Limited education as a risk factor in cervical cancer.
Corral F, Cueva P, Yépez J, Montes E.
National Tumor Registry, Society for the Struggle against Cancer (Registro Nacional de Tumores, Sociedad de Lucha contra el Cáncer-SOLCA), Quito, Ecuador.
The study reported here analyzes the influence of formal education on the behavior and age at onset of carcinoma of the cervix in 2204 women in Quito, Ecuador, between 1985 and 1994. The results indicate that education had a considerable degree of influence on the behavior of this neoplasia. That is, women with primary education or less were found to have almost twice the cervical cancer incidence of those with secondary or higher education, while those who were illiterate had almost six times the incidence found among university-educated women. Overall, it seems reasonable to consider women's education a key factor in defining risk groups for cervical cancer-so much so that grouping by instructional level would make it possible to improve the effectiveness of cervical cytology-based preventive measures.
PIP: To investigate the association between formal education and cervical cancer incidence, the 2204 cervical cancer cases from Quito, Ecuador, reported to the National Tumor Registry for the 1985-94 period were reviewed. The incidence of cervical cancer (in situ and invasive) per 100,000 women was 88.3 among women with no education, 52.6 among those with a primary education, 28.8 among women with a secondary education, and 14.9 among those with a university education. Invasive cervical cancer incidence among women with no more than a primary education rose sharply from the 20-24 year group to the 55-59 year group, declined slightly in the 60-64 year group, then peaked at 123 cases/100,000 women 65 years and over. Among those with a secondary education, incidence peaked at 72.5 cases/100,000 in the 55-59-year group. Among women with higher education, the incidence was only 8.6/100,000 in the 40-44 year group, remained under 30 in the 45-49 and 50-54-year groups, and peaked at 44/100,000 in women 65 years and over. A similar pattern was observed for in situ carcinoma. Among illiterate women, only 13.1% of cancers were detected at stage I compared with 48.5% among women with a secondary or higher education; conversely, 51.7% of cancers among illiterate women were detected in the advanced stages III and IV compared with 21.8% among those with a secondary or higher education. These findings suggest the feasibility of considering women's education a significant factor in defining risk groups for cervical cancer.
PMID: 9041743 [PubMed - indexed for MEDLINE]