Estimation of Joint Risks for Developing Uterine Cervix Cancer in Korea

Yoon, Hachung; Shin, Aesun; Park, Sue Kyung; Jang, Myung Jin; Yoo, Keun Young

Abstract

OBJECTIVE
This study was aiming at estimating the joint effects of various risk factors associated with uterine cervix cancer in Korea.
METHODS
Data obtained from a case-control study were analyzed with a multiplicative model.
RESULTS
After adjustment for age and husband's educational attainments, the family history of cervical cancer (OR=2.1, 95% CI=1.2-3.9), unstable marital status due to separation, by death or divorce, etc. (OR=2.8, 95% CI=1.7-4.6), and a large number of deliveries (> or = 3 vs. nulliparous OR=6.5, 95% CI=1.4-29.9) increased the risk of uterine cervix cancer. Conversely, first sexual intercourse at an older age (> or = 25 years vs. <19 years OR=0.4, 95% CI=0.2-0.6) and husband's circumcision (OR=0.7, 95% CI=0.5-1.0) decreased the risk. In the multiplicative model, the highest joint risk (OR=39.2, 95% CI 5.9-258.9) was observed in women with a family history of uterine cervical cancer, an unstable marital status, where the ex-husband was not circumcised, with 3 or more delivery experiences, and having her first sexual intercourse when younger than 19 years of age. However, women without a family history of uterine cervix cancer, married to a circumcised husband, having had her first sexual intercourse at 25 years or older, and nulliparous, showed the lowest joint effect (OR=0.3, 95% CI=0.1-0.5).
CONCLUSION
As carcinogenesis is a complex action involving various factors, we consider a joint effects approach to be appropriate in an epidemiological study on risk factors for uterine cervix neoplasms.cervix neoplasm.