BEHAVIORAL RISK-FACTORS FOR CERVICAL DYSPLASIA
DOI:
https://doi.org/10.52340/jecm.2023.05.03Keywords:
economic, demographic, behavioral, risk-factors, cervical dysplasia, AdjaraAbstract
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
Downloads
References
Siegel RL, Miller KD, Jemal A.Cancer Statistics, 2019. CA Cancer J Clin. 2019;69(1):7–34.
დაავადებათა კონტროლის ეროვნული ცენტრი. ონკოლოგიური დაავადებები, ონკოლოგიურ დაავადებათა საქართველოში გავრეცელების თავისებურებები, 2016, ეპიდემიოლოგიური ბიულეტენი, 2016, 21(10-11):1-32.
Si C.J., Shu L., Zheng P.F., Zhang X.Y., Yu X.L., Gao W., Zhang L. Dietary patterns and endometrial cancer: A meta-analysis. Eur. J. Cancer Prev. 2017; 26:336–345.
Brennan S.F., Cantwell M.M., Cardwell C.R., Velentzis L.S., Woodside J.V. Dietary patterns and breast cancer risk: A systematic review and meta-analysis. Am. J. Clin. Nutr. 2010; 91:1294–1302.
Sedjo R. L., Roe D. J., Abrahamsen M., et al. Vitamin A, carotenoids, and risk of persistent oncogenic human papillomavirus infection. Cancer Epidemiology and Prevention Biomarkers. 2002;11(9):876–884.
Barchitta M, Maugeri A, Quattrocchi A, Agrifoglio O, Scalisi A, and Agodi A. The Association of Dietary Patterns with High-Risk Human Papillomavirus Infection and Cervical Cancer: A Cross-Sectional Study in Italy. Nutrients. 2018; 10(4):469.
Wen X, Wen D, Yang Y, Chen Y, Akazawa K, Liu Y, Shan B. Urban-rural disparity in cervical cancer in China and feasible interventions for tackling the rural excess. Medicine (Baltimore). 2019; 98(1): e13907.
González CA, Travier N, Luján-Barroso L, Castellsagué X, Bosch FX, Roura E, Bueno-de-Mesquita HB, Palli D, Boeing H, Pala V et al. Dietary factors and in situ and invasive cervical cancer risk in the European prospective investigation into cancer and nutrition study. Int. J. Cancer 2011; 129:449–459.
Zhang X, Dai B, Zhang B, Wang Z. Vitamin a and risk of cervical cancer: A meta-analysis. Gynecol. Oncol. 2012; 124:366–373.
Zhou X, Meng Y. Association between serum folate level and cervical cancer: A meta-analysis. Arch. Gynecol. Obstet. 2016; 293:871–877.
Cao D, Shen K, Li Z, Xu Y, Wu D. Association between vitamin C intake and the risk of cervical neoplasia: A meta-analysis. Nutr. Cancer 2016; 68:48–57.
Hwang JH, Lee JK, Kim TJ, Kim MK. The association between fruit and vegetable consumption and HPV viral load in high-risk HPV-positive women with cervical intraepithelial neoplasia. Cancer Causes. Control. 2010; 21:51–59.
Siegel EM, Salemi JL, Villa LL, Ferenczy A, Franco EL, Giuliano AR. Dietary consumption of antioxidant nutrients and risk of incident cervical intraepithelial neoplasia. Gynecol. Oncol. 2010; 118:289–294.
Guo L, Zhu H, Lin C, Che J, Tian X, Han S, Zhao H, Zhu Y, Mao D. Associations between antioxidant vitamins and the risk of invasive cervical cancer in chinese women: A case-control study. Sci. Rep. 2015; 5:13607.
Kim J, Kim MK, Lee JK, Kim JH, Son SK, Song ES, Lee KB, Lee JP, Lee JM, Yun YM. Intakes of vitamin A, C, and E, and beta-carotene are associated with risk of cervical cancer: A case-control study in Korea. Nutr. Cancer 2010; 62:181–189.
Tomita LY, Longatto Filho A, Costa MC, Andreoli MA, Villa LL, Franco EL, Cardoso MA. Diet andserum micronutrients in relation to cervical neoplasia and cancer among low-income Brazilian women. Int.J. Cancer 2010; 126:703–714.
Piyathilake CJ, Henao OL, Macaluso M, Cornwell PE, Meleth S, Heimburger DC, Partridge EE. Folate is associated with the natural history of high-risk human papillomaviruses. Cancer Res. 2004; 64:8788–8793.
García-Closas R, Castellsagué X, Bosch X, González CA. The role of diet and nutrition in cervical carcinogenesis: A review of recent evidence. Int. J. Cancer 2005; 117:629–637.
Reddy L, Odhav B, Bhoola KD. Natural products for cancer prevention: A global perspective. Pharmacol. Ther. 2003; 99:1–13.
Field CJ, Johnson IR, Schley PD. Nutrients and their role in host resistance to infection. J. Leukoc. Biol. 2002; 71:16–32.
Lukac A, Sulovic N, Smiljic S, Ilic AN, Saban O. The Prevalence of the Most Important Risk Factors Associated with Cervical Cancer. Mater Sociomed. 2018; 30(2):131–135.
Comparetto C, Borruto F. Cervical cancer screening: A never-ending developing program. World J Clin Cases. 2015 Jul 16; 3(7):614-24.
Parada R, Morales R, Giuliano AR, Cruz A, Castellsagué X, Lazcano-Ponce E. Prevalence, concordance and determinants of human papillomavirus infection among heterosexual partners in a rural region in central Mexico. BMC Infect Dis. 2010; 10:223.
Sellix MT, Menaker M. Circadian clocks in mammalian reproductive physiology: effects of the "other" biological clock on fertility. Discov Med 2011; 11(59):273-81.
Pendergast FJ, Livingstone KM, Worsley A, McNaughton SA. Correlates of meal skipping in young adults: a systematic review. Int J Behav Nutr Phys Act 2016; 13(1):125-39.
Bowen J, Brindal E, James-Martin G, Noakes M. Randomized Trial of a High Protein, Partial Meal Replacement Program with or without Alternate Day Fasting: Similar Effects on Weight Loss, Retention Status, Nutritional, Metabolic, and Behavioral Outcomes. Nutrients 2018; 10(9):1145-60.
Downloads
Published
How to Cite
Issue
Section
