Use of oral contraceptives and risk of invasive cervical cancer in previously screened women

Ebeling, K; Nischan, P; Schindler, Ch.

doi:10.1002/ijc.2910390402

Cited by 43 publications

(12 citation statements)

References 13 publications

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“…These findings augment previous reports where a direct relation of child-bearing to cervical cancer had been reported (EBELING et al 1987). With reference to nulliparous women, the risk of invasive cervical cancer was reported to increase significantly with increasing number of births; the risk being about 5 times greater in women with 5 or more births (PARAZZINI et al 1992).…”

Section: Discussionsupporting

confidence: 85%

Elevated frequency of Micronuclei in uterine smears of cervix cancer patients

Gandhi

Kaur

2003

Caryologia

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Section: Discussionsupporting

confidence: 85%

Elevated frequency of Micronuclei in uterine smears of cervix cancer patients

Gandhi

Kaur

2003

Caryologia

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“…Among studies that contributed to the present collaborative reanalysis, four cohort studies did not include information on sexual behavior (25)(26)(27)(28). Findings on sexual behavior have been published from eight studies that were not included and were consistent with our present results (14,(16)(17)(18)(19)(20)(21)(22)(23).…”

Section: Discussionsupporting

confidence: 70%

Cervical Carcinoma and Sexual Behavior: Collaborative Reanalysis of Individual Data on 15,461 Women with Cervical Carcinoma and 29,164 Women without Cervical Carcinoma from 21 Epidemiological Studies

Tajkumar¹,

Cuzick²,

Appleby³

et al. 2009

Cancer Epidemiology, Biomarkers &Amp; Prevention

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High-risk human papillomavirus (HPV) types cause most cervical carcinomas and are sexually transmitted. Sexual behavior therefore affects HPV exposure and its cancer sequelae. The International Collaboration of Epidemiological Studies of Cervical Cancer has combined data on lifetime number of sexual partners and age at first sexual intercourse from 21 studies, or groups of studies, including 10,773 women with invasive cervical carcinoma, 4,688 women with cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ, and 29,164 women without cervical carcinoma. Relative risks for invasive cancer and CIN3 were estimated by conditional logistic regression. Risk of invasive cervical carcinoma increased with lifetime number of sexual partners (P for linear trend <0.001). The relative risk for z6 versus 1 partner, conditioned on age, study, and age at first intercourse, was 2.27 [95% confidence interval (95% CI), 1.98-2.61] and increased to 2.78 (95% CI, 2.22-3.47) after additional conditioning on reproductive factors. The risk of invasive cervical carcinoma increased with earlier age at first intercourse (P for linear trend <0.001). The relative risk for age at first intercourse V14 versus z25 years, conditioned on age, study, and lifetime number of sexual partners was 3.52 (95% CI, 3.04-4.08), which decreased to 2.05 (95% CI, 1.54-2.73) after additional conditioning on reproductive factors. CIN3/carcinoma in situ showed a similar association with lifetime number of sexual partners; however, the association with age at first intercourse was weaker than for invasive carcinoma. Results should be interpreted with caution given the strong correlation between sexual and reproductive factors and the limited information on HPV status.

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“…Data could not be retrieved for 10 published studies [14][15][16][17][18][19][20][21][22][23][24] and 1 research group 25 declined to take part in the collaboration. Of the studies identified, original data were available from 25,6, and all had information on reproductive factors and were therefore included in the present collaborative reanalysis (Table I).…”

Section: Resultsmentioning

confidence: 99%

“…The results of these studies were consistent with our present results. 16,17,19,[21][22][23][24] The difficulty of disentangling the effect of reproductive variables from sexual behaviour and HPV infection cannot, however, be overstated. If the number of sexual partners is inaccurately reported, or information on some potentially relevant aspects of sexual behaviour (e.g., husband's sexual behaviour in our present reanalysis) is not available, a residual confounding effect cannot be completely ruled out.…”

Section: Discussionmentioning

confidence: 99%

Cervical carcinoma and reproductive factors: Collaborative reanalysis of individual data on 16,563 women with cervical carcinoma and 33,542 women without cervical carcinoma from 25 epidemiological studies

Rajkumar

Cuzick

Appleby

et al. 2006

Intl Journal of Cancer

195

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Cervical carcinoma and reproductive factors: Collaborative reanalysis of individual data on 16,563 women with cervical carcinoma and 33,542 women without cervical carcinoma from 25 epidemiological studies International Collaboration of Epidemiological Studies of Cervical CancerThe International Collaboration of Epidemiological Studies of Cervical Cancer has combined individual data on 11,161 women with invasive carcinoma, 5,402 women with cervical intraepithelial neoplasia (CIN)3/carcinoma in situ and 33,542 women without cervical carcinoma from 25 epidemiological studies. Relative risks (RRs) and 95% confidence intervals (CIs) of cervical carcinoma in relation to number of full-term pregnancies, and age at first fullterm pregnancy, were calculated conditioning by study, age, lifetime number of sexual partners and age at first sexual intercourse. Number of full-term pregnancies was associated with a risk of invasive cervical carcinoma. After controlling for age at first fullterm pregnancy, the RR for invasive cervical carcinoma among parous women was 1.76 (95% CI: 1.53-2.02) for 7 full-term pregnancies compared with 1-2. For CIN3/carcinoma in situ, no significant trend was found with increasing number of births after controlling for age at first full-term pregnancy among parous women. Early age at first full-term pregnancy was also associated with risk of both invasive cervical carcinoma and CIN3/carcinoma in situ. After controlling for number of full-term pregnancies, the RR for first full-term pregnancy at age <17 years compared with 25 years was 1.77 (95% CI: 1.42-2.23) for invasive cervical carcinoma, and 1.78 (95% CI: 1.26-2.51) for CIN3/carcinoma in situ. Results were similar in analyses restricted to high-risk human papilloma virus (HPV)-positive cases and controls. No relationship was found between cervical HPV positivity and number of fullterm pregnancies, or age at first full-term pregnancy among controls. Differences in reproductive habits may have contributed to differences in cervical cancer incidence between developed and developing countries. ' 2006 Wiley-Liss, Inc.Key words: cervical carcinoma; cervical intraepithelial neoplasia; reproductive factors; full-term pregnancy; age at first full-term pregnancy; collaborative reanalysis; relative risk Parity was one of the earliest risk factors to be associated with cancer risk. Already in 1842, on the basis of death certificates in Verona, Italy, Rigoni-Stern observed that cancers of the uterus (which at that time chiefly originated from the cervix) were more frequent in married women, who tended to be multiparous, whereas breast neoplasms were more common in nulliparae, including nuns. 1Epidemiological studies conducted in the 1950's and 1960's pointed to sexual habits, and subsequent studies to sexual infections, specifically high-risk human papillomavirus (HPV) types, 2 as the key factor in cervical carcinogenesis. Consequently, they tended to consider that the association between reproductive factors and cervical cancer was chiefly accounted for by...

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Use of oral contraceptives and risk of invasive cervical cancer in previously screened women

Cited by 43 publications

References 13 publications

Elevated frequency of Micronuclei in uterine smears of cervix cancer patients

Elevated frequency of Micronuclei in uterine smears of cervix cancer patients

Cervical Carcinoma and Sexual Behavior: Collaborative Reanalysis of Individual Data on 15,461 Women with Cervical Carcinoma and 29,164 Women without Cervical Carcinoma from 21 Epidemiological Studies

Cervical carcinoma and reproductive factors: Collaborative reanalysis of individual data on 16,563 women with cervical carcinoma and 33,542 women without cervical carcinoma from 25 epidemiological studies

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