Cervical cancer is a complex and multifactorial disease. Although there are substantial data supporting the causative role of persistent human papillomavirus (HPV) infection in the development of cervical cancer, the complete course of the disease has never been completely understood. Several risk cofactors have been suggested with controversial results. Portugal has the highest incidence of squamous cell carcinoma (SCC) within western Europe and there are no known studies regarding the role of cofactors in SCC. The aim of our study was to evaluate the role of smoking, sexual behaviour, reproductive and contraceptive history, in the time-to-onset (TTO) of severe cervical lesions (HGSIL/SCC) in the Portuguese population. We verified that age of first sexual intercourse under 18 years (odds ratio (OR) 2.8), pregnancy (OR 2.9), first pregnancy under 21 years (2.6), number of pregnancies (OR 2.3-5.4) and parity (OR 1.9-5.7) are risk factors in the development of cervical neoplasia. Smoke exposure index (SEI) was significantly different (P=0.002) between cases and controls. Our results regarding time-to-onset demonstrate that smoking (P<0.001, log rank test), number of sexual partners (P<0.001, log rank test) and use of oral contraceptives (P<0.001, log rank test) are important determinants in the earlier onset of severe cervical lesions. Using this approach, our findings may help to clarify the role of smoking and other cofactors in the persistence and progression of cervical lesions.
smoking cervical cancer time to onset cofactors, oral contraceptives cervical cancer risk HPV cofactors, cervical squamous cell carcinoma risk factors Portuguese women, smoking sexual behavior reproductive history cervical neoplasia, HPV persistent infection cervical cancer progression cofactors, oral contraceptive use cervical lesion onset acceleration, parity early pregnancy cervical cancer risk southern Europe, Matos cervical cancer cofactors smoking Portugal, HGSIL SCC time to onset determinants epidemiology, cervical cancer multifactorial risk reproductive contraceptive history
PMID 16175054 16175054 DOI 10.1097/01.cej.0000174780.44260.32 10.1097/01.cej.0000174780.44260.32
Cite this article
Matos, A., Moutinho, J., Pinto, D., & Medeiros, R. (2005). The influence of smoking and other cofactors on the time to onset to cervical cancer in a southern European population. European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP), 14(5), 485-491. https://doi.org/10.1097/01.cej.0000174780.44260.32
Matos A, Moutinho J, Pinto D, Medeiros R. The influence of smoking and other cofactors on the time to onset to cervical cancer in a southern European population. Eur J Cancer Prev. 2005;14(5):485-491. doi:10.1097/01.cej.0000174780.44260.32
Matos, Ana, et al. "The influence of smoking and other cofactors on the time to onset to cervical cancer in a southern European population." European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP), vol. 14, no. 5, 2005, pp. 485-491.
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