背景:宫颈癌前病变在宫颈转化区发展,并通过称为宫颈上皮内瘤变(CIN)1、2和3的阶段进行。如果未经治疗,CIN2或CIN3可导致宫颈癌。在埃塞俄比亚,宫颈癌前病变的决定因素没有得到很好的记录。因此,这项研究旨在寻找在公共卫生机构筛查宫颈癌的女性中宫颈癌前病变的决定因素。
方法:2020年1月至4月进行的一项研究涉及216名女性,由54例(宫颈癌筛查期间VIA阳性)和162例对照(VIA阴性)组成。它的重点是30至49岁接受宫颈癌筛查的女性。多变量logistic回归分析评估了癌前病变与不同危险因素之间的联系,考虑P<0.05的显著性水平。
结果:使用口服避孕药超过5年的女性出现癌前病变的可能性增加近5倍(调整比值比(AOR)=4.75;95%CI:1.48,15.30)。此外,初次性交年龄较早(15岁以下)发生癌前病变的几率增加了四倍(AOR=3.77;95%CI:1.46,9.69).此外,有HIV血清阳性结果且有性传播感染(STIs)病史的女性发生宫颈癌前病变的几率分别为3.4倍(AOR=3.45;95%CI:1.29,9.25)和2.5倍(AOR=2.58;95%CI:1.10,6.09).
结论:结论:使用口服避孕药超过五年的妇女,在15岁之前开始性活动,并有性传播感染史,包括艾滋病毒,发生宫颈癌前病变的风险更高。旨在促进行为改变以防止早期性活动和性传播感染的针对性干预策略对于避免宫颈癌前病变至关重要。至关重要的是,尽早为女性青少年引入生命历程原则,承认在生命的关键阶段预防和控制癌前病变的潜力,从青春期早期到成年,涵盖所有发展阶段。
BACKGROUND: Precancerous cervical lesions develop in the transformation zone of the cervix and progress through stages known as cervical intraepithelial neoplasia (CIN) 1, 2, and 3. If untreated, CIN2 or CIN3 can lead to cervical cancer. The determinants of cervical precancerous lesions are not well documented in Ethiopia. Therefore, this study aims to find the determinants of cervical precancerous lesions among women screened for cervical cancer at public health facilities.
METHODS: A study conducted from January to April 2020 involved 216 women, consisting of 54 cases (positive for VIA during cervical cancer screening) and 162 controls (negative for VIA). It focused on women aged 30 to 49 undergoing cervical cancer screening. Multivariable logistic regression analysis assessed the link between precancerous lesions and different risk factors, considering a significance level of p < 0.05.
RESULTS: Women who used oral contraceptives for a duration exceeding five years showed a nearly fivefold increase in the likelihood of developing precancerous lesions (Adjusted Odds Ratio (AOR) = 4.75; 95% CI: 1.48, 15.30). Additionally, early age at first sexual intercourse (below 15 years) elevated the odds of developing precancerous lesions fourfold (AOR = 3.77; 95% CI: 1.46, 9.69). Furthermore, women with HIV seropositive results and a prior history of sexually transmitted infections (STIs) had 3.4 times (AOR = 3.45; 95% CI: 1.29, 9.25) and 2.5 times (AOR = 2.58; 95% CI: 1.10, 6.09) higher odds of developing cervical precancerous lesions compared to their counterparts.
CONCLUSIONS: In conclusion, women who have used oral contraceptives for over five years, started sexual activity before the age of 15 and have a history of sexually transmitted infections, including HIV, are at higher risk of developing precancerous cervical lesions. Targeted intervention strategies aimed at promoting behavioural change to prevent early sexual activity and STIs are crucial for avoiding cervical precancerous lesions. It is crucial to introduce life-course principles for female adolescents early on, acknowledging the potential to prevent and control precancerous lesions at critical stages in life, from early adolescence to adulthood, encompassing all developmental phases.