Factors Associated with Development of High-Grade Squamous Intraepithelial Lesions of the Uterine Cervix in Women Younger than 30 Years

摘要

Objective: To determine the factors associated with the increased risk of developing high-grade squamousintraepithelial lesions (HSIL) of the uterine cervix in women younger than 30 years compared with those aged ≥ 30years who also had HSIL. Methods: Patients with HSIL who underwent loop electrosurgical excision procedure (LEEP)between January 2006 and July 2017 at Chiang Mai University Hospital were retrospectively reviewed. We analyzedthe factors associated with the development of HSIL by comparing two age groups between women aged 30 yearsand those aged ≥ 30 years. The factors analyzed included the well-recognized risk factors for cervical cancer, i.e. ageat sexual debut, number of sexual partners, use of oral contraceptive (OC) pills, smoking history, sexually transmitteddiseases and HIV status. Univariate and multivariate logistic regressions were used to assess factors associated withthe increased risk of developing HSIL in women younger than 30 years compared with those aged ≥ 30 years. Results:During the study period, there were 345 patients with HSIL, 30 were 30 years (case group) and 315 aged ≥ 30 years(control group). By multivariate analyses , early sexual debut(OR, 2.86; 95% CI, 1.01-8.13; P=0.047), multiple sexualpartners (OR, 2.94; 95% CI, 1.23-7.02; P=0.015), history of genital warts (OR, 20.46; 95% CI, 2.27-183.72; P=0.007)and history of smoking (OR, 2.95; 95% CI, 1.10-7.93; P=0.032) were significantly associated with the developmentof HSIL in women younger than 30 years when compared with those aged ≥ 30 years. The OC use, HIV status andunderlying diseases were not significantly different in both groups. Conclusion: Early age at sexual debut, multiplesexual partners, history of genital warts and smoking are significant risk factors for developing HSIL in women youngerthan 30 years. Cervical cancer screening should be considered in young women with such factors.