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Women’s Health: Importance of Reproductive Tract Infections, Pelvic Inflammatory Disease and Cervical Cancer

  • André Meheus
Part of the Reproductive Biology book series (RBIO)

Abstract

Upper reproductive tract infections and their consequences are major health problems for women worldwide, particularly in resource-poor settings. The syndrome of pelvic inflammatory disease (PID) is mostly due to sexually transmitted infections that start in the lower reproductive tract and ascend into the upper reproductive tract. Cervical cancer is also usually the result of sexually transmitted infection, and human papilloma virus (HPV) appears to be the causal agent. These conditions can be effectively controlled and prevented by relatively simple and inexpensive methods, and what is needed now is the commitment of human and financial resources for activities to prevent and treat reproductive tract infections.

Keywords

Cervical Cancer Human Papilloma Virus Ectopic Pregnancy Chlamydia Trachomatis Pelvic Inflammatory Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Weström L, Mârdh P-A. Salpingitis. In: Holmes KK, Mârdh P-A, Sparling PF et al., eds. Sexually transmitted diseases, New York: McGraw-Hill, 1984: 615–32.Google Scholar
  2. 2.
    Weström L. Incidence, prevalence and trends of acute pelvic inflammatory disease and its consequences in industrialized countries. Am J Obstet Gynecol 1980; 138: 880–92.PubMedGoogle Scholar
  3. 3.
    Barbacci MB, Spence MR, Kappus EW, Burkman RC, Rao L, Quinn TC. Postabortal endometritis and isolation of Chlamydia trachomatis. Obstet Gynecol 1986; 68: 686–90.PubMedGoogle Scholar
  4. 4.
    Osser S, Persson K. Postabortal pelvic infection associated with Chlamydia trachomatis and the influence of humoral immunity. Am J Obstet Gynecol 1984; 50: 699–703.Google Scholar
  5. 5.
    Qvigstad E, Skang K, Jerve F, Fying P, Ulstrup JC. Pelvic inflammatory disease associated with Chlamydia trachomatis infection after therapeutic abortion. Br J Vener Dis 1983; 59: 189–92.PubMedGoogle Scholar
  6. 6.
    Burkman RT, Tonascia JA, Atienza MF, King TM. Untreated endocervical gonorrhea and endometritis following elective abortion. Am J Obstet Gynecol 1976; 126: 648–51.PubMedGoogle Scholar
  7. 7.
    Eschenbach DA, Buchanan TM, Pollock HM et al. Polymicrobial etiology of acute pelvic inflammatory disease. N Engl J Med 1975; 293: 166–71.PubMedCrossRefGoogle Scholar
  8. 8.
    Wasserheit JN, Bell TA, Kiviat NB et al. Microbial causes of proven pelvic inflammatory disease and efficacy of clindamycin and tobramycin. Ann Intern Med 1986; 104: 187–93.PubMedCrossRefGoogle Scholar
  9. 9.
    Weström L, Mârdh P-A. Acute pelvic inflammatory disease (PID). In: Holmes KK, Mdrdh P-A, Sparling PF et al., eds. Sexually transmitted diseases, second edition, New York: McGraw-Hill, 1990: 593–613.Google Scholar
  10. 10.
    Weström L. Effect of acute pelvic inflammatory disease on fertility. Am J Obstet Gynecol 1975; 121: 707–13.PubMedGoogle Scholar
  11. 11.
    Wasserheit JN. The significance and scope of reproductive tract infections among third world women. Int J Gynaecol Obstet 1989; Suppl 3: 145–68.Google Scholar
  12. 12.
    Catty MJ, Nzioki JM, Verhagen AR. The role of gonococcus in acute pelvic inflammatory disease in Nairobi. E Afr Med J 1972; 49: 376–9.Google Scholar
  13. 13.
    Grech ES, Everett JV, Mukasa F. Epidemiological aspects of acute pelvic inflammatory disease in Uganda. Trop Doc 1973; 3: 123–7.Google Scholar
  14. 14.
