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Prevalence and risk factors for cervical neoplasia: a cervical cancer screening program in Beijing.

Tao L, Han L, Li X, Gao Q, Pan L, Wu L, Luo Y, Wang W, Zheng Z, Guo X - BMC Public Health (2014)

Bottom Line: Women aged 25-65 years were screened using the ThinPrep cytologic test and gynecologic examination.Among 728,704 women screened, the prevalence of cervical intraepithelial neoplasia (CIN) I, II, III was 50.2, 34.0, and 36.4 per 100,000, respectively.High education level (college and above compared with junior middle school or lower) was found to be protective (aOR = 0.79, 95% CI: 0.37-0.90).

View Article: PubMed Central - PubMed

Affiliation: School of Public Health, Capital Medical University, Beijing, China. guoxiuh@ccmu.edu.cn.

ABSTRACT

Background: Cervical cancer is the second most common cancer and cause of cancer-related death for women worldwide. The aims of this study were to investigate the prevalence of cervical neoplasia and examine factors associated with high-grade cervical squamous intraepithelial lesions (HSIL) among women taking part in a cervical cancer screening program in Beijing.

Methods: Women aged 25-65 years were screened using the ThinPrep cytologic test and gynecologic examination. Univariate and multivariate logistic regressions were conducted to investigate factors associated with HSIL.

Results: Among 728,704 women screened, the prevalence of cervical intraepithelial neoplasia (CIN) I, II, III was 50.2, 34.0, and 36.4 per 100,000, respectively. Prevalence of cervical cancer was 12.2 per 100,000. Risk factors for HSIL included being in age group of 46-55 years (adjusted odds ratio [aOR] = 1.15, 95% CI: 1.07-1.44, compared with the 25-35 age group), bleeding after intercourse (aOR = 2.08, 95% CI: 1.40-3.10), and presence of trichomonas vaginalis infection (aOR = 2.62, 95% CI: 1.35-5.07), cervical inflammation (aOR = 4.22, 95% CI: 3.39-5.26), and genital warts (aOR = 3.89, 95% CI: 2.54-7.70). High education level (college and above compared with junior middle school or lower) was found to be protective (aOR = 0.79, 95% CI: 0.37-0.90).

Conclusions: The prevalence of cervical neoplasia is relatively high in Beijing. Women aged 46-55 years, those with a lower education level, those reporting bleeding after intercourse, and those affected by Trichomonas vaginalis infection, cervical inflammation and genital warts are at higher risk for HSIL. Particular efforts should be made to ensure these women are included in cervical cancer screening programs.

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Related in: MedlinePlus

Adjusted OR and 95% CI for risk factors for HSIL. Abbreviation: HSIL = high-grade squamous intraepithelial lesion; age group (46–55 vs 25–35); education level (college and above vs junior middle school or lower).
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Fig2: Adjusted OR and 95% CI for risk factors for HSIL. Abbreviation: HSIL = high-grade squamous intraepithelial lesion; age group (46–55 vs 25–35); education level (college and above vs junior middle school or lower).

Mentions: A total of 728,704 women from the 18 districts of Beijing participated in the screening program, representing 9.4% of the 25 to 65-year-old female population in Beijing in 2009. Of these participants, 366 women (50.2 per 100,000) were diagnosed as CIN I, 248 (34.0 per 100,000) as CIN II, 265 (36.4 per 100,000) as CIN III and 89 (12.2 per 100,000) as having cervical cancer. Prevalence of HSIL (CIN grades II and III) was 70.40 per 100,000 women. The prevalence of HSIL and cervical cancer by Beijing district are shown in Table 1 and Figure 1. Yanqing district had the highest prevalence of CIN I, CIN II, and HSIL, at 136.8, 119.0, and 255.8 per 100,000, respectively. The highest prevalence of CIN III was in Mentougou district (149.3 per 100,000) and the highest prevalence of cervical cancer was in Xicheng district (25.3 per 100,000).There were significant differences between women with HSIL (n = 513) and those with normal histology (n = 702,168) in terms of age group, education level, parity, bleeding after intercourse, contraceptive used, presence of Trichomonas vaginalis infection, cervical inflammation, and genital warts. However, there was no significant difference in terms of work or not, menstrual cycle, menstrual period, gravidity, number of abortions, and presence of yeast infection and bacterial vaginosis (Table 2). Risk factors significantly associated with presence of HSIL in univariate logistic regression were being in age band of 46–55 years (compared with the reference group 25–35 years), higher education level, parity, bleeding after intercourse, and presence of Trichomonas vaginalis, cervical inflammation and genital warts (Table 3). Risk factors that remained significant in multivariate logistic regression were being in the age band of 46–55 years (adjusted odds ratio [aOR] = 1.15, 95% CI: 1.07–1.44, compared with the age band of 25–35 years), bleeding after intercourse (aOR = 2.08, 95% CI: 1.40–3.10), and presence of Trichomonas vaginalis infection (aOR = 2.62, 95% CI: 1.35–5.07), cervical inflammation (aOR = 4.22, 95% CI: 3.39–5.26) and genital warts (aOR = 3.89, 95% CI: 2.54–7.70). Higher education level was found to be protective against HSIL (aOR = 0.79, 95% CI: 0.37–0.90, college and above compared with junior middle school or lower education level) (Table 4, Figure 2).Table 1


Prevalence and risk factors for cervical neoplasia: a cervical cancer screening program in Beijing.

