Journal of Cancer Education
ISSN: 0885-8195 (Print) 1543-0154 (Online) Journal homepage: http://www.tandfonline.com/loi/hjce20
Risk profiles of women with cervical neoplasia Margaret R. Spitz , Michele F. Mitchell , John J. Fueger & Guy R. Newell To cite this article: Margaret R. Spitz , Michele F. Mitchell , John J. Fueger & Guy R. Newell (1991) Risk profiles of women with cervical neoplasia, Journal of Cancer Education, 6:4, 241-246 To link to this article: http://dx.doi.org/10.1080/08858199109528128
Published online: 01 Oct 2009.
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Article views: 2
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=hjce20 Download by: [Australian Catholic University]
Date: 01 September 2017, At: 10:29
J. Cancer Education. Vol. 6, No. 4, pp. 241-246, 1991 Printed in the U.S.A. Pergamon Press pic
0885-8195/91 $3.00 + .00 © 1991 American Association for Cancer Education
RISK PROFILES OF WOMEN WITH CERVICAL NEOPLASIA
Downloaded by [Australian Catholic University] at 10:29 01 September 2017
MARGARET R. SPITZ;* MICHELE F. MITCHELL;† JOHN J. FUEGER;* GUY R. NEWELL*
Abstract — Risk-factor profiles were compared in M. D. Anderson Cancer Center patients with various uterine cervix histologic diagnoses. Intraepithelial neoplasia (n = 171) and condyloma (n = 82) were associated with significantly lower patient age (mean 23.6 and 25.8 years, respectively). In addition, these two groups were lowest in annual income, age at beginning intercourse and at first pregnancy, and highest in percentages of black and Hispanic patients, number of sexual partners, and history of gonorrhea. Women with squamous carcinoma in situ (n = 47), who were about a decade older, exhibited a similar socioeconomic distribution and sexual history. All three groups also reported high prevalences of current smokers, were most likely to use oral contraceptives, and were least likely to use diaphragms or condoms. Patients with invasive squamous cell carcinoma (n = 77) had a mean age of 46.3 years, a large lowest-income constituency, and the highest mean number of pregnancies; they were least likely to have used oral contraceptives. Adenocarcinoma (n = 21) was epidemiologically distinct: a predominance of white women characterized by high socioeconomic status, elevated body mass index, and none of the liberal sexual practices of the other groups. Primary and secondary prevention strategies must be tailored to the unique needs and socioeconomic status of the young at-risk populations.
INTRODUCTION The continuum of cervical disease that begins with mild dysplasia, ranges through carcinomain-situ (CIS), and ends with invasive squamous carcinoma has well-delineated epidemiologic characteristics. In contrast, the risk profile of women with cervical adenocarcinoma is not clearly characterized despite its reported increase in incidence relative to all invasive cervical cancers.1'2 There is a similar lack of definition concerning risk factors for cervical human papillomavirus (HPV) infection, although there are cytologic and morphologic features (eg, koilocytosis) that taken together facilitate the diagnosis of HPV infection.3 It is well established that early detection and effective treatment of cervical cancer precursors prevent the development of invasive cervical cancer. Since the women at risk are often the socioeconomically disadvantaged constituency, culturally sensitive and specifically targeted ed*Department of Cancer Prevention and Control; †Department of Gynecology, The University of Texas M. D. Anderson Cancer Center, Houston. Reprint requests to: Dr. Margaret R. Spitz, Department of Cancer Prevention and Control, Box 189, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030.
ucational programs are needed to achieve success in primary and secondary prevention. The purpose of this study was to delineate risk profiles of women with cervical diseases, since an understanding of the prevalence of risk factors can improve the development of succinct and meaningful educational messages. MATERIAL AND METHODS The Department of Cancer Prevention and Control at The University of Texas M. D. Anderson Cancer Center maintains an automated risk factor database that includes self-reported information on lifestyle practices of patients, including indices of sexual behavior and smoking status, together with histologic and cytologic diagnoses. These data enabled us to contrast risk profiles of women in these various diagnostic categories. Study participants were selected from women patients referred to the institution because of abnormal Pap test results by county and city health departments, from publicly funded city familyplanning clinics, and from private physicians. Study participants had registered at the cancer center during October 1985 through February 1989 and were respondents to our self-administered risk-factor questionnaires. This instrument is the central component of our Patient
241
242
M. R. SPTTZ et al
Table 1. Select demographic variables by histologic diagnoses*
Downloaded by [Australian Catholic University] at 10:29 01 September 2017
Cervical condyloma
ON
CIS
Race White Black Hispanic Other
29 (35.4) 43 (52.4) 10 (12.2)
83 (48.5) 67 (39.2) 21 (12.3)
37 (78.7) 6 (12.8) 4 (8.5)
Total
Squamous cell carcinoma
54 12 7 4
(70.1) (15.6) (9.1) (5.2)
Adenocarcinoma
/•value
19 (90.5) 2 (9.5)
82
171
47
77
21
ISSN: 0885-8195 (Print) 1543-0154 (Online) Journal homepage: http://www.tandfonline.com/loi/hjce20
Risk profiles of women with cervical neoplasia Margaret R. Spitz , Michele F. Mitchell , John J. Fueger & Guy R. Newell To cite this article: Margaret R. Spitz , Michele F. Mitchell , John J. Fueger & Guy R. Newell (1991) Risk profiles of women with cervical neoplasia, Journal of Cancer Education, 6:4, 241-246 To link to this article: http://dx.doi.org/10.1080/08858199109528128
Published online: 01 Oct 2009.
