Determinants of the geographic variation of invasive cervical cancer in Costa Rica

The incidence of cervical cancer in Costa Rica is about twice as high in the coastal regions as in the interior. To study these regional variation, we used data from a 1986-1987 case-control study of 192 Costa Rican women with invasive cervical cancer and 372 controls. Risk factors identified included the following: The study participant's (1) number of sexual partner, (2) age at first sexual intercourse, (3) number of live births, (4) presence of type 16/18 human papillomavirus (HPV) DNA, (5) venereal disease (VD) history, (6) Pap smear history, and (7) socioeconomic status. The adjusted relative risk (RR) and 95 percent confidence intervals (CI) for each of these risk factors were as follows: (1) -4 vs. 1 sexual partner: RR = 2.0,95 percent CI = 1.1-3.5; (2) age of initiation -15 vs. 18 years: RR = 1.5, 95 percent CI = 0.9-2.5; (3) -6 vs. -1 live birth: RR = 1.7, 95 percent CI = 0.7-3.9; (4) HPV 16/18 DNA in cervix: RR = 2.8, 95 percent CI = 1.9-4.2; (5) VD history: RR = 2.2, 95 percent CI 1.2-4.0; (6) no Pap smear; RR = 2.4 95 percent CI = 1.5-3.8; and (7) low socioeconomic status: RR = 2.0, 95 percent CI = 1.2-3.2. The population-attibutable risk related to HPV detection, four or more sexual partners, six or more live births, no prior Pap smear, and low socioeconomic status were 39 percent, 38 percent, 29 percent, and 22 percent, respectively

Cáncer de cérvix en Costa Rica: primera parte / Cervical cancer in Costa Rica: 1st part

El Cáncer Cérvico-uterino es un problema de salud pública en América Latina y su incidencia sobrepasa las incidencias del mundo, siendo también la primera causa de mortalidad femenina en América Latina representando entre el 20-40% de las muertes femeninas. Su incidencia entre las mujeres de 20-54 años, en América Latina, es de 1:1000 mujeres por año. Costa Rica presenta una incidencia de 20.2/100.000 mujeres, lo cual nos coloca entre los países de riesgo intermedio junto con Colombia. Siendo países de alto riesgo: República Dominicana-Chile-Paramá-Barbados y Países de Bajo Riesgo: Cuba Uruguay. Se discute la incidencia del Cáncer de Cérvix en Costa Rica comparado con el resto del mundo y se propone realizar una nueva Campaña Nacional para detectar todos los casos y así reducir el índice de mortalidad de esta terrible enfermedad