Reproductive and infectious risk factors for invasive cervical cancer in Taiwan

A community-based case-control study was carried out to assess multiple risk factors for invasive cervical cancer in Taiwan. All of 183 cases of pathologically confirmed cervical cancer cases and 293 healthy neighborhood controls were recruited from Taipei metropolitus. Healthy controls were matched with cervical cancer cases for age and residence. Multiple risk factors for cervical cancer were obtained from study subjects through standardized interviews according to a structured questionnaire. Serotiters of antibodies to Chlamydia trachomatis (CLT), human cytomegalovirus (HCMV) and human herpes simplex virus type 2 (HSV-2) were determined by enzyme-linked immunosorbent assay. Multiple logistic regression analysis were used to derive maximum likelihood estimates of multivariate-adjusted odds ratios (AOR) and confidence intervals (CI). After adjustment for potential risk factors, parity and number of vaginal delivery were associated with an increased risk of invasive cervical cancer. The higher the number of vaginal delivery, the higher the risk of developing cervical cancer (AOR = 6.2, 95% CI = 1.7-22.6 for 7 or more deliveries compared with 0-2 deliveries as the referent group). Increased cervical cancer risk was also significantly associated with the history of chronic cervicitis (AOR = 2.1, 95% CI = 1.1-3.8) and elevated serotiters of CLT (AOR = 7.0, 95% CI = 1.7-28.9), HCMV (AOR = 4.1, 95% CI = 1.5-11.3) and HSV-2 (AOR = 2.3, 95% CI = 1.1-4.6). The use of diaphragm for contraception was found to be associated with a decreased risk of cervical cancer (AOR = 0.4, 95% CI = 0.1-1.0).