Risk Factors for Cervical Cancer in Northeastern Thailand: Detailed Analyses of Sexual and Smoking Behavior

Cervical cancer is a serious public health problem in Thailand. We investigated possible risk factors forcervical cancer including HPV infection, p53 polymorphism, smoking and reproductive history among womenin Northeast Thailand using a case control study with 177 cases and age-matched controls. Among the HPVcarriers, a significantly increased risk for cervical cancer with an OR of 36.97 (p<0.001) and an adjusted OR of38.07 (p<0.001) were observed. Early age at first sexual exposure, and multiple sexual partners increased therisk of cervical cancer with ORs ranging between 1.73-2.78 (p<0.05). The interval between menarche and firstsexual intercourse <6 years resulted in a significant increase in the risk for cervical cancer with ORs rangingbetween 3.32-4.09 and the respective adjusted OR range for the 4-5 and 2-3 year-old groups were 4.09 and 2.92.A higher risk was observed among subjects whose partner had smoking habits, whether currently or formerly;with respective ORs of 3.36 (p<0.001) and 2.17 (p<0.05); and respective adjusted ORs of 2.90 (p<0.05) and 3.55(p<0.05). Other smoking characteristics of the partners including smoking duration ≥ 20 years, number ofcigarettes smokes ≥ 20 pack-years and exposure time of the subject to passive smoking ≥ 5 hrs per day were foundto be statistically significant risks for cervical cancer with adjusted ORs of 3.75, 4.04 and 11.8, respectively. Ourdata suggest that the risk of cervical cancer in Thai women is substantially associated with smoking characteristicsof the partner(s), the interval between menarche and first sexual intercourse as well as some other aspects ofsexual behavior.