    Muir DG, Belsey MA. Pelvic inflammatory disease and its consequences in the developing world. Am J Obstet Gynecol 1980; 138: 913–28.PubMedGoogle Scholar
  15. 15.
    Plummer FA, Laga M, Brunham RC et al. Postpartum upper genital tract infections in Nairobi, Kenya: epidemiology, etiology and risk factors. J Infect Dis 1987; 156: 92–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Ratnam AV, Din SN, Chatterjee TK. Gonococcal infection in women with pelvic inflammatory disease in Lusaka, Zambia. Am J Obstet Gynecol 1980; 138: 965–73.PubMedGoogle Scholar
  17. 17.
    Rosenberg MJ, Schulz KF, Button N. Sexually transmitted diseases in sub-Saharan Africa. Lancet 1986; 2: 152.CrossRefGoogle Scholar
  18. 18.
    Meheus A, Reniers J, Coet M et al. Chlamydia trachomatis in women with acute salpingitis and infertility in Central Africa. In: Oriel D, Ridgway G, Schachter J, Taylor-Robinson D, Ward M, eds. Chlamydial infections. Proceedings of the sixth international symposium on human chlamydial infections, Cambridge University Press, 1986: 241–4.Google Scholar
  19. 19.
    Mabey DCW, Ogbaselassie G, Robertson JN, Heckels JE, Ward ME. Tubal infertility in the Gambia: chlamydial and gonococcal serology in women with tubal occlusion compared with pregnant controls. Bull WHO 1985; 63: 1107–13.PubMedGoogle Scholar
  20. 20.
    De Muylder X, Laga M, Tennstedt C, Van Dyck E, Aelbers GN, Piot P. The role of Neisseria gonorrhoeae and Chlamydia trachomatis in pelvic inflammatory disease and its sequelae in Zimbabwe. J Infect Dis 1990; 162: 501–5.PubMedCrossRefGoogle Scholar
  21. 21.
    Wertheim LJ, Abren A, Valdés-Vivo P. Problems and approaches in the surveillance and control of sexually transmitted diseases: the Cuban experience. Am J Obstet Gynecol 1980; 138: 1082–7.Google Scholar
  22. 22.
    Eschenbach DA, Rosene K, Tompkins LS, Watkins H, Gravett MG. Endometrial cultures obtained by a triple-lumen method from afebrile and febrile postpartum women. J Infect Dis 1986; 153: 1038–45.PubMedCrossRefGoogle Scholar
  23. 23.
    World Health Organization. Maternal mortality: a global factbook, Geneva: World Health Organization 1991.Google Scholar
  24. 24.
    Mason PR, Katzenstein DA, Chimbira `FHK, Mtimavalye L, Puerperal Sepsis Study Group. Vaginal flora of women admitted to hospital with signs of sepsis following normal delivery, caesarian section or abortion. Cent Afr J Med 1989; 35: 344–50.PubMedGoogle Scholar
  25. 25.
    Armon PJ. Maternal deaths in the Kilimanjaro region of Tanzania. Trans Roy Soc Med Hyg 1979; 73: 284–8.CrossRefGoogle Scholar
  26. 26.
    Caffrey KT. Maternal mortality: a continuing challenge in tropical practice. A report from Kaduna, northern Nigeria. East Afr Med J 1979; 56: 274–7.PubMedGoogle Scholar
  27. 27.
    Mahokha AE. Maternal mortality: Kenyatta National Hospital 1972–1977. East Afr Med J 1980; 57: 451–60.Google Scholar
  28. 28.
    Crowther CA. Maternal deaths at Harare Maternity Hospital during 1983. S Afr J Med 1986; 69: 180–3.Google Scholar
  29. 29.
    Mason PR, Katzenstein DA, Chimbira THK, Mtimavalye L, Puerperal Sepsis Study Group. Microbial flora of the lower genital tract of women in labor at Harare Maternity Hospital. Cent Afr J Med 1989; 35: 337–44.PubMedGoogle Scholar
  30. 30.
    Temmerman M, Laga M, Ndinya-Achola JO et al. Microbial aetiology and diagnostic criteria of postpartum endometritis in Nairobi, Kenya. Genitourin Med 1988; 64: 172–5.PubMedGoogle Scholar
  31. 31.
