cancer as well as unconfirmed cases with suspicious or positive cytologic findings. Age at 1st pregnancy and marriage were highly correlated. The data are cons istent with the view that age at 1st pregnancy, alone or in conjunction with early marriage, is a determinant of cervical cancer. Number of pregnancies was not related. It is possible an unidentified 3rd factor is responsible.