MQT SO YtU TO NGUY CO MAC UNG THU- C6 TCT CUNG tf PHU UKf Tif 30 D^N 65 TUOl: K^T QUA NGHIEN CLTU BENH CHU'NG TAI B A C N I N H V A C A N THO 2013
IVan Thj Dfte Hanh'*, Vfl Thj Hoing Lan', Ngnyln Thanh BinhS Bui Thi Thu H i ' 'Tru&ng Dai hpc Yti cong cpng
'S& Yti Bdc Ninh T O M T A T
Ung thi/ d td cung Id loai ung thu- thu&ng gdp vd gdy td vong hang diu d phy n& tren todn thi gi6i vd tai Vidt Nam. Theo s l lifu gidm sdt tinh hlnh mic ung thi/. tai Vi§t Nam, Ung thi/ co td cung Id mdt trong 5 loai ung ttiu pho bien d nO gidi. Nghien cdu tidnh chdng dui^c t i ^ hdnh nham tim hilu mpt s l ylu to nguy ca gdy Ung ttil/ c6 td cung d phg nO td 30 din 65 hjii tai Bic Ninh vd Cin Tho nam 2013 Ting s l dd c6 150 tmdng hop bdnh vd 200 tnremg hgp chdng tham gia nghidn a>u Kit qua cho thiy cdc ylu to lam tdng nguy co phdt Inin cdc tin thutyng tien ung thu d td cung nhu- dd tdng sd dyng vidn uing trdnh thai {OR=6,69, KTC 95%:2,98- 15,01), ting s l lln anh con (OR=1.73; KTC 95%: 1.32-2.28) vd uing nitpj (OR=10.1; KTC 95%: 2,00-51,1).
Cdc ylu t i bdo v | bao gim dilu ki|n kinh t l khd (OR=0.49; KTC 95%: 0.18 - 0,77), dang sd dgng thulc uing trdnh thai (OR=0.19; KTC 95%: 0,05 - 0.75), tuli quan hf tinh dgc lln diu tren 18 tuli (OR=0,77; KTC 95%
0.68 - 0,89) vd vide dd tu-ng can thidp bd thai (OR=0.20; KTC 95%: 0,11 - 0,37). Kit qud nghidn cdu gpi y cdc nhdm uu tidn can thidp (nhdm nguy co cao) nhim Idm gidm tinh trgng mdc cdc ton ttiumig tiln ung thi/ vd ung thu d td cung d cdc phg nO dd lap gia dinh td 30 din 65 tuli.
Td khoa: Ung thu c l td cung, phg nCr, Bdc Ninh. Cin Tho
I. DAT VAN DE
Ung tiiu cfl tii eung (UTCTC) Ii Ioai ung thu thudng gip fi nft, dftng hing thft ba ttong cie logi ung thu noi chung va dftng thu tu ttong so cic nguyen nhin gay tti vong d phy nft tten toin tiifi gifii [I]. Nam 2008, UTCTC ehifim 9% (529.800 ea) ttong tflng sfl cic truomg hpp ung thu moi loin ciu vi ehifim 8% (275,100 ca) ttong tflng sfl cie trudng hop tft vong d nft gifii, v i phin Idn xiy ra o cie nudc dang phit trifin [1]. Tai Viet Nam, theo sfi lipu giim sat tinh hinh mic ung tiiu, 2001-2004, UTCTC li mpt ttong 5 loai ung thu phfl bifin a nft gifii.
