Creation of risk index for premalignant changes of the uterine cervix

摘要

Objective: To construct a risk index for premalignant changes in the cervix uteri based on histopathological examination (HP) of biopsy of the cervix, in relation to demographic determinants, sexual behavior, and barriers for the implementation of preventive gynecological practice. Materials and Methods: The study included 525 patients; 90 had abnormal PAP test (ASC-US, L-SIL, H-SIL, and AIS). In 85 participants with unsatisfactory findings after colposcopy, targeted biopsy was performed. In 54 patients premalignant changes in the cervix uteri were found. The control group was represented by 31 respondents with benign changes in the cervix uteri. Distributions frequency of selected variables (socio-demographic and factors relating to the behavior associated with risk of cervical cancer) are shown in comparison to HP biopsy (benign /L-SIL, H-SIL, and CIS) and significance of the differences was tested by chisquare test. For a minimum level of statistical significance, p 0.05 was used, while p 0.01 was taken as statistically high significance. Variables that showed high significance after univariate logistic regression are further tested by multivariate analysis, and association is expressed through odds ratio and 95% confidence interval. Results: The authors presented factors that showed high statistical significance, making the risk model for development of malignancy on cervix uteri: the early onset of sexual activity, sexually transmitted diseases in the personal history, and the negative attitude in taking the Pap smear. Conclusion: The application of the model of risk index for cervical cancer would be helpful for doctors in primary healthcare in identifying women at increased risk, primarily in developing countries, such as Serbia.