CORRELATION OF CERVICAL-CANCER MORTALITY WITH REPRODUCTIVE AND DIETARY FACTORS, AND SERUM MARKERS IN CHINA

Background. Cervical cancer is the second leading cause of cancer deat h among Chinese women. Within China, a considerable geographical varia tion in mortality rates has been observed, but the reasons are not wel l understood. Methods. Cervical cancer rates were examined in relation to indices of reproductive factors, dietary habits, and selected seru m biomedical markers in 65 rural Chinese counties. Results. Cervical c ancer mortality rates correlated positively and significantly with ant ibodies to herpes simplex virus type 2 (HSV-2) (r = 0.40, P < 0.01), s erum levels of ferritin (r = 0.33, P < 0.01), body mass index (BMI) (r = 0.42, P < 0.01) and cigarette smoking (r = 0.51, P < 0.05) and nega tively and significantly with age at first birth (r = -0.51, P < 0.01) , consumption of green vegetables (r = -0.40, P < 0.01) and animal foo ds (r = -0.40, P < 0.01), and serum levels of selenium (r = -0.26, P < 0.05). When these variables were considered in the multiple regressio n analysis, early age at first birth and higher BMI were positively as sociated with cervical cancer mortality, while consumption of green ve getables and animal foods were negatively correlated. In the serum mod el, infection with HSV-2 and low levels of sex hormone binding globuli n (SHBG) were positively related to cervical cancer mortality. No rela tion was found for consumption of fruits. Conclusions. Although limita tions of these ecologic data preclude causal inferences, findings in t his study, including associations with HSV-2 infection, early age at f irst birth, consumption of green vegetables and animal foods, may prov ide