Trfin thfi gidi, cie yfiu tfi nguy co efta UTCTC da dupc ghi nhin bdi rit nhifiu eie nghifin eftu, bao gfim vi-rut HPV, quan he tinh dpe (QHTD) sdm ho$c QHTD vdi nhifiu ban tinh, su dpng thufle ttinh thai, sinh dfi nhifiu, but thuflc ii, chfi dfi dinh duang, tufli, ehung tpc, tifin sft gia
dinh [2]. Tuy nhifin, tai Viet Nam, hifn nay chi cfi rapt sfl it nghien cftu vfi nhiing yeu to nguy ea liem ting dfii voi viee phil trifin t6n tiiuong tifin ung tiiu/UTCTC. Vi viy, dfi tim hifiu cp the ban vfi cic yfiu to nguy co dfii vfii tifin ung thu/UTCTC die trung a phu nft Vift nam, mftc dp inh hufimg efta cic yfiu lfl nguy CO vi thye hifn ehuong trinh mpc lieu quflc gia phong chfing ung thu 2012-2015, nghifin eftu niy dupc tifin hanh nham xae djnh eic yeu lfi nguy CO gay UTCTC d phu nft d i lap gia dinh 30 dfin 65 tiifli tai Bie Ninh vi Cin Tha, 2013.
II. PHlTONG P H A P NGHIEN ClTU 2.1 Tbi^t k^ nghifin cum
Nghifin Cliu bfnh ehftng dupc tifin hinh dfi tim hifiu eie yeu tfi nguy co dfii voi cac tfln thuang tien ung ihuAmg Ihu co tft cimg d nhom doi tupng php
•T6c gia: Tran Thj Due Hanh Ota chi Trudng D^i hpc Y te cong cpng Di?n tho^: (04)3 736 5896/09 19864183 Email: ttdh@ hsph.edu. vn
Ngdy nh|n bai: 02/03/2015 Ngiy phan bien-31/03/2015 Ngay dang bai: 20/04/2015
Tgp ehi Y bpc dy phfing. Tip XXV, Sfi 3 (163) 2015
nft di 1^ gja fflnh 30-65 tufli tgi Bic Ninh vi c i n Tho nam 2013, do diy lidp ttifii cot/If mfii mic UTCTC eao nhit lgi Vift Nam [ I ].
2.2 Mau nghien cum
Cfi mau nghien cftu dupe tinh theo eong thftc eua Tfl chfte Y tfi thfi gifii khuyfin cio, ip dyng cho nghien eftu bfnh ehftng [3]:
[Z,.„„ V2P,(1-P,) + Z,„ VP,(1-P.) + P, (1- P,)1^
Trong dfi: n: Cd mau cho mfli nhfim, p, . ty If cie trudng hpp ehftng cfi phai nhifim p^:
ty If cac tnrdng hpp bfnh cfi phoi nhifim, lyc mau (p) = 80%, mftc y nghTa a = 0,05 va ti sfi ehfinh (OR) ufic tinh li 3,70. Ti If quan hp linh dyc sdm trudc 18 tufli fi php nft 15-65 dupc sft dyng Ii bifin phoi nhiem chinh vi ufic tinh bing 1,9% [4] (ty lp timdng hpp ehftng cfi phoi nhiem). Cfl raiu cin thifit cho nhfim bfnh v i ehftng (ti If 1:1) li 150 bfnh vi 150 ehftng.
2.3 Tifiu chuan chpn bpnh
Li lit ci tihihig trudng hpp phu nft trong dfi tuoi nghifin cftu ttfin dja bin nghifin cum, dupc chin doin tifin ung thu/UTCTC voi mftc dp ton thuang te bio efi tti eung tft CIN 3 ttfi Ifin vi tfin thuang niy li nguyfin phit, dupc xic djnh thfing qua ehin doin mfi bfinh hpe sinh thifit tir I/I/2013 dfin 30/10/2013.
2.4 Tieu chuan chpn chumg
Moi trufimg bpp bpnh, trufimg hpp chung dupc chpn ghep cip theo dja ban sinh sflng va tuoi. Cie truomg hpp chung dupe phfing vin vi lira sinh thifit dira bio kfit qui chin doin UTCTC am tinb. Dy tni ty If khfing tham gia cfta cie trudng hpp ehftng, nghifin eftm ehpn mdi 2 chiing tuong ftng. Kfit qua da cfi 150 trudng hpp bpnh vi 200 trudng hpp ehftng phft hpp tifiu ehuan tham gia vio nghifin eftu.
