[Gonorrhea infection as a risk indicator for cervix cancer]

The epidemiology of cervical cancer suggests that, like a venereal disease, it is transmitted by sexual intercourse. Out of 164 women who had gonorrhea in 1954 and 1959, preinvasive cervical cancer was diagnosed in 29 (17.7%) and invasive cervical cancer in 8 (4.9%) 23 and 24 years later respectively. Preinvasive and invasive cervical cancers were also still developing toward the end of the observation period, and for this reason the incidence of cervical cancer was investigated again in the same group of women 30 and 31 years, respectively, after the gonorrhea. Two more preinvasive and two invasive cervical cancers were diagnosed, bringing the total number of women who had had gonorrhea and subsequently had a cervical malignancy to 40 (24.4%). In the control group, of the same age and from the same urban population, cervical malignancy occurred in 9 cases (5.6%; p less than 0.001). This corresponds to a 4.4-fold relative risk in the cohort of gonorrhea patients. The fact that 25% of all women who have had gonorrhea develop a cervical malignancy indicates that a history of gonorrhea is the most unequivocal variable for predicting the subsequent development of cervical cancer. These women should be kept under closer observation; pathologic smears should be analyzed and dealt with more specifically.