RISK-FACTORS FOR CERVICAL DYSPLASIA - IMPLICATIONS FOR PREVENTION

This study assessed the aetiologic and public health importance of var ious risk factors for cervical dysplasia. A case-control design was us ed in which all cases had a histologically confirmed mild, moderate or severe cervical dysplasia. Controls were sampled from the general pop ulation. A total of 257 cases and 705 controls returned a postal quest ionnaire about marital status, sexual behaviour and contraceptive use, smoking behaviour and dietary intake of some nutrients. An increased risk was observed for women who were smokers and women who reported mo re than one sexual partner. For women who reported more than six sexua l partners, the adjusted odds ratio was 11.5 (95% CI: 6.6-20.2); for w omen who smoked more than 20 cigarettes per day, an adjusted odds rati o of 2.5 (95% CI: 1.6-3.9) was found. Use of oral contraceptives for m ore than 10 years increased the risk: the adjusted odds ratio was 2.3 (95% CI: 1.2-4.5). The population attributable risk percentage (PAR%) of these three risk factors together was 72%, while number of sexual p artners, number of cigarettes smoked and oral contraceptive use alone amounted to a PAR% of 57%, 29% and 8% respectively. Considering the pr eventive potential against the background of causality of the relation ships and the social acceptability of the proposed changes, it is conc luded that cervical cancer and its precursors might for the greater pa rt be prevented by behavioural changes, such as reducing smoking and u sing contraceptive barrier methods.