The effect of exogenous hormones, smoking and HPV on the incidence of screen detected pre-invasive cervical cancer.

子宫颈癌是全球女性癌症死亡的主要原因之一。在新南威尔士州，每年约有15 000名妇女被发现患有浸润前宫颈癌（宫颈上皮内瘤变（CIN）I、II或III级）。宫颈癌的早期症状有哪些？宫颈癌的早期症状有哪些？此外，最近长期接触吸烟和激素避孕是两个新的因素，被认为是该疾病的独立风险因素。激素替代疗法（HRT）的准备采取更年期是一个类似的组成激素避孕药，（雌激素和孕激素），因此妇女对HRT也可能在增加的风险。国际上没有全面的研究来衡量这些外源性激素对浸润前宫颈癌发展的相对重要性，其方式与公共卫生相关（例如，最近长期使用口服避孕药和停用时间，以及吸烟者和非吸烟者）。澳大利亚没有关于目前使用激素避孕药或HRT的妇女比例的数据。澳大利亚没有关于主要高危HPV亚型（例如16、18、33、45）的当地流行率数据，无法描述其分布情况，也无法为宫颈筛查计划和未来的疫苗接种计划提供信息。新南威尔士州巴氏试验登记处保存了所有参加宫颈筛查计划的妇女的筛查史，因此这是招募代表性样本进入研究的理想来源。我们希望使用NSW Pap Test Register对约2600名NSW女性进行一项大型研究，以衡量激素，吸烟和HPV感染对CIN II或III发展的相对重要性。

Cervical cancer is one of the leading causes of cancer death in women internationally. About 15,000 women are detected in NSW annually as having pre-invasive cervical cancer (cervical intraepithelial neoplasia (CIN) grade I, II or III). Infection with certain high risk human papillomaviruses is known to be necessary for the development of cervical cancer. In addition, recent long term exposure to smoking and to hormonal contraception are two new factors considered as independent risk factors for the disease. Hormone replacement therapy (HRT) preparations taken around the menopause are a similar composition to hormonal contraceptives, (oestrogen and progestogen), therefore women on HRT may also be at increased risk. No comprehensive study exists internationally to measure the relative importance of these exogenous hormones on the development of pre-invasive cervical cancer in a way that is of public health relevance (e.g. recent long-term use of oral contraceptives and time since stopped, and among smokers and non-smokers). No Australian data are available on the proportion of women who are current users of hormonal contraceptives or HRT. No local prevalence data on the major high risk HPV subtypes (e.g. 16, 18, 33, 45) are available for Australia to describe its distribution and to inform the cervical screening program and future vaccine initiatives. The NSW Pap Test Register holds the screening history of all women on the cervical screening program, hence this is an ideal source for recruiting a representative sample into a study. We wish to conduct a large study of ~2600 NSW women using the NSW Pap Test Register to measure the relative importance of hormones, smoking and HPV infection on the development of CIN II or III.