Cancer of the uterine cervix.II. A biometric approach to etiology

The relative importance of a number of environmental, social and physiological factors in cancer of the cervix is evaluated in a study of individuals voluntarily attending a cancer detection center. The population is considered as 4 groups—randomly selected well controls, those with the cancer precursor, dysplasia of the cervix, those with pre-invasive cancer of the cervix and those with invasive stages of the disease. The distribution of the variables among these groups indicated that 15 of the 20 variables were, on a univariate basis, significantly related to cancer of the cervix. The 20 variables were then considered simultaneously. Using the method of stepwise regression analysis of the data, a subset of factors—endocrine marker, age at marriage, marital events and religion—is most effective in predicting cancer status. These factors are of relatively little value in separating one stage of the disease from another. These findings suggest an association between a behavioral pattern—expressed in married women as early age at marriage and multiple marital events—and a hormonal factor in patients with cancer of the cervix.