2.5 Thu thap v i xu* ly s6 lifu
Sfi lieu thu thgp dupc nhap vi quin ly
bang chucmg ttinh Epi Data va phin tich bing phin mfim SPSS18. Kifim djnh ANOVA, Chi- square, hfli quy logistic dupe thyc hifin dfi tun hifiu eie yfiu to nguy co giy UTCTC.
2.6 Dao dur nghi&n cum
Doi tupng dupe thflng tin diy dft vfi rape dich vi nfli dung nghifin cftu trudc khi tham gia. Sy tham gia cua cic doi tupng li hoan loin ty nguyfn, dugc thfi hifn thflng qua bin ehap nhan thara gia nghifin eftu. Dfii tupng phfing vin cfi thfi nit lui khfli nghien eftu vio bit ki thfii difim nio mi chju bit ki anh hufimg nio.
Toin bp thflng tin eua dfii tupng rai hfia, dim bio luu gift bi ragt. Nghien cuu da dupe thflng qua bdi Hpi dflng dao dfte Trufing Dai hpc Y le cflng eflng theo quy^t djnh sfi 132/2013/
YTCC-HD3 ngay 21/5/2013.
III. K E T QUA
3.1 Die diem d6i tuptig nghifin cum Trung binh tufii ciia nhfim chumg d Bic Ninh li 43,5 (dp Ifch chuin 4,5) li tuang ftng voi trung binb tuoi d nhfim bfnh li 43,0 (dp Ipeh chuin 4,1). 6 Can Tho, tuoi trung binh cua nhfim ehiing vi nhfim bfnh lin lupt li 53,7 vi 54,4 (Bing I). Ty If dfli tupng ed trinh dp hpc vin tft cap 3 ttd Ifin vi ty lfi dang a vfii ehong d nhfim ehftng cao horn so vfii d nhfira bfnh. Trong khi dfi, ty If hO nghfio ttong nhfim chirng lai thip ban (Bang 2).
Tgp ehi Y hpc dy phfing. Tip XXV, Sfi 3 (163) 2015
Bdng 1. Phan b l t u l i cua doi ttfiyng trong nghidn cdu bfnh chdng
Ddc dilm Dg lull dli hrgng tai Bdc Ninh DO tull ali tuvng tai Cin Tha
Nhdm chdng Trung binh (Dd l$ch chuan)
43,5 (4.5) 53,7 (6.7)
Nhdm bfnh Trung binh (Dp Idch chuin)
43,0(4,1) 54,4 (8,8)
Bang 2. Mpt s l dgc dilm chung ci^a d l i tinjmg trong nghidn cdu b^nh chipng
Dgc dilm Trinh dd hoc vln cao nhit ciia dli Td d p 3 hodc hon Ti> d p 2 trd xuing Hidn c6 d vd'i ching hay khdng Cd
Khdng
Dilu ki$n kinh t l h | gia dinh Nghdo (c6 chdng nhdn h i nghdo) Khdng nghdo
Nhom chijmg N(%) tuvng
71 (35,5) 129(64,5) 181 (90,5) 19(9.5) 32(16,0) 168 (84,0)
Nhom bfnh N(%) 20 (13,3) 130(86,7) 105(70,0) 45 (30,0) 35 (25,9) 100(74,1) Nghi nghidp chinh cue
Cdnbp Cdng nhdn Ldm rudng Th<? thCi cdng Budn bdn, kinh doanh N0I tr?
Nghi tir do
dli tuang
26(13.0) 12 (6,0) 57 (28.5) 6 (3.0) 54 (27.0) 24 (12.0) 21 (10.5)
10 (6,7) 5 (3,3) 80 (53.3)
0 (0,0) 25(16,7) 25(16.7) 5 (3,3)
3.2 Moi lien quan hai bien
Trong nghifin cftu niy, mfli quan hf gifta linh trang cfi cic ton thuong tifin ung thu/UTCTC vi mpt sfl die difim tifin su san phy khoa da dupc xem xet (Bing 3). Tuoi quan he tinh dye
lin diu, tuoi mang thai lan diu d nhfira chimg cao han so vdi nhfim bpnh. Tuy nhifin, long sfi lin sinh con va sfi con bifn ed eua nhfim bfnh Igi eao hom so vfii nhom edn Igi. Sy khic bift niy CO y nghta thfing kfi (Bing 3).
