PROSTITUTION, CONDOM USE, AND INVASIVE SQUAMOUS-CELL CERVICAL-CANCER IN THAILAND

Cervical cancer is probably caused by a sexually transmitted agent. A case-control study was conducted in three hospitals in Thailand to inv estigate further the role of male sexual behavior, particularly regard ing sexual contacts with prostitutes, in the development of this disea se. Data were obtained from interviews with 225 married women with inv asive squamous cell cervical carcinoma and 791 hospitalized controls, all of whom reported having only one sexual partner, and from intervie ws with their husbands. Risk of cervical cancer was strongly related t o the women's husbands having visited prostitutes without using a cond om when the husbands were less than 30 years old. A strong increasing trend in risk in relation to decreasing frequency of the husbands' con dom use with prostitutes was observed, and a weaker increasing trend i n risk with husbands' estimated lifetime total number of visits to pro stitutes was found. The average latent period between the women's like ly initial exposure to a sexually transmitted oncogenic agent and her diagnosis of invasive cervical cancer was about a quarter of a century . Regular use of condoms by customers of prostitutes could reduce the number of invasive cervical cancer cases in the general population of Thailand by at least one fourth.