Prostitution, condom use, and invasive squamous cell cervical cancer in Thailand
Thomas, D.B.; Ray, R.M.; Pardthaisong, T.; Chutivongse, S.; Koetsawang, S.; Silpisornkosol, S.; Virutamasen, P.; Christopherson, W.M.; Melnick, J.L.; Meirik, O.; Farley, T.M.; Riotton, G.
American Journal of Epidemiology 143(8): 779-786
1996
ISSN/ISBN: 0002-9262 PMID: 8610687 DOI: 10.1093/oxfordjournals.aje.a008815Document Number: 295870
Researchers compared data on 225 Thai married women with invasive squamous cell cervical cancer admitted to Siriraj and Chulalongkorn hospitals in Bangkok and at Maharaj Nakorn Chiang Mai Hospital during October 1979-September 1998 with data on 791 hospitalized Thai controls to examine the role of male sexual behavior and prostitution in the development of cervical cancer and the likely protective effect of condom use against cervical cancer. All the cases and controls claimed to have had only one sexual partner. Interviews were conducted with the husbands of all the cases and controls. There was a significant trend of increasing risk of cervical cancer as the frequency of husband's condom use with prostitutes declined (p = 0.004) (relative risk [RR] = 2.05 for rarely or never, 1.24 for sometimes, and 0.96 for always or frequently). The increasing risk of cervical cancer associated with little or no condom use with prostitutes was highest when the husbands were less than 30 years old (RR = 2.11 vs. 1.56-1.81 for age 20 or older). There was a weaker trend of increasing risk of cervical cancer with the husband's estimated lifetime total number of visits to prostitutes (p = 0.12). On average, the latent period between the wife's likely first exposure to a sexually transmitted oncogenic agent (i.e., date of their marriage) and her diagnosis of invasive cervical cancer was 24 years. These findings indicate the condom use with prostitutes would reduce the risk of cervical cancer.