Study on Risk Factors for Cervical Carcinoma at Central Women’s Hospital, Yangon

1. . . Study on Risk Factors for Cervical Carcinoma at Central Women’s Hospital, Yangon MuyarSoe, MyatThazinAung, Win WinMya University of Medicine (1), Yangon, Myanmar Introduction Results Table (6) history of pap smear within previous 3 years among case and control • This study also found that carcinoma cervix was significantly associated with a previous history of sexually transmitted disease or warts (P=0.001). • Table (4) Type of contraception among case and control • Carcinoma Cervix was not found to be significantly more common in contraceptive user than non user. • In table (4), among the contraceptive users ,there was a significant association between oral contraceptive pills usage and carcinoma cervix (P=0.05) (OR =2.5; 95% CI=1.43-143.21). • Table (5) History of Circumcision among husbands of case and control • Carcinoma cervix was found to be less common in woman whose husband had a history of circumcision (P=0.025) (OR=0.00-0.86). Table (3) History of STD or warts among case and control • At the global level, the cervical cancer (Ca Cx)constitutes the second most common type of cancer in women. • First most frequent gynaecological cancer among Myanmar women. (Myanmar, human papillomavirus and related cancers, fact Sheet, WHO, 2009) • Although the incidence and motality from cervical cancer have declined substantially over the recent decades, attributed largely to early detection by means of cervical smear and effective interventions, cervical cancer is still one of the most common cancers in women worldwide (Ferlay et al, 2001). • Mean age of cases was 51.4 ± 10.5 years with minimum 30 years and maximum 73 years. Mean age of controls was 50.3 ± 9.2 with minimum 32 years and maximum 70 years. • Table (1) Mean age at first coitus among case and control • Table (1) shows mean age of first coitus was significantly younger in the case group (P=0.04). • Table (2) Educational status among cases and control • Table (2) shows that carcinoma cervix was found to be more common in women with lower educational status (P=0.013) (OR - 3.57; 95% CI = 1.14- 11.48). • There was no statistical significant association between the carcinoma cervix and number of sexual partners (P= 0.356) (OR=0.23, CI=0.01-2.38), parity (P=0.314) (OR= 0.60; CI= 0.20-1.82), and smoking (P=1.0) (OR=1; 95% CI=0.51-1.9) in this study. Carcinoma cervix was significantly common in women who did not take pap smear within previous 3 years.( P=0.000, OR = 98.22, 95% CI =11.19-2221.7) Aim Conclusions • The aim of this study was to identify the risk factors for the development of carcinoma cervix in women who were admitted to the gynaecological ward at Central Women’s Hospital, Yangon. This study found that younger age at first coitus, lower educational status, history of sexually transmitted disease or warts were the significant risk factors for carcinoma cervix. The similar finding was found in the study by Green J et al (2003) and also in Gonzalez et al (2004). But there was no statistical significant association between the carcinoma cervix and number of sexual partners, and smoking in this study. In Myanmar, number of sexual partner can be inferred as number of marriage according to traditional and cultural situation. Having multiple sexual partners was a rare practice in Myanmar. There was a significant association between oral contraceptive pills usage and carcinoma cervix. It is also found that carcinoma cervix was less common in woman whose husband had a history of circumcision. Taking pap smear within 3 years significantly reduced the risk of carcinoma cervix in this study. This study covers the common risk factors about cervical cancer and found some association about them. Materials and Method • Study Design - Hospital based case control study • Study population -Thirty five women with cervical carcinoma (cases) and 35 controlled women • Cases were women admitted to the gynaecological ward at Central Women’s Hospital, Yangon (CWH), and diagnosed as carcinoma cervix • Controls were age matched women with any other gynaecological diseases other than carcinoma cervix and also admitted to CWH, Yangon • Study period - During September 2010 to May, 2011 • Method • Cases and controls were asked about the common risk factors according to the preformed questionnaires after getting informed consent. • Data analysis • Analyzed by using SPSS software version 16 • For categorical data, Chi square test or Fisher’s Exact test were used where appropriate. • To compare means, student t test was used. • The level of significance was set at 0.05 (95% confidence interval). References 1.Ferlay J et al (2000).Cancer incidence, motality, and prevalence worldwide, version 1.0 IARC Cancer Base, vol (5). Lyon IARC Press; 2001 2.Gonzalez B and Green J (2004). Comparison of risk factors for squamous cell and adenocarcinomas of the cervix: a meta-analysis. Br J Cancer; 90(9): p-1787-1791 2.Green J et al (2003). Risk factors for adenocarcinoma and squamous cell carcinoma of the cervix in women aged 20–44 years: the UK National Case–Control Study of Cervical Cancer. Br J Cancer :89(11): p-2078 - 2086. 3. WHO, Human Papillomavirus and Related Cancers, Fact Sheet 2009.