    Perin PR, Duncan ME, Krause DW, Awoke S. Pelvic inflammatory disease and puerperal sepsis in Ethiopia. 1. Etiology. Am J Obstet Gynecol 1980; 138: 969–73.Google Scholar
  32. 32.
    Cohen L, Veie JC, Calkins BM. Improved pregnancy outcome following successful treatment of chlamydial infection. JAMA 1990; 263: 3160–3.PubMedCrossRefGoogle Scholar
  33. 33.
    Venugopal MS, Bhaskaran CS. Puerperal and postabortal sepsis: a bacteriological study. J Obstet Gynecol India 1968; 18: 70–8.Google Scholar
  34. 34.
    Lavaois P, Rioux JE, Côté L. Chlamydial infection among females attending an abortion clinic: prevalence and risk factors. Can Med Assoc J 1987; 137: 33–7.Google Scholar
  35. 35.
    Nasah BT, Nguematcha R, Eyong M, Godwin S. Gonorrhoea, trichomonas and candida among gravid and nongravid women in Cameroun. Int J Gynaecol Obstet 1980; 18: 48–52.PubMedGoogle Scholar
  36. 36.
    Chanduri P, Sng EH, Yuen WS. Chlamydia trachomatis infection in unmarried women seeking abortion. Genitourin Med 1986; 62: 17–8.Google Scholar
  37. 37.
    Odujinrin OMT. Sexual activity, contraceptive practice and abortion among adolescents in Lagos. Int J Gynaecol Obstet 1991; 34: 361–6.PubMedCrossRefGoogle Scholar
  38. 38.
    Osinusi BO. The role of previous abortions on secondary infertility in Ibadan. J Obstet Gyn East Cent Afr 1986; 5: 37–8.Google Scholar
  39. 39.
    Nichols D, Lapido OA, Paxman JM, Otolorin EO. Sexual behavior, contraceptive practice and reproductive health among Nigerian adolescents. Stud Fam Plann 1986; 17: 100–6.PubMedCrossRefGoogle Scholar
  40. 40.
    Nichols D, Woods ET, Gates DS, Sherman J. Sexual behavior, contraceptive practice, and reproductive health among Liberia adolescents. Stud Fam Plann 1987; 18: 169–76.PubMedCrossRefGoogle Scholar
  41. 41.
    Weström L. Pelvic inflammatory disease: bacteriology and sequelae. Contracept 1987; 36: 111–28.CrossRefGoogle Scholar
  42. 42.
    Cates W, Rolfs RT, Aral SO. Sexually transmitted diseases, pelvic inflammatory disease, and infertility: an epidemiologic update. Epidemiol Rev 1990; 12: 199–220.PubMedGoogle Scholar
  43. 43.
    Frank O. Sterility in women in sub-Saharan Africa. IPPF Med Bull 1987; 21: 6–8.PubMedGoogle Scholar
  44. 44.
    World Health Organization. Programme of research, development and research training in human reproduction, 1985, annual report, Geneva: World Health Organization, 1985.Google Scholar
  45. 45.
    Cates W, Farley TMM, Rowe PJ. Worldwide patterns of infertility: is Africa different? Lancet 1985; 2: 596–8.PubMedCrossRefGoogle Scholar
  46. 46.
    Marchbanks PA, Annegers JF, Coulam CB, Strathy JH, Kurland LT. Risk factors for ectopic pregnancy: a population-based study. JAMA 1988; 259: 1823–7.PubMedCrossRefGoogle Scholar
  47. 47.
    Thorbum J, Bernstsson C, Philipson M, Lindblom B. Background factors of ectopic pregnancy. I. Frequency distribution in a case-control study. Eur J Obstet Gynecol Reprod Biol 1986; 23: 321–31.CrossRefGoogle Scholar
  48. 48.
    Thorbum J, Philipson M, Lindblom B. Background factors of ectopic pregnancy. II. Risk estimation by means of a logistic model. Eur J Obstet Gynecol Reprod Biol 1986; 23: 333–40.CrossRefGoogle Scholar
  49. 49.
