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Risk factors for rapid-onset cervical cancer.
Am J Obstet Gynecol 1999; 180(3 Pt 1):571-7AJ

Abstract

OBJECTIVES

The current study was designed to elucidate risk factors associated with the development of cervical cancer during the course of routine Papanicolaou smear screening (rapid-onset cervical cancer).

STUDY DESIGN

Four hundred eighty-three women diagnosed with invasive cervical cancer, representing 73% of all such tumors diagnosed in Connecticut between 1985 and 1990, were studied. Papanicolaou smear screening and risk factor information was obtained by questionnaire and physician record review. Results from human papillomavirus deoxyribonucleic acid testing by polymerase chain reaction of tumor samples were available for 278 study participants. Prediagnostic Papanicolaou smear slides were reviewed for 67% of cases with a screening history. Screening history information, slide review, and questionnaire data were used to classify women as having rapid-onset cervical cancer (n = 43), possible rapid-onset cervical cancer (n = 111), or normal-onset cervical cancer (n = 329).

RESULTS

Compared with normal-onset cases, rapid-onset cases tended to be younger (P =.001) and were more likely to be white (P =.002), diagnosed with adenocarcinomas or adenosquamous carcinomas (P =.001), and diagnosed with early-stage disease (P =.001). Cases diagnosed as possible rapid-onset disease tended to have a profile that was intermediate to that observed for rapid-onset and normal-onset cases. Human papillomavirus deoxyribonucleic acid was detected in 75.2% of cases tested. Compared with women who tested positive for human papillomavirus type 16 or other, those positive for human papillomavirus type 18 had a relative risk for rapid-onset disease of 1.6 (95% confidence interval 0.52-4.9). No significant association was observed between type 18 and possible rapid-onset disease when possible rapid-onset cases were compared with women diagnosed with normal-onset cervical cancer (relative risk 0.67, 95% confidence interval 0.29-1.6). Oral contraceptive use, cigarette smoking, number of pregnancies, and a maternal history of cervical cancer were not significantly associated with rapid-onset disease.

CONCLUSIONS

Results from this study suggest that the risk factors associated with the development of rapid-onset cervical cancer are similar to those for normal-onset disease.

Authors+Show Affiliations

National Cancer Institute, Bethesda, Maryland, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10076130

Citation

Hildesheim, A, et al. "Risk Factors for Rapid-onset Cervical Cancer." American Journal of Obstetrics and Gynecology, vol. 180, no. 3 Pt 1, 1999, pp. 571-7.
Hildesheim A, Hadjimichael O, Schwartz PE, et al. Risk factors for rapid-onset cervical cancer. Am J Obstet Gynecol. 1999;180(3 Pt 1):571-7.
Hildesheim, A., Hadjimichael, O., Schwartz, P. E., Wheeler, C. M., Barnes, W., Lowell, D. M., ... Schiffman, M. (1999). Risk factors for rapid-onset cervical cancer. American Journal of Obstetrics and Gynecology, 180(3 Pt 1), pp. 571-7.
Hildesheim A, et al. Risk Factors for Rapid-onset Cervical Cancer. Am J Obstet Gynecol. 1999;180(3 Pt 1):571-7. PubMed PMID: 10076130.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for rapid-onset cervical cancer. AU - Hildesheim,A, AU - Hadjimichael,O, AU - Schwartz,P E, AU - Wheeler,C M, AU - Barnes,W, AU - Lowell,D M, AU - Willett,J, AU - Schiffman,M, PY - 1999/3/17/pubmed PY - 1999/3/17/medline PY - 1999/3/17/entrez SP - 571 EP - 7 JF - American journal of obstetrics and gynecology JO - Am. J. Obstet. Gynecol. VL - 180 IS - 3 Pt 1 N2 - OBJECTIVES: The current study was designed to elucidate risk factors associated with the development of cervical cancer during the course of routine Papanicolaou smear screening (rapid-onset cervical cancer). STUDY DESIGN: Four hundred eighty-three women diagnosed with invasive cervical cancer, representing 73% of all such tumors diagnosed in Connecticut between 1985 and 1990, were studied. Papanicolaou smear screening and risk factor information was obtained by questionnaire and physician record review. Results from human papillomavirus deoxyribonucleic acid testing by polymerase chain reaction of tumor samples were available for 278 study participants. Prediagnostic Papanicolaou smear slides were reviewed for 67% of cases with a screening history. Screening history information, slide review, and questionnaire data were used to classify women as having rapid-onset cervical cancer (n = 43), possible rapid-onset cervical cancer (n = 111), or normal-onset cervical cancer (n = 329). RESULTS: Compared with normal-onset cases, rapid-onset cases tended to be younger (P =.001) and were more likely to be white (P =.002), diagnosed with adenocarcinomas or adenosquamous carcinomas (P =.001), and diagnosed with early-stage disease (P =.001). Cases diagnosed as possible rapid-onset disease tended to have a profile that was intermediate to that observed for rapid-onset and normal-onset cases. Human papillomavirus deoxyribonucleic acid was detected in 75.2% of cases tested. Compared with women who tested positive for human papillomavirus type 16 or other, those positive for human papillomavirus type 18 had a relative risk for rapid-onset disease of 1.6 (95% confidence interval 0.52-4.9). No significant association was observed between type 18 and possible rapid-onset disease when possible rapid-onset cases were compared with women diagnosed with normal-onset cervical cancer (relative risk 0.67, 95% confidence interval 0.29-1.6). Oral contraceptive use, cigarette smoking, number of pregnancies, and a maternal history of cervical cancer were not significantly associated with rapid-onset disease. CONCLUSIONS: Results from this study suggest that the risk factors associated with the development of rapid-onset cervical cancer are similar to those for normal-onset disease. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/10076130/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(99)70256-5 DB - PRIME DP - Unbound Medicine ER -