Prostitution and other cofactors in preinvasive and invasive lesions of the cervix.
OBJECTIVE
To examine risk factors for preinvasive and invasive lesions of the cervix in Venezuelan female sex workers (FSW).


METHODS
A total of 438 FSW were analysed. Each FSW had their clinical history recorded, a gynaecological examination, a Pap smear and a colposcopic examination of the cervix. A cervical biopsy was taken under colposcopic guidance when there was an abnormal epithelium. The statistical methods used were Student's t-test, chi(2) test and logistic regression.


RESULTS
The sex workers' mean age was 32.1 +/- 7.9 years old (mean +/- standard deviation). The age of the first sexual intercourse activity for the FSW was 15.9 +/- 2.1 years. Sixty-four of the 84 women (76.2%) who had cervical biopsies had preinvasive and invasive lesions; 41 (9.4%) had cervical intra-epithelial neoplasia (CIN) 1, 12 (2.7%) had CIN 2, eight (1.8%) had CIN 3, two (0.5%) had microinvasive carcinoma, and one (0.2%) had invasive carcinoma. Forty of these 64 women (62.5%) with preinvasive or invasive lesions had a concurrent histological diagnosis of human papilloma virus (HPV) infection (P < 0.0001). The FSW with cervical pathology were younger (P < 0.05) and had their first sexual intercourse earlier (P < 0.02) than FSW with no pathology. Two hundred and seventy-six (63%) of the FSW were current smokers, and 47 of these women (17.6%) had cervical pathology (P < 0.03).


CONCLUSIONS
First sexual experience before 20 years of age, cigarette smoking and HPV infection were high-risk factors for preinvasive and invasive lesions of the cervix in Venezuelan FSW.
Núñez
José T
JT
Department of Obstetrics and Gynecology, Faculty of Medicine, Manuel Noriega Trigo Hospital, University of Zulia, Maracaibo, Venezuela. jnunezt@telcel.net.ve
Delgado
Mariela
M
Girón
Hugo
H
Pino
Gloria
G
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D012307:Risk Factors; D011477:Sex Work; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000209:etiology*; D014626:Vaginal Smears; D014687:Venezuela / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000209:etiology*