SEXUAL RISK-FACTORS FOR CERVICAL-CANCER AMONG RURAL INDIAN WOMEN - A CASE-CONTROL STUDY

Background. The association between sexual behaviour and cervical canc er is well established. Despite a high incidence of cervical cancer in India, its role has not been widely investigated in Indian women amon g whom the rate of sexual promiscuity is known to be very low. A hospi tal-based case-control study was carried out to investigate the role o f sexual risk factors in cervical cancer among rural Indian women. Met hods. A case-control design was used in which a total of 268 subjects, comprising 134 women with invasive cervical cancer as cases and 134 c ontrol women were studied. A multiple logistic regression model was us ed to analyse the data. Results. The risk factors found to be associat ed with cervical cancer were early age at first coitus, extramarital s ex partners of women and the time interval since first exposure. In a multiple logistic regression model, independent effects were observed for early age at first coitus, showing maximum risk in women who repor ted their first intercourse at 112 years of age, compared to that of w omen at greater than or equal to 18 years (odds ratio [OR] = 3.5, 95% confidence interval [CI]:1.1-10.9). Increased risk was also seen for w omen who had extramarital sex relationships (OR = 5.5, 95% CI : 1.5-19 .5). The significant effect of early age at first coitus persisted aft er adjustment for latency period which also showed its independent ris k association with cervical cancer in the multivariate analysis. Concl usion. These findings confirm the association between early age at fir st coitus and cervical cancer in women with a low rate of sexual promi scuity and define the role of these risk factors in cervical carcinoge nesis among rural Indian women.