Early age at first sexual intercourse and early pregnancy are risk factors for cervical cancer in developing countries

Early age at first sexual intercourse (AFSI) has long been associated with an increased risk of invasive cervical carcinoma (ICC). Age at first pregnancy (AFP) and ICC have been investigated less, although AFSI and AFP are strongly interrelated in most developing countries. A pooled analysis of case-control studies on ICC from eight developing countries with 1864 cases and 1719 controls investigated the roles of AFSI, AFP, and ICC risk. Age at first sexual intercourse, AFP and age at first marriage (AFM) were highly interrelated and had similar ICC risk estimates. Compared with women with AFSI >= 21 years, the odds ratio (OR) of ICC was 1.80 (95% Cl: 1.50-2.39) among women with AFSI 17-20 years and 2.31 (95% Cl: 1.85-2.87) for AFSI <= 16 years (P-trend < 0.001). No statistical interaction was detected between AFSI and any established risk factors for ICC. The ICC risk was 2.4-fold among those who reported AFSI and AFP at <= 16 years compared with those with AFSI and AFP at >= 21 years. These data confirm AFSI and AFB as risk factors for ICC in eight developing countries, but any independent effects of these two events could not be distinguished. British Journal of Cancer (2009) 100, 1191-1197. doi: 10.1038/sj.bjc.6604974 www.bjcancer.com