Risk factors related to biological behaviour of precancerous lesions of the uterine cervix
1990

Risk Factors for Precancerous Lesions of the Uterine Cervix

Sample size: 2184 publication Evidence: moderate

Author Information

Author(s): N.S Murthy, A. Sehgal, L. Satyanarayana, D.K. Das, V. Singh, B.C. Das, M.M. Gupta, A.B. Mitra, U.K. Luthra

Primary Institution: Institute of Cytology and Preventive Oncology (ICMR), Maulana Azad Medical College Campus, New Delhi, India

Hypothesis

What factors influence the progression of cervical dysplasia to carcinoma in situ?

Conclusion

The study found that the initial grade of dysplasia and early age at consummation of marriage significantly influenced the progression to malignancy.

Supporting Evidence

  • 75 dysplasia cases progressed to carcinoma in situ during the follow-up.
  • The overall rate of progression of dysplasia to malignancy was 15.7%.
  • HPV 16/18 sequences were found in 67.3% of dysplasia subjects who progressed to carcinoma in situ.
  • Women with consummation of marriage before 18 years had a 2.8-fold higher risk of developing malignancy.
  • Illiterate women had a 1.74 times higher risk for development of malignancy than literate women.

Takeaway

This study looked at women with precancerous cervical lesions and found that those with more severe dysplasia and who married young were more likely to develop cancer.

Methodology

A cohort of 1,107 cervical dysplasia cases and 1,077 matched controls were followed up for up to 132 months to assess progression to carcinoma in situ.

Potential Biases

Potential bias due to the lack of organized cytology screening in India and reliance on self-reported data.

Limitations

The study did not include women who had undergone previous Pap tests, and some cases were lost to follow-up due to hysterectomy or moving away.

Participant Demographics

Women aged 20-60 years, primarily from Delhi, India.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI = 2.5, 14.1

Statistical Significance

p<0.001

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