ROLE OF MALE-BEHAVIOR IN CERVICAL CARCINOGENESIS AMONG WOMEN WITH ONELIFETIME SEXUAL PARTNER

Background. The role of male behavior in the genesis of cervical cance r was examined. In India, where the incidence of cervical cancer is am ong the highest in the world, promiscuity among women is virtually unk nown. In this study, the authors investigated the role of male behavio r in cervical carcinogenesis among Indian women who had one lifetime s exual partner. Methods. A case-control study was used. Results. Premar ital sexual relationships (relative risk [RR], 1.9; confidence interva l, 1.2-3.2) and extramarital sexual relationships (RR, 2.7; confidence interval, 1.5-4.9) of husbands were risk factors. When husbands had s exual relationships both before and during the marriage, their wives' risk of getting cervical cancer increased by 6.9 (CI, 2.3-20.7). Risk also increased with husbands having three or more extramarital sexual partners (RR, 3.05; CI, 1.25-12.6). Sexual contact with prostitutes be fore or after marriage, however, did not increase the risk. History of sexually transmitted disease before marriage (RR, 2.9) or after marri age (RR, 5.9) was an important risk factor, which persisted after cont rolling for other factors. Sexual abstinence for 40 or more days after a wife's giving birth or having an abortion provided protection. Sex with uncircumcised men or men circumcised after age 1 year increased t he risk of cervical cancer (RR, 4.1). Bidi smoking (bidi is a cheap sm oking stick of 4-8 cm, consisting of a rolled piece of dried temburni leaf [Diospyres melanoxylon] containing 0.15-0.25 g of coarsely ground tobacco) for more than 20 years was a significant risk factor (RR = 2 .4), whereas cigarette smoking was not a risk factor. Conclusions. Mal e sexual partners play a role in cervical carcinogenesis.