BEHAVIORAL RISK-FACTORS FOR CERVICAL DYSPLASIA
Keywords:economic, demographic, behavioral, risk-factors, cervical dysplasia, Adjara
Objectives. The aim of our study was to study socio-economic, demographic and behavioral risk- factors for the development of cervical dysplasia (CD) in the Adjara region.
Methods. 775 women of the Adjara region (age 25-60) were examined, who were referred to obstetrics and gynecology clinics, where all of them underwent a PAP testing, colposcopic examination and, if necessary, morphological study. The study participants were divided according to geographical location (mountain and seaside): group 1 – Mountainous Adjara (n=194; mean age - 40.10 ± 8.85 years), Group 2 - Seaside Adjara (n=581; mean age - 40.10 ± 8.85 years). The characteristics of eating behavior and sleep regimen have been studied by special structured questionnaire. The education level, marital and employment status, and family income were studied.
Results. 89 out of 775 patients (11.48%) were finally diagnosed by morphological examination. Distribution of percentages clearly showed that the number of patients with CD was significantly higher in mountainous Adjara (n=28, 14.43%) compared to residents of seaside Adjara (n=54, 9.29%) (RR=1.55, p =0.043). Marital status was not a significant risk factor for CD (p=NS) as well as family income level (p=NS). The significant risk factors from eating behavior disorders were: protein-lack food (RR=1.37; p=0.021), breakfast skipping (RR=2.67; p<0.001), infrequent (<3) meal intakes (RR=1.33; p=0.043). Among sleep disorders, the following are significant: overall sleep disorders (RR=1.61; p=0.041); chronic insomnia (RR=9.24; p<0.001); excessive sleepiness (RR=34.68; p<0.001).
The analysis of cervical background diseases showed that there is a significant difference in the percentage of cervical erosions between the groups [31 (34.8%) vs. 125 (18.2%); RR=2.21, 95% CI – 1.64-2.99; p<0.001].
Conclusion. The results of the study showed the role of behavioral disorders on the development of CD. In particular, the frequency of food intake, breakfast skipping, low-protein diet and sleep disorders should be considered as the basis for the development of energy imbalance, which, in turn, has a significant impact on the formation of CD. However, the evidence of our results needs to be confirmed by further randomized controlled trials to reach strong and evidence-based conclusions
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