    Chow JM, Yonekura ML, Richwald GA, Greenland S, Sweet RL, Schachter J. The association between Chlamydia trachomatis and ectopic pregnancy. A matched-pair, case-control study. JAMA 1990; 263: 3191–2.CrossRefGoogle Scholar
  50. 50.
    Kihlstrom E, Lindgren R, Ryden G. Antibodies to Chlamydia trachomatis in women with infertility, pelvic inflammatory disease and ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol 1990; 35: 199–204.PubMedCrossRefGoogle Scholar
  51. 51.
    Tuomivaara LM. Ectopic pregnancy and genital infections: a case-control study. Ann Med 1990; 22: 21–4.PubMedCrossRefGoogle Scholar
  52. 52.
    Miettinen A, Heinonen PK, Teisala K, Hakkarainen K, Punnonen R. Serologic evidence for the role of Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma hominis in the etiology of tubal factor infertility and ectopic pregnancy. Sex Transm Dis 1990; 17: 10–4.PubMedGoogle Scholar
  53. 53.
    Weström L, Bengtsson LPH, Mârdh P-A. Incidence, trends, and risks of ectopic pregnancy in a population of women. Br Med J 1981; 282: 15–8.CrossRefGoogle Scholar
  54. 54.
    Daisley H. Ectopic pregnancies in Trinidad. A clinico-pathological study of 154 consecutive surgically treated cases. West Indian Med J 1989; 38: 222–7.PubMedGoogle Scholar
  55. 55.
    Picaud A, Nlome Nze AR, Ogowet Igumu N, Faye A, Loundou J. La grossesse extra-utérine. Etude de 509 cas traités chirurgicalement au CHU de Librevie. J Gynécol Obstét Biol Reprod (Paris) 1989; 18: 714–20.Google Scholar
  56. 56.
    Lindow SW, Moore PJ. Ectopic pregnancy: analysis of 100 cases. Int J Gynaecol Obstet 1988; 27: 371–5.PubMedCrossRefGoogle Scholar
  57. 57.
    Oransaye U. Reproductive performance among patients with ectopic pregnancy. Nig Med J 1979; 9: 247–51.Google Scholar
  58. 58.
    Centers for Disease Control. Ectopic pregnancies-United States 1987; MMWR 1990; 39 (24): 401–4.Google Scholar
  59. 59.
    Johnsen HM, Becker-Christensen F. Ectopic pregnancy in Greenland. An epidemiological study. Arctic Med Res 1990; 49: 43–7.PubMedGoogle Scholar
  60. 60.
    Olatunbosun OA, Okonufua FE. Ectopic pregnancy-the African experience. Postgrad Doct Afr 1986; 8: 74–8.Google Scholar
  61. 61.
    World Health Organization. Maternal health and safe motherhood programme, 1990. Unpublished data, Geneva.Google Scholar
  62. 62.
    Makinen JI, Salmi TA, Nikkanen VP, Koskinen EY. Encouraging rates of fertility after ectopic pregnancy. Int J Fertil 1989; 34: 46–51.PubMedGoogle Scholar
  63. 63.
    Ogunniyi SO, Faleyimu BL. Fertility after ectopic pregnancy in an African population. Int J Gynaecol Obstet 1989; 30: 245–8.PubMedCrossRefGoogle Scholar
  64. 64.
    Meheus A, Schulz KF, Cates W. Development of prevention and control programs for sexually transmitted diseases in developing countries. In: Holmes KK, Mârdh P-A, Sparling PF et al., eds. Sexually transmitted diseases, second edition, New York: McGraw-Hill, 1990: 1041–6.Google Scholar
  65. 65.
    World Health Organization. Management of patients with sexually transmitted diseases, WHO, Technical Reports Series 810, Geneva: World Health Organization, 1991.Google Scholar
  66. 66.
    Expert Committee on Pelvic Inflammatory Disease. Pelvic inflammatory disease-research directions in the 1990s. Sex Transm Dis 1991; 18: 46–64.CrossRefGoogle Scholar
  67. 67.
