【摘要】 背景与目的:宫颈癌是最常见的妇科恶性肿瘤,发病率仅次于乳腺癌,其病因至今尚未完全明了。本研究旨在探讨中国已婚妇女宫颈癌发生的影响因素,为预防和控制宫颈癌的发生提供循证依据。方法:以"宫颈癌"、"危险因素"、"影响因素"和"病例对照"为检索词,收集1986—2009年的15篇关于中国已婚妇女宫颈癌发病有关的研究,应用Meta分析的Mantl-Haensel固定效应模型及Dersimonion-Laird随机效应模型,综合定量评价宫颈癌危险因素的作用。结果:纳入本次meta分析的15篇研究文献中,累计宫颈癌病例2 591例,对照7 731例。各因素的合并OR值及其95%CI为:人类乳头瘤病毒(HPV)感染:217.06(90.49～520.64)、人工流产次数:3.63(2.18～6.04)、性伴侣:2.68(1.92～3.74)、被动吸烟:2.64(1.78～3.93)、丈夫包皮过长:2.26(1.46～3.51)、宫颈肿瘤家族史:2.21(1.69～2.89)、早婚:2.05(1.42～2.94)、精神创伤:1.95(1.63～2.34)、结婚次数:1.92(1.42～2.59)、吸烟:1.91(1.56～2.35)、多产:1.85(1.30～2.64)、初产年龄过早:1.80(1.24～1.83)、饮茶:0.42(0.28～0.62)、多食蔬菜:0.22(0.11～0.45)。结论:影响中国已婚妇女宫颈癌发生的主要危险因素是:HPV感染、人工流产次数、性伴侣、被动吸烟、丈夫包皮过长、宫颈肿瘤家族史、早婚、精神创伤、结婚次数、吸烟、多产及初产年龄过早;保护因素是:多食蔬菜及饮茶。更多还原

【Abstract】 Background and purpose:Cervical cancer is the most common form of malignant gynecologic tumor.The incidence rate was ranked as second place in women with cancer.However,the etiology of cervical cancer is not fully understood yet.This study investigated the factors that influence cervical cancer among married women in China and try to raise the suggestion for the better prevention and control of cervical cancer.Methods:Fifteen case-control studies from 1986 to 2009 were collected from research literatures using keywords such as ‘cervical cancer’,‘risk factors’,‘influential factors’ and ‘case-control study’.We adopted the Mentel-Haensel fixed effect model and Dersimonion-Laird random effect model to gain a comprehensive and quantitative assessment of cervical cancer and its risk factors.Results:Among the 15 case-control studies,the total number of cases and controls were 2 591 and 7 731,respectively.The combined OR value and its 95% CI value for each risk factor were:HPV:217.06(90.49-520.64),number of abortions:3.63(2.18-6.04),number of sexual partners:2.68(1.92-3.74),exposure to second hand smoke:2.64(1.78-3.93),length of husband’s foreskin being too long:2.26(1.46-3.51),family history of cervical cancer:2.21(1.69-2.89),early marriage:2.05(1.42-2.94),psychic trauma:1.95(1.63-2.34),number of times married:1.92(1.56-2.35),rate of prolificacy:1.85(1.30-2.64),early reproduction:1.80(1.24-1.83),eating more vegetables:0.22(0.11-0.45)and drinking tea:0.42(0.28-0.62).Conclusion:The major risk factors for cervical cancer among married women in China are:HPV,number of abortions,number of sexual partners,exposure to second hand smoke,length of husband’s foreskin being too long,family history of cervical cancer,early marriage,psychic trauma,number of times married,smoking,rate of prolificacy,and early reproduction.Protective factors include eating more vegetables and drinking tea.更多还原