Epidemiology

The epidemiology of this disease has been extensively studied and strong associations demonstrated with:

♦ Low social class

♦ Multiparity

♦ Cigarette smoking

♦ Early onset of sexual intercourse (before 17)

♦ Non-barrier forms of contraception

More recent studies have focused attention specifically on papillo-mavirus transmission and the increased susceptibility of the cervical epithelium of the sexually active teenage female.

This disease has dramatic variations in incidence around the world. In the developing countries of South-East Asia, Africa, and South America, it is the commonest female cancer. Limited regional studies in South America have revealed massive incidences up to 96/100 000 (against 14.5/100 000 in the UK and only 2/100 000 in Israel).

The UK saw significant incidence changes during the different decades of the twentieth century. High rates occurred in the cohorts of women who were aged 20-30 years during the First and Second World Wars when they entered their 50s and 60s. More recently, a rise in incidence occurred in the late 1970s and early 1980s in women aged 30-50 years. The UK incidence is now falling for the first time in a century. This is attributed to the success of the population-based screening programme, which was introduced following success in Finland and British Columbia.

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