Submit your article to this journal
Article views: 2
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=hjce20 Download by: [Australian Catholic University]
Date: 01 September 2017, At: 10:29
J. Cancer Education. Vol. 6, No. 4, pp. 241-246, 1991 Printed in the U.S.A. Pergamon Press pic
0885-8195/91 $3.00 + .00 © 1991 American Association for Cancer Education
RISK PROFILES OF WOMEN WITH CERVICAL NEOPLASIA
Downloaded by [Australian Catholic University] at 10:29 01 September 2017
MARGARET R. SPITZ;* MICHELE F. MITCHELL;† JOHN J. FUEGER;* GUY R. NEWELL*
Abstract — Risk-factor profiles were compared in M. D. Anderson Cancer Center patients with various uterine cervix histologic diagnoses. Intraepithelial neoplasia (n = 171) and condyloma (n = 82) were associated with significantly lower patient age (mean 23.6 and 25.8 years, respectively). In addition, these two groups were lowest in annual income, age at beginning intercourse and at first pregnancy, and highest in percentages of black and Hispanic patients, number of sexual partners, and history of gonorrhea. Women with squamous carcinoma in situ (n = 47), who were about a decade older, exhibited a similar socioeconomic distribution and sexual history. All three groups also reported high prevalences of current smokers, were most likely to use oral contraceptives, and were least likely to use diaphragms or condoms. Patients with invasive squamous cell carcinoma (n = 77) had a mean age of 46.3 years, a large lowest-income constituency, and the highest mean number of pregnancies; they were least likely to have used oral contraceptives. Adenocarcinoma (n = 21) was epidemiologically distinct: a predominance of white women characterized by high socioeconomic status, elevated body mass index, and none of the liberal sexual practices of the other groups. Primary and secondary prevention strategies must be tailored to the unique needs and socioeconomic status of the young at-risk populations.
INTRODUCTION The continuum of cervical disease that begins with mild dysplasia, ranges through carcinomain-situ (CIS), and ends with invasive squamous carcinoma has well-delineated epidemiologic characteristics. In contrast, the risk profile of women with cervical adenocarcinoma is not clearly characterized despite its reported increase in incidence relative to all invasive cervical cancers.1'2 There is a similar lack of definition concerning risk factors for cervical human papillomavirus (HPV) infection, although there are cytologic and morphologic features (eg, koilocytosis) that taken together facilitate the diagnosis of HPV infection.3 It is well established that early detection and effective treatment of cervical cancer precursors prevent the development of invasive cervical cancer. Since the women at risk are often the socioeconomically disadvantaged constituency, culturally sensitive and specifically targeted ed*Department of Cancer Prevention and Control; †Department of Gynecology, The University of Texas M. D. Anderson Cancer Center, Houston. Reprint requests to: Dr. Margaret R. Spitz, Department of Cancer Prevention and Control, Box 189, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030.
ucational programs are needed to achieve success in primary and secondary prevention. The purpose of this study was to delineate risk profiles of women with cervical diseases, since an understanding of the prevalence of risk factors can improve the development of succinct and meaningful educational messages. MATERIAL AND METHODS The Department of Cancer Prevention and Control at The University of Texas M. D. Anderson Cancer Center maintains an automated risk factor database that includes self-reported information on lifestyle practices of patients, including indices of sexual behavior and smoking status, together with histologic and cytologic diagnoses. These data enabled us to contrast risk profiles of women in these various diagnostic categories. Study participants were selected from women patients referred to the institution because of abnormal Pap test results by county and city health departments, from publicly funded city familyplanning clinics, and from private physicians. Study participants had registered at the cancer center during October 1985 through February 1989 and were respondents to our self-administered risk-factor questionnaires. This instrument is the central component of our Patient
241
242
M. R. SPTTZ et al
Table 1. Select demographic variables by histologic diagnoses*
Downloaded by [Australian Catholic University] at 10:29 01 September 2017
Cervical condyloma
ON
CIS
Race White Black Hispanic Other
29 (35.4) 43 (52.4) 10 (12.2)
83 (48.5) 67 (39.2) 21 (12.3)
37 (78.7) 6 (12.8) 4 (8.5)
Total
Squamous cell carcinoma
54 12 7 4
(70.1) (15.6) (9.1) (5.2)
Adenocarcinoma
/•value
19 (90.5) 2 (9.5)
82
171
47
77
21