Bdng 3. Mpt s l dgc dilm t i l n s d sdn php khoa vd quan hd tinh dgc
Dgc dilm Nhom chdng Nhdm b|nh
Trung binh (D^ l$ch chuin) Trung binh (D? I|ch chuin) Tuli quan hd tinh dyc Idn diu*
Tull mang thai lln diu*
Ting s i lln sinh con*
S l con hi|n cd*
21,97(3.55) 23,33 (3,96) 2.25 (0.98) 2,15(0.96)
19.76(1.80) 21,92(2.73) 3.10(1,38) 2.90(1.19) ''p<O.OOI"
Tgp chi Y hpc dy phfing, T|ip XXV, Sfl 3 (163) 2015
Bang 3. M6t s l d$c dilm tiln sd sdn phg khoa va quan h$ tinh dyc (tilp) Dac diim
Oa timg bj sdy thai**
Kh6ng Cd
Da tifng can thi^p bo thai**
Khang C6
Co cdc dSu hieu liinh nguygt bit thifirng**
Khdng C6
Nh6m chi>ng (N, %) 158(79,0)
42(21) 61 (30,5) 139(69.5) 194(97.0) 6 (3,0)
Nh6m bfnh (N, %) 65 (56.7) 65 (43.3) 105 (70.0) 45 (30.0) 135 (90.0) 15(10,0) Sd dgng vidn uing trdnh thai"
Chua tdng diing Dd diing Dang dimg
156 (78.0) 18 (9,0) 26(13,0)
110(73.3) 35 (23,3) 5(3.3) Cd Ihudng xuydn uing n/gu hay khfing**
KhOng C6
198 (99,0) 2(1,0)
135(90,0) 15(10.0)
3.3 Mpt so y^u to nguy ca mic tiln ung thu cd tii' cung/ ung thu co tir cung
Kfit qui cua mfl hinh hoi quy logistic da bifin ehi ra ring, cic yfiu tfl Iim ting nguy ca phit trifin eac tfln thuomg tifin UTCTC li do di lung sft dung vifin uflng tranh thai, tfing so lan sinh con v i tinh trang uflng rupu. Nguy CO phit trien eic Ifin thuang fi nhftng phy nft hifn da timg sft dpng vifin ufing ttanh thai eao horn so vfii nhirng ngudi chua bao gifi sft dyng (OR=6,69; KTC 95%: 2,98 - 15,01). Vdi moi lan sinh eon vfi sau, nguy ea phat trifin eie ton thuang tifin ung thu efta nguoi phy nft tang Ifin 1,73 lin (OR=l,73; KTC 95%: 1,32- 2,28). Nhihig php nft cfi ufing rupu ed nguy co phat ttien cic tfln thuang tifin ung thu cao gip khoing 10 lin so voi nhiing phu nft chua hing ufing (OR=10,1; KTC 95%: 2,00-51,10).
Difiu kifn kinh tfi hfi gia dinh khi, vifc dang sft dyng thufic ufing trinh thai, tufli quan he tinh dye lin diu sau 18 tufli vi vipc di tirng
can thipp bfl thai tfi ra la yfiu to bio vf cfi thfi lim giim nguy ea phit trien cie tfin thuong tien UTCTC d phy nft cfi chflng tufli 30-65. Cl nhiing gia dinh efi dieu kifn khi (mftc thu nhip binh quin dau ngudi >400.000 nghin/ngudi/
thing d nfing thfin v i >500.000 nghin/ngudi/
thing d thinh phfl) tbi nguy ca phit trien cac Ifln thuang tifin ung thu d phy nft giim mpt nfta so voi nhom cdn lgi (OR=0,49; KTC 95%: 0,18 - 0,77). Nguy cfi phit tiifin cic tfin thuomg d nhiing phy nft dang diing vifin ufing ttanh thai giam chi con khoing 1/5 so vfii nguy CO niy d nhihig ngudi chua sft dyng vifin uong ttinh thai bao gid (OR=0,19; KTC 95%:0,05 - 0,75). Quan hf tinh dyc lan dau sau 18 tufii ciing duoc xem li yfiu tfi bio vf lira giim nguy ca phit ttifin nhihig tfin thuong niy mfit cich cfi y nghia thflng ke (OR=0,77; KTC 95%: 0,68 - 0,89). Nhftng phu nft d i tiing can thiep bfi thai lai cfi nguy eo phil trien nhihig tfln thuong tifin UTCTC tiiip ban nhftng phy nft cho biet bp cbua tiing can thifp bd tiiai (OR=0,20; KTC 95%: 0,11-0,37).
