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Am J Epidemiol. 1996 Apr 15;143(8):779-86.

Prostitution, condom use, and invasive squamous cell cervical cancer in Thailand.

Author information

1
Fred Hutchinson Cancer Research Center, Program in Epidemiology, Seattle, WA 98104, USA.

Abstract

Cervical cancer is probably caused by a sexually transmitted agent. A case-control study was conducted in three hospitals in Thailand to investigate further the role of male sexual behavior, particularly regarding sexual contacts with prostitutes, in the development of this disease. Data were obtained from interviews with 225 married women with invasive squamous cell cervical carcinoma and 791 hospitalized controls, all of whom reported having only one sexual partner, and from interviews with their husbands. Risk of cervical cancer was strongly related to the women's husbands having visited prostitutes without using a condom when the husbands were less than 30 years old. A strong increasing trend in risk in relation to decreasing frequency of the husbands' condom use with prostitutes was observed, and a weaker increasing trend in risk with husbands' estimated lifetime total number of visits to prostitutes was found. The average latent period between the women's likely initial exposure to a sexually transmitted oncogenic agent and her diagnosis of invasive cervical cancer was about a quarter of a century. Regular use of condoms by customers of prostitutes could reduce the number of invasive cervical cancer cases in the general population of Thailand by at least one fourth.

PIP:

Researchers compared data on 225 Thai married women with invasive squamous cell cervical cancer admitted to Siriraj and Chulalongkorn hospitals in Bangkok and at Maharaj Nakorn Chiang Mai Hospital during October 1979-September 1998 with data on 791 hospitalized Thai controls to examine the role of male sexual behavior and prostitution in the development of cervical cancer and the likely protective effect of condom use against cervical cancer. All the cases and controls claimed to have had only one sexual partner. Interviews were conducted with the husbands of all the cases and controls. There was a significant trend of increasing risk of cervical cancer as the frequency of husband's condom use with prostitutes declined (p = 0.004) (relative risk [RR] = 2.05 for rarely or never, 1.24 for sometimes, and 0.96 for always or frequently). The increasing risk of cervical cancer associated with little or no condom use with prostitutes was highest when the husbands were less than 30 years old (RR = 2.11 vs. 1.56-1.81 for age 20 or older). There was a weaker trend of increasing risk of cervical cancer with the husband's estimated lifetime total number of visits to prostitutes (p = 0.12). On average, the latent period between the wife's likely first exposure to a sexually transmitted oncogenic agent (i.e., date of their marriage) and her diagnosis of invasive cervical cancer was 24 years. These findings indicate the condom use with prostitutes would reduce the risk of cervical cancer.

[Indexed for MEDLINE]

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