    Stanley K, Stjernswärd J, Koroltchouk V. Women and cancer. World Health Stat Quart 1987; 40: 267–78.Google Scholar
  68. 68.
    Standaert B, Meheus A. Le cancer du col utérin en Afrique. Méd Afr Noire 1985; 32: 407–15.Google Scholar
  69. 69.
    Parkin DM, Läärä E, Muir CS. Estimates of the worldwide frequency of sixteen major cancers in 1980. Int J Cancer 1988; 32: 407–15.Google Scholar
  70. 70.
    WHO Meeting. Control of cancer of the cervix uteri. Bull WHO 1986; 64: 607–18.Google Scholar
  71. 71.
    Muir CS, Waterhouse J, Mack T, Powell J, Lohelan S. Cancer incidence in five continents. IARC Scientific Publications, No. 88, Lyon: IARC, 1988.Google Scholar
  72. 72.
    Briggs RM, Holmes KK, Kiviat N, Barker E, Eschenbach DA, DeJong R. High prevalence of cervical dysplasia in STD clinic patients warrants routine cytologic screening. Am J Public Health 1980; 70: 1212–4.PubMedCrossRefGoogle Scholar
  73. 73.
    Hill GB, Adelstein AM. Cohort mortality from carcinoma of the cervix. Lancet 1967; 2: 606–7.Google Scholar
  74. 74.
    Johnson SR, Smith EM, Guenther SM. Comparison of gynecologic health care problems between lesbian and bisexual women. J Reprod Med 1987; 32: 805–11.PubMedGoogle Scholar
  75. 75.
    Cross HE, Kennel EE, Lilienfeld AM. Cancer of the cervix in an Amish population. Cancer 1968; 21: 102–8.PubMedCrossRefGoogle Scholar
  76. 76.
    Larsson E, Webb AT. Cancer survey: experiences in mass screening of cervical smears. Obstet Gynecol 1963; 22: 630–5.PubMedGoogle Scholar
  77. 77.
    Lyon JL, Klauber MR, Gardner JW, Smart CR. Cancer incidence in Mormons and non-Mormons in Utah, 1966–1970. N Engl J Med 1976; 294: 129–33.PubMedCrossRefGoogle Scholar
  78. 78.
    Boyd JT, Do R. A study of the aetiology of carcinoma of the cervix uteri. Br J Cancer 1964; 18: 419–34.CrossRefGoogle Scholar
  79. 79.
    Lancaster WD, Norrild B. Diagnosis of HPV by DNA hybridization techniques. In: Munoz N, Bosch FX, Jensen OM, eds. Human papilloma virus and cervical cancer. IARC Scientific Publications, No. 94, Lyon: IARC, 1989.Google Scholar
  80. 80.
    McCance DJ, Walker PG, Dyson J, Coleman DV, Singer A. Presence of human papilloma virus DNA sequences in cervical intraepithelial neoplasia. Br Med J 1983; 287: 784–8.CrossRefGoogle Scholar
  81. 81.
    Zur Hausen H. Papilloma viruses and human cancer. Cancer 1987; 59: 1692–6.PubMedCrossRefGoogle Scholar
  82. 82.
    McCance DJ, Kalache K, Ashdown K, Andrade-Menezes F, Smith P, Do R. Human papilloma virus type 18 in carcinoma of the penis in Brazil. Int J Cancer 1986; 37: 55–60.PubMedCrossRefGoogle Scholar
  83. 83.
    Crum CP, Ikenberg H, Richart RM, Gissmann L. Human papilloma virus type 16 and early cervical neoplasia. N Engl J Med 1984; 310: 880–3.PubMedCrossRefGoogle Scholar
  84. 84.
    Walker PG, Singer A, Dyson JL, Shah KV, To A, Coleman DV. The prevalence of human papilloma virus antigen in patients with cervical intraepithelial neoplasia. Br J Cancer 1983; 48: 99–101.PubMedCrossRefGoogle Scholar
  85. 85.