Tap ehi Y hpe dy phfing, Tgp XXV, Sfl 3 (163) 2015
Bang 4. M i l lidn quan da biln trong nghidn cdu bdnh chi>ng D$c diim Ty s l chdnh*
Trtnh (3$ hoc vln cao nhit cua dli Ti/ d p 3 hodc hon Ti/ d p 2 trd xuing Hidn c6 d vdi ching hay khdng
Co Khdng
tu'png
Cd thu'd'ng xuyen uing n/gru hay khfing Khfing
Cd
Dilu kidn kinh t l hp gia dinh Nghdo
Khdng nghdo Dd tdng can thidp bd thai
Khong Cd
Gidtr)P 1.00 0,59 1.00 2.01 1.00 10.1 1,00 0,49 1.00 0.20
Khoang tin cdy 95%
0,186
0,080
0,005
0.047
•=0.001
0,27-1,29
0 , 9 2 - 4 , 3 7
2,00-51.1
0,24 - 0,99
0 , 1 1 - 0 , 3 7 S d dung vidn u i n g trdnh tiiai
C h i r a bao gifi*
D a dCing D a n g d i i n g T i n g s l l l n sinh c o n T u l i quan hd t i n h dgc l l n d i u
0.19 1,73 0,77
<0.001 0,017
<0,001
<0,001
2,98 -15,01 0,05 - 0,75 1,32 -2,28 0,68 - 0.89
• Ty s6 chinh sau khi kiim sodt cdc yeu i6 ve trinh do hpc vdn, linh Irgng hon nhdn, dteu ki^n kmh le hp gta dinh, vi$c su dvng nrgu Ihudng xuyen. tiin su can ihifp bo thai, luoi quan Ap tinh dyc ldn ddu, viic su dung vien uong trdnh thai.
IV. BAN LUAN
Nghifin cftu cd 150 ea bfnh vi 200 ca ehftng tham gia. Tinh ttgng bpnh, khfing bfnh dupe ehin doin chinh xie qua chuin vang xet nghifm sinh thifit mfi bpnh hpe va vifc ehi thu thgp cic ca bfnh mfii mie ttong nim 2013, do ludng cic phoi nhifim trufic dfi, nhira dim bio tinh trang phoi nhiera xic djnh ttong nghien cftu xiy ra trudc khi bi bfnh, hgn chfi sai s6 v^
ra§t trinh tt; thai gian khi xie djnh cin nguyen, do tinb ttgng phoi nhiem cfi the tbay dfii tft tinh tt^g mic ung thu mang lai (phoi nhiera xiy ra sau khi cd bpnh), hgn chfi cic sai s6 ttong do ludng sy ket hpp. Vife ehi nghifin eftu ufin ca mdi mic eung gfip phin hgn chfi sai so nhd lai.
Cie ttvdng hpp bfnh dupe ehpn ghfip cap vfi khoing tufii 5 nim vi nai eu ttii giftp loai bfi eic yfiu to nhifiu lifin quan dfin tufli, tinh trang
Tap chi Y hpc dy phdng. Tap XXV, Sfl 3 (163) 2015
kinh tfi xi hpi vi tiep c%n dich vy y te. Cic thfing lin vfi sft dyng hormonf, suy giim mien djeh, chfi dp in kifing di dupc tbu tiigp dfi kiem soit cie yfiu tfi nhifiu tifira ting. Ngoii ra, cic phan tich da bifin eiing giftp kifim soit dupe eic yfiu tfl nhifiu cfl thfi arJi hudng dfin kfit qui.
