Ranking lifestyle risk factors for cervical cancer among Black women : a case-control study from Johannesburg, South Africa

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dc.contributor.authorSingini, Mwiza Gideonen_ZA
dc.contributor.authorSitas, Freddyen_ZA
dc.contributor.authorBradshaw, Debbieen_ZA
dc.contributor.authorChen, Wenlong Carlen_ZA
dc.contributor.authorMotlhale, Melitahen_ZA
dc.contributor.authorKamiza, Abram Bunyaen_ZA
dc.contributor.authorBabb de Villiers, Chantalen_ZA
dc.contributor.authorLewis, Cathryn M.en_ZA
dc.contributor.authorMathew, Christopher G.en_ZA
dc.contributor.authorWaterboer, Timen_ZA
dc.contributor.authorNewton, Roberten_ZA
dc.contributor.authorMuchengeti, Mazvitaen_ZA
dc.contributor.authorSingh, Elviraen_ZA
dc.date.accessioned2022-01-03T09:08:20Z
dc.date.available2022-01-03T09:08:20Z
dc.date.issued2021-12-08
dc.descriptionCITATION: Singini, M. G. et al. 2021. Ranking lifestyle risk factors for cervical cancer among Black women : a case-control study from Johannesburg, South Africa. PLoS ONE, 16(12):e0260319, doi:10.1371/journal.pone.0260319.
dc.descriptionThe original publication is available at https://journals.plos.org
dc.description.abstractBackground: Aside from human papillomavirus (HPV), the role of other risk factors in cervical cancer such as age, education, parity, sexual partners, smoking and human immunodeficiency virus (HIV) have been described but never ranked in order of priority. We evaluated the contribution of several known lifestyle co-risk factors for cervical cancer among black South African women. Methods : We used participant data from the Johannesburg Cancer Study, a case-control study of women recruited mainly at Charlotte Maxeke Johannesburg Academic Hospital between 1995 and 2016. A total of 3,450 women in the study had invasive cervical cancers, 95% of which were squamous cell carcinoma. Controls were 5,709 women with cancers unrelated to exposures of interest. Unconditional logistic regression models were used to calculate adjusted odds ratios (ORadj) and 95% confidence intervals (CI). We ranked these risk factors by their population attributable fractions (PAF), which take the local prevalence of exposure among the cases and risk into account. Results : Cervical cancer in decreasing order of priority was associated with (1) being HIV positive (ORadj = 2.83, 95% CI = 2.53–3.14, PAF = 17.6%), (2) lower educational attainment (ORadj = 1.60, 95% CI = 1.44–1.77, PAF = 16.2%), (3) higher parity (3+ children vs 2–1 children (ORadj = 1.25, 95% CI = 1.07–1.46, PAF = 12.6%), (4) hormonal contraceptive use (ORadj = 1.48, 95% CI = 1.24–1.77, PAF = 8.9%), (5) heavy alcohol consumption (ORadj = 1.44, 95% CI = 1.15–1.81, PAF = 5.6%), (6) current smoking (ORadj = 1.64, 95% CI = 1.41–1.91, PAF = 5.1%), and (7) rural residence (ORadj = 1.60, 95% CI = 1.44–1.77, PAF = 4.4%). Conclusion : This rank order of risks could be used to target educational messaging and appropriate interventions for cervical cancer prevention in South African women.en_ZA
dc.description.sponsorshipSouth African Medical Research Council
dc.description.sponsorshipUK Medical Research Council
dc.description.urihttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0260319
dc.description.versionPublisher's version
dc.format.extent15 pages
dc.identifier.citationSingini, M. G. et al. 2021. Ranking lifestyle risk factors for cervical cancer among Black women : a case-control study from Johannesburg, South Africa. PLoS ONE, 16(12):e0260319, doi:10.1371/journal.pone.0260319.
dc.identifier.issn1932-6203 (online)
dc.identifier.otherdoi:10.1371/journal.pone.0260319
dc.identifier.urihttp://hdl.handle.net/10019.1/124029
dc.language.isoen_ZAen_ZA
dc.publisherPublic Library of Science
dc.rights.holderAuthors retain copyright
dc.subjectCervix uteri -- Cancer -- Epidemiologyen_ZA
dc.titleRanking lifestyle risk factors for cervical cancer among Black women : a case-control study from Johannesburg, South Africaen_ZA
dc.typeArticleen_ZA
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