Using the logistic-regression technique, a hospital-based casecontrol study of 177 married women with invasive squamouscell cervical cancer and I49 hospital-visiting controls enabled evaluation of selected reproductive factors as risks. Early age at marriage was found to be the single best predictor of the disease status. However, those who married late but gave birth to a large number of children were generally found to be suffering from cervical cancer. The results support the hypothesis that it is not so much parity per se that enhances the risk, but the rapidity of multiple pregnancies that matters. Logistic analysis also revealed the independent influence of birth interval on the risk of cervical cancer. These findings warrant serious consideration in future studies, given the obvious implications for prevention. Other implications for the prevention of cervical cancer are briefly discussed.
Carcinoma of the cervix is one of the most common malignant diseases among women in developing countries. Worldwide, it ranks second among all female cancers and fifth among all cancers (Mould and Myles, 1987). Its incidence is found to be very low in countries such as USA, Canada, England and Wales, and in the countries of Western Europe. According to the National Cancer Control l'rogramme for India, it is the most common gynaecologic malignancy obscrvcd among Indian womcn. According t o WIiO, India alone accounts for I X percent of thc more than 900,000 cervicalcancer victims in thc world each year.
Many contributing factors are believed to be responsible for the incidence of cervical cancer, hereafter referred to as CC.
Because of its direct influence on diet pattern, personal hygiene, puberty onset and life style, low socio-economic status (SES) is supposed to be one of the important risk factors associated with its incidence (Stocks, 1955). However, early sexual life, multiple pregnancies, the pre-and extramarital sex life of both male and female partners, and multiple sex partners are some of the other contributing factors for the development of CC (Brinton et al., 1987).
The majority of Indian publications on CC are based on information collcctcd from urban cancer cenfrcs and hence do not usually rcflcct the true rural picture o f this disease in India. For this reason, the present investigation wax designed t o dctcmiinc Ihc role of reproductive Ixtors in t he incidence of carcinoma o l the cervix among rural marricd wonien in the disrrict of Hankura. West Hengal. India, through a hospitabased case-control study.
Using a multiple logistic-regression technique for direct estimation of the odds ratios (OR) associated with the risk factors, the study cvaluates the risk of CC associated with the patient's age at marriage, age at first pregnancy, number of pregnancies and the avcragc interval between them, and educational level. The dependence of the OR on other 'To whom correspondence and reprint requests should be sent, at