Tit ci nhung yfiu tfl ttfin gpi y ring eie sai ehf ch cfta kfit qui da dupc ban ehfi tfii da vi efi kfit qui cfi nhifiu khi nang phin inh nguy ca mic bfnh cua quan thfi nghien eftu.
Kfit qui nghifin euu chi ra ring, uflng ruou li yfiu to lim ting khi nang raic cic tfln thuang tifin UTCTC (OR=10,1; KTC 95%:
2,00-51,1). Kfit qui nay eao ban kfit qua mpt sfi nghifin eftu dpc trudc diy ttfin 3552 phu nft Dan Mach ttong 38 nam. (SIR=1,8; KTC95%:
1,2-2,6) [5] vi kfit qui nghifin cua EHsabete Weiderpass trfin 36.856 bfnh nhin ed diu hifu lgm dyng rupu lgi tbdi diem xuat vifn (SIR=
97
2,9; KTC95%:2,4-3,5) [6].
Theo nghifin ciiu nay, vipc da timg su dyng thufic ttinh thai lira ting khi ning bi cic tfln thuomg tien ung thu so vfii vific chua timg sft dung (OR=6,69; KTC 95%: 2,98-15,01). Kfit qui cua nghien cftu thip hom vdi kfit qui nghifin cum eua Vessey vi cpng sy nira 2010 (RR=
3,4; KTC95%:I,6 - 8,9) vi eao hon kfit qui cua Urban v i cfing sy, nim 2012 (OR=I,57, KTC95%: 1,03-2,40; cho nhftng timdng hpp da dftng sft dyng <I0 nim) [7, 8].
Nghifin ciiu chi ra tie dpng bio vf cua vifc dang sft dung thuflc trinh thai so vfii vifc chua tftng sft dyng (OR=0,19; KTC 95%: 0,05 - 0,75). Ket qua vfi tie dpng bio vp nay eao han kfit qui tft nghifin cftu eua Celentano ttfin 153 ca UTCTC va 95 ca chung, ghep cip vfi tufii, ncri cu trft, tinh trgng hfln nhan, (OR = 0,38, KTC95%:0,2-0,7) [9].
Theo kfit qui nghifin cftu, sfl lan sinh eon ttong ddi eing ting thi nguy eo phit trifin eie tfin thuomg tifin UTCTC fi php nft 30-65 cing ldn (OR=l,73; KTC 95%: 1,32-2,28). Kfit qui niy tuong ducmg vdi kfit qui nghifin eftu bfnh chirng 177 ca ung thu bifiu mo viy vi 177 ea chiing, gbep c$p vfi khoang tuoi 5 nim lgi Thii Lan 20II (OR=l,73; KTC 95%: 1,11-2,70) [10].
Quan hp tinh dpe lin dau mufin dupe ehiing minh la yfiu tfi tfl bao ve khoi nguy ea bi cac tfin thuang tifin UTCTC ttong nghifin eftu niy (OR=0,77; KTC 95%: 0,68 - 0,89). Kfit qui niy tuang duang vfii kfit qui cua Celentano va cpng sy dua ra tix nghifin eftu bpnh ehftmg ghfip cap tt^n 153 ttirdng hpp ung thu cfi tft cung tai My (OR=0,88, KTC 95%:0,81-0,95) [9].