    Editorial. Human papilloma viruses and cervical cancer: a fresh look at the evidence. Lancet 1987; 1: 725–6.Google Scholar
  86. 86.
    World Health Organization. Genital human papilloma virus infections and cancer: memorandum from a WHO meeting. WHO Bull 1987; 65: 817–27.Google Scholar
  87. 87.
    zur Hausen H. Human genital cancers: synergism between two virus infections or synergism between a virus infection and initiating events? Lancet 1982; 2: 1370–2.PubMedCrossRefGoogle Scholar
  88. 88.
    Galloway DA, McDougall JK. The oncogenic potential of herpes simplex viruses: evidence for a “hit-and-run” mechanism. Nature 1983; 302: 21–4.PubMedCrossRefGoogle Scholar
  89. 89.
    Iwasaka T, Yokoyama M, Hayashi Y, Sugimori H. Combined herpes simplex virus type 2 and human papilloma virus type 16 or 18 deoxyribonucleic acid leads to oncogenic transformation. Am J Obstet Gynecol 1988; 159: 1251–52.PubMedGoogle Scholar
  90. 90.
    Schachter J: Chlamydial infection. N Engl J Med 1978; 298: 490–5.PubMedCrossRefGoogle Scholar
  91. 91.
    Rotkin ID. A comparison review of key epidemiological studies in cervical cancer related to current searches for transmissible agents. Cancer Res 1973; 22: 1353–67.Google Scholar
  92. 92.
    Harris RCW, Brinton LA, Cowde RH et al. Characteristics of women with dysplasia or carcinoma in situ of the cervix uteri. Br J Cancer 1980; 42: 359–69.PubMedCrossRefGoogle Scholar
  93. 93.
    Buckley JD, Harris RCW, Do R, Vessey MP, Williams PT. Case-control study of the husbands of women with dysplasia or carcinoma of the cervix uteri. Lancet 1981; 2: 1010–5.PubMedCrossRefGoogle Scholar
  94. 94.
    Cuzick J, De Stavola B, McCance D et al. A case-control study of cervix cancer in Singapore. Br J Cancer 1989; 60: 238–43.PubMedCrossRefGoogle Scholar
  95. 95.
    Reeves WC, Brinton LA, Brenes MM, Quiroz E, Rawls WE, De Britton RC. Case-control study of cervical cancer in Herrera Province, Republic of Panama. Int J Cancer 1985; 36: 55–60.PubMedCrossRefGoogle Scholar
  96. 96.
    Slattery ML, Robison LM, Schuman KL et al. Cigarette smoking and exposure to passive smoke as risk factors for cervical cancer. JAMA 1989; 261: 1593–8.PubMedCrossRefGoogle Scholar
  97. 97.
    Richardson AC, Lyon JB. The effect of condom use on squamous cell cervical intraepithelial neoplasia. Am J Obstet Gynecol 1981; 140: 909–13.PubMedGoogle Scholar
  98. 98.
    Wright NH, Vessey MP, Kenward B, McPherson K, Do R. Neoplasia and dysplasia of the cervix uteri and contraception: a possible protective effect of the diaphragm. Br J Cancer 1978; 38: 273–9.PubMedCrossRefGoogle Scholar
  99. 99.
    Hendershot GE. Coitus-related cervical cancer risk factors: trends and differentials in racial and religious groups. Am J Public Health 1983; 73: 299–301.PubMedCrossRefGoogle Scholar
  100. 100.
    Hildesheim A, Brinton LA, Main K et al. Barrier and spermicial contraceptive methods and risk of invasive cervical cancer. Epidemiol 1990; 1: 266–72.CrossRefGoogle Scholar
  101. 101.
    Beral V, Hannaford P, Kay C. Oral contraceptive use and malignancies of the genital tract. Results from the Royal College of General Practitioners’ Oral Contraception Study. Lancet 1988; 2: 1331–5.PubMedCrossRefGoogle Scholar
  102. 102.
    Brinton LA, Huggins GR, Lehman HF et al. Long-term use of oral contraceptives and risk of invasive cervical cancer. Int J Cancer 1986; 38: 339–44.PubMedCrossRefGoogle Scholar
  103. 103.
