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American Journal of Epidemiology Vol. 130, No. 3: 486-496
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health

research-article

PARITY AS A RISK FACTOR FOR CERVICAL CANCER

LOUISE A. BRINTON1,, WILLIAM C. REEVES2, MARIA M. BRENES2, ROLANDO HERRERO3, ROSA C. DE BRIlTON,4, EDUARDO GAITAN5, FRANCISCO TENORIO6, MARIANA GARCIA2 and WILLIAM E. RAWLS7

1Environmental Epidemiology Branch, National Cancer Institute Bethesda, MD.
2Gorgas Memorial Laboratory Panama City, Republic of Panama.
3Unidad Nacional de Cancerologia Caja Costarricense de Seguro Social, San Jose, Costa Rica.
4Instituto Oncologico Nacional Panama City. Republics de Panama.
5Division de Epiderniologia, Instituto Nacional de Cancerologia Bogota, Colombia.
6Hospital Nacional de Oncologia, Inatituto Mexicano del Seguro Social Mexico City, Mexico.
7Molecular Virology and Immunology Program, Department of Pathology, McMaster University Hamilton, Ontario, Canada.

Reprint requests to Dr. Louise A. Brinton, Environmental Epidemiology Branch, National Cancer Institute, Executive Plaza North, Room 443, Bethesda, MD 20892

In a case-control study of 759 invasive cervical cancer patients and 1,430 controls in Colombia, Costa Rica, Mexico, and Panama conducted during 1986– 1987, an assodation with number of pregnancies persisted after adjustment for sexual and socioeconomic variables. Risks rose steadily to 5.1 (95% confidence interval 2.7–9.7) for those with 14 or more pregnancies and a relation of risk to multiparity was observed in all four study countries. Pregnancy associations appeared to relate to the number of live births rather than to miscarriages or abortions, with multiparity relations most pronounced among premenopausal women and oral contraceptive users. Human papillomaviruses types 16 and 18, as measured by filter in situ hybridization, were not significantly associated wtth number of births and did not explain the strong relation of parity to risk. Our results indicate the need for further consideration of reproductive factors on cervical cancer risk, with attention given to possible mechanisms of action, including hormonal factors and cervical trauma.

cervix neoplasms; cesarean section; hormones; infection; reproduction


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