Tao L, Han L, Li X, Gao Q, Pan L, Wu L, Luo Y, Wang W, Zheng Z, Guo X - BMC Public Health (2014)

Adjusted OR and 95% CI for risk factors for HSIL. Abbreviation: HSIL = high-grade squamous intraepithelial lesion; age group (46–55 vs 25–35); education level (college and above vs junior middle school or lower).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4256817&req=5

Fig2: Adjusted OR and 95% CI for risk factors for HSIL. Abbreviation: HSIL = high-grade squamous intraepithelial lesion; age group (46–55 vs 25–35); education level (college and above vs junior middle school or lower).
Mentions: A total of 728,704 women from the 18 districts of Beijing participated in the screening program, representing 9.4% of the 25 to 65-year-old female population in Beijing in 2009. Of these participants, 366 women (50.2 per 100,000) were diagnosed as CIN I, 248 (34.0 per 100,000) as CIN II, 265 (36.4 per 100,000) as CIN III and 89 (12.2 per 100,000) as having cervical cancer. Prevalence of HSIL (CIN grades II and III) was 70.40 per 100,000 women. The prevalence of HSIL and cervical cancer by Beijing district are shown in Table 1 and Figure 1. Yanqing district had the highest prevalence of CIN I, CIN II, and HSIL, at 136.8, 119.0, and 255.8 per 100,000, respectively. The highest prevalence of CIN III was in Mentougou district (149.3 per 100,000) and the highest prevalence of cervical cancer was in Xicheng district (25.3 per 100,000).There were significant differences between women with HSIL (n = 513) and those with normal histology (n = 702,168) in terms of age group, education level, parity, bleeding after intercourse, contraceptive used, presence of Trichomonas vaginalis infection, cervical inflammation, and genital warts. However, there was no significant difference in terms of work or not, menstrual cycle, menstrual period, gravidity, number of abortions, and presence of yeast infection and bacterial vaginosis (Table 2). Risk factors significantly associated with presence of HSIL in univariate logistic regression were being in age band of 46–55 years (compared with the reference group 25–35 years), higher education level, parity, bleeding after intercourse, and presence of Trichomonas vaginalis, cervical inflammation and genital warts (Table 3). Risk factors that remained significant in multivariate logistic regression were being in the age band of 46–55 years (adjusted odds ratio [aOR] = 1.15, 95% CI: 1.07–1.44, compared with the age band of 25–35 years), bleeding after intercourse (aOR = 2.08, 95% CI: 1.40–3.10), and presence of Trichomonas vaginalis infection (aOR = 2.62, 95% CI: 1.35–5.07), cervical inflammation (aOR = 4.22, 95% CI: 3.39–5.26) and genital warts (aOR = 3.89, 95% CI: 2.54–7.70). Higher education level was found to be protective against HSIL (aOR = 0.79, 95% CI: 0.37–0.90, college and above compared with junior middle school or lower education level) (Table 4, Figure 2).Table 1

Bottom Line: Women aged 25-65 years were screened using the ThinPrep cytologic test and gynecologic examination.Among 728,704 women screened, the prevalence of cervical intraepithelial neoplasia (CIN) I, II, III was 50.2, 34.0, and 36.4 per 100,000, respectively.High education level (college and above compared with junior middle school or lower) was found to be protective (aOR = 0.79, 95% CI: 0.37-0.90).

View Article: PubMed Central - PubMed

Affiliation: School of Public Health, Capital Medical University, Beijing, China. guoxiuh@ccmu.edu.cn.

ABSTRACT

Background: Cervical cancer is the second most common cancer and cause of cancer-related death for women worldwide. The aims of this study were to investigate the prevalence of cervical neoplasia and examine factors associated with high-grade cervical squamous intraepithelial lesions (HSIL) among women taking part in a cervical cancer screening program in Beijing.

Methods: Women aged 25-65 years were screened using the ThinPrep cytologic test and gynecologic examination. Univariate and multivariate logistic regressions were conducted to investigate factors associated with HSIL.

Results: Among 728,704 women screened, the prevalence of cervical intraepithelial neoplasia (CIN) I, II, III was 50.2, 34.0, and 36.4 per 100,000, respectively. Prevalence of cervical cancer was 12.2 per 100,000. Risk factors for HSIL included being in age group of 46-55 years (adjusted odds ratio [aOR] = 1.15, 95% CI: 1.07-1.44, compared with the 25-35 age group), bleeding after intercourse (aOR = 2.08, 95% CI: 1.40-3.10), and presence of trichomonas vaginalis infection (aOR = 2.62, 95% CI: 1.35-5.07), cervical inflammation (aOR = 4.22, 95% CI: 3.39-5.26), and genital warts (aOR = 3.89, 95% CI: 2.54-7.70). High education level (college and above compared with junior middle school or lower) was found to be protective (aOR = 0.79, 95% CI: 0.37-0.90).

Conclusions: The prevalence of cervical neoplasia is relatively high in Beijing. Women aged 46-55 years, those with a lower education level, those reporting bleeding after intercourse, and those affected by Trichomonas vaginalis infection, cervical inflammation and genital warts are at higher risk for HSIL. Particular efforts should be made to ensure these women are included in cervical cancer screening programs.

Show MeSH
Related in: MedlinePlus