| Objective To investigate risk factors of cervical cancer and HPV (human papillomavirus, HPV) persistence, provide the basis for the prevention of cervical cancer.Methods The data based on a cross-sectional screening study in Yangcheng and Xiangyuan Counties, Shanxi Province which the cervical cancer was very popular. All cases were confirmed by histology. The cervical cytological samples were collected by self-sampling and direct-sampling methods. The HPV DNA was analyzed by Hybrid Capture Assay (HC), which could detect 13 HPV types. Questionnaires included baseline information, menstrual/marital/ pregnant histories, sexual behavior, health habits, contraception, medical history and family history of cancer. x2test, t test and unconditional logistic regression model were used for data analysis by SPSS 10.0.Results1. Prevalence rate of cervical cancer (including CIN3, cervical intraepithelial neoplasm )Subjects were divided into five age groups(<35, 35~39, 40~44, 45~49, >49 years old).In Xiangyuan county, the prevalence rates of the five groups for cervical cancer were 0.8%, 1.5%, 1.9%, 3.1% and 3.3% respectively, while in Yangcheng county, that were 1.1%, 2.2%, 3.2%, 4.5% and 4.9% respectively. The elder women had more probability suffering from cervical cancer.In Xiangyuan county, the prevalence rate of cervical cancer was was 2.0%, while in Yangcheng county, that was 3.0%.Rates of the two county has significant difference ( x2 =9.601, P=0.002).2. HPV infection and cervical cancerThe prevalence rates of HPV infection and HPV persistence were 20% and 12.9% in the investigated region. The prevalence rates of HPV infection were increased with the serious of cervical lesions ( x2 =2469.3, P=0.000).Contracted with the normal group, the ORs of HPV infection and HPV persistence were 142.8(73.0~279.2) and 361.1 (185.1~704.4). The HPV titration was increased with the serious of cervical lesions. There are more opportunities to get cervical cancer if subjects were in higher titrationspersistent state.3. Risk factors of cervical cancerUnivariate analysis showed that risk factors with statistical significance included age, pregnancy times, age at first sexual intercourse, HPV infection, HPV persistence, HPV titration et al. Analysis with non-conditional logistic regression model revealed that age, HPV persistence and HPV titration was obviously associated with the occurrence of cervical cancer. In addition, compared with the two countries, factors which included age, pregnancy times, age at first sexual intercourse, number of sexual partners, HPV infection, HPV persistence and HPV titration were the same. However, in Yangcheng, first menstrual period, menstrual periods and cervicitis/polyp had statistical significance, while in Xiangyuan, pregnancy times, tuberculosis and the number of sexual partners had statistical significance.4. Related factors of HPV persistence and HPV titrationUnivariate analysis showed that risk factors with statistical significance included age, pregnancy times, birth times, smoking, menstrual periods, the number of sexual partners, tuberculosis. Analysis with non-conditional logistic regression model revealed that smoking, the number of sexual partners, tuberculosis, cervicitis/polyp and discharge was obviously associated with the occurrence of HPV persistence. Husband has other sexual partners, the number of sexual partners and Genital herpes were related with the factors of HPV titration.Conclusion The main risk factor for cervical cancer in this region was HPV infection, especially HPV persistence and high HPV titration. Two pronged strategy of primary prevention for cervical cancer included (1) High risk strategy: It was particularly important to detect and treat HPV persistence, especially for women who were high HPV titration. (2)The population strategy: the prevention and control of HPV persistence and HPV titration should pay attention on their relate factors, such as smoking, sexual behavior, hygienic habits during menstruation, tuberculosis, cervicitis/poly...
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