Trong nghifin cftu niy, can thifip bfi thai thfi hifn li yeu to bio vf trudc nguy ea bj cie tfin thuomg tifin UTCTC (OR=0,20; KTC 95%:
0,11 - 0,37). Kfit qui niy ehua dupc nhie den ttong y vin ttong nude vi qufic lfi. Ng- hien cftu bpnh ehftng cua Parazzini vi efing sy de cip ring khfing cfi moi quan hf niy khi kfit qua kifim djnh khong eo y nghia thflng ke (OR=I,30; KCTC95%: 0,66-2,48) (4). Chung
tfli nhin thiy cfi moi lien hf ttong nghifin cftu niy cfi the do sy tuomg tic giiia ngo phi thai vi su dyng thufle ttrinh tiiai khi ty If ngo phi thai ttong nhfim dang uflng thuoe trinh thai bing 0 vi khic vdi ty If ttong nhfim da timg uong thufic. Moi tucmg tic niy cung d i duac Brin- ton vi cpng sy nhin dinh [11]
Kinh te bfi gia dinh d mfte kha (thu nhgp binh quin diu ngudi >400.000 ngbm/ngudi/
thing 6 nfing thfin hoac >500.000 nghin/
ngudi/thing d thinh phfi) dupc chi ra la mfit yfiu t6 bio vf (OR=0,49; KTC 95%: 0,18 - 0.77). Kfit qua nghifin eum nay thap ban so vfii kfit qui nghien cuu cua Ji Man Kim vi cpng sy tgi Hin Quoc 2012. Ji Man Kim va epng sy da ehi ra ring, nhftng phy nft cfi thu nhip binh quin diu ngufii hing thing d pban muc 5 (mftc thip nhit) efi nguy ea bj nhumg tfln thuomg lifin UTCTC eao gip khoing 2,5 lin so vdi nhftng phy nft ttong nhfim 1 (OR=2,47 KTC95%:
2,08-2,94) [12].
V. KtT LU^JN
Nghien cftu niy cho thiy cie yfiu to lim ting nguy ea phit trifin tfln thuong tifin UTCTC d phy nft ehu yfiu li do uflng rupu (OR=10,1;
KTC 95%: 2,00-51,1), da tftng sft dyng vien uflng ttinh thai (OR=6,69; KTC 95%:2,98- 15,01) vi sfl lan sinb eon ttong dfii (OR=l,73;
KTC 95%: 1,32-2,28). Cie yeu tfl bio vf cfi the lim giim nguy eo phit trien ton thuang lifin UTCTC Ii difiu kifn kinh tfi hp gia dinh khi (OR=0,49; KTC95%:0,18-0,77), vifc dang su dung thufle uflng ttanh thai (OR=0,19;
KTC95%: 0,05-0,75), tiifli quan hf tinh dpc lin diu tt^n 18 tiifli (OR=0,77; KTC 95%:
0,68 - 0,89) vi vipc da timg can thifp bfi thai (OR=0,20; KTC 95%: 0,11-0,37).
TAI LIEU THAM KHAO
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RISK FACTORS FOR CERVICAL CANCER AMONG WOMEN AGED 30-65 YEARS: RESULTS OF CASE-CONTROL STUDY IN BAC NINH AND CAN THO 2013
IVan Thi Due Hanh', Vu Thi Hoang Lan>, Nguyen Thanh Bi^h^ Bui Thi Thu Ha' 'Hanoi School of Public Health,
'Bac Ninh Department ofHealthv
Invasive cervical cancer (ICC) is one of the most common cancers and the leading cause of death among women worldwide and Vietnam. The researeh was eondueted to ex- plore the nsk factors for cervical cancer among Vietnamese women aged frora 30 to 65 in Bac Ninh and Can Tho in 2013. Atottil of 150 cases and 200 cases enrolled in tbe research. Results of the multivariate logistic regression model showed that the factors are likely to increase the risk of ICC including: used oral contracep- tives (OR - 6.69; 95% CI: 2.98-I5.0I), num- ber of butiis (OR = 1.73; 95% CI:1.32-2.28)
and alcohol drinking (OR = lO.I 95% CI:
2.00-51.1). The protential protective factors are fair household eeonomic conditions (OR = 0.49; 95% CI:0.18-0.77), using oral contt^eep- tives (OR = 0.19; 95% CI: 0.05-0.75), first sex at 18 years of age or older (OR = 0.77; 95% : 0.68-0.89) and experienced an abortion (OR = 0.20; 95% CI:0.Il-0.37). The results propose the potential ICC risk factors among married women aged 30 lo 65 years.
Keywords: Invasive cervical cancer, woman, Bae Ninh, Can Tho
Tgp chi Y hpc dy phdng. Tip XXV, So 3 (163) 2015