    Brinton LA. Oral contraceptives and cervical neoplasia. Contracept 1991; 43: 581–95.CrossRefGoogle Scholar
  104. 104.
    Skegg DCG, Corwin PA, Paul C, Do R. Importance of the male factor in cancer of the cervix. Lancet 1982; 2: 581–3.PubMedCrossRefGoogle Scholar
  105. 105.
    Kjaer SK, de Villiers EM, Dahl C et al. Case-control study of risk factors for cervical neoplasia in Denmark. I: Role of the “male factor” in women with one lifetime sexual partner. Int J Cancer 1991; 48: 39–44.PubMedCrossRefGoogle Scholar
  106. 106.
    Zunzunegui MV, King MC, Coria CF, Charlet J. Male influences on cervical cancer risk. Am J Epidemiol 1986; 123: 302–307.PubMedGoogle Scholar
  107. 107.
    Kennaway EL. The racial and social incidence of cancer of the uterus. Br J Cancer 1948; 2: 177–212.PubMedCrossRefGoogle Scholar
  108. 108.
    Wynder EL. Environmental factors in cervical cancer: an approach to its prevention. Br Med J 1955; 1: 743–7.PubMedCrossRefGoogle Scholar
  109. 109.
    Megafu U. Cancer of the genital tract among Ibo women in Nigeria. Cancer 1979; 44: 1875–8.PubMedCrossRefGoogle Scholar
  110. 110.
    Dodge OG, Linse CA, Davies JNP. Circumcision and the incidence of carcinoma of the penis and the cervix. East Afr Med J 1963; 40: 440–4.PubMedGoogle Scholar
  111. 111.
    Abou-Daoud. Epidemiology of carcinoma of the cervix uteri in Lebanese Christians and Moslems. Cancer 1967; 20: 1706–14.PubMedCrossRefGoogle Scholar
  112. 112.
    Boyd JT, Do R, Gurd CH. Cancer incidence in Fiji. Int J Epidemiol 1973; 2: 177–8.PubMedCrossRefGoogle Scholar
  113. 113.
    Winkelstein W Jr. Smoking and cervical cancer-current status: a review. Am J Epidemiol 1990; 131: 945–57.PubMedGoogle Scholar
  114. 114.
    Schiffman MH, Haley NJ, Felton JS et al. Biochemical epidemiology of cervical neoplasia: measuring cigarette smoke constituents in the cervix. Cancer Res 1987; 47: 3886–88.PubMedGoogle Scholar
  115. 115.
    Parizzini F, La Vecchia C, Negri E, Cecchetti G, Fedele L. Reproductive factors and the risk of invasive and intraepithelial cervical neoplasia. Br J Cancer 1989; 59: 805–9.CrossRefGoogle Scholar
  116. 116.
    Brinton LA, Reeves WC, Brenes MM et al. Parity as a risk factor for cervical cancer. Am J Epidemiol 1989; 130: 486–96.PubMedGoogle Scholar
  117. 117.
    Schneider V, Kay S, Lee HM. Immunosuppression as a high risk factor in the development of condyloma acuminata and squamous neoplasia of the cervix. Acta Cytol 1983; 27: 220–4.PubMedGoogle Scholar
  118. 118.
    Byrne MA, Taylor-Robinson D, Munday PE, Harris JRW. The common occurrence of human papilloma virus infection and intraepithelial neoplasia in women infected by HIV. AIDS 1989; 3: 379–82.PubMedCrossRefGoogle Scholar
  119. 119.
    Devesa SS, Young JL Jr, Brinton LA, Fraumeni JF Jr. Recent trends in cervix uteri cancer. Cancer 1989; 64: 2184–90.PubMedCrossRefGoogle Scholar
  120. 120.
    World Health Organization. Sixth report of the WHO Expert Committee on Venereal Diseases and Treponematoses, WHO Technical Reports, Series 736, Geneva: World Health Organization, 1986.Google Scholar
  121. 121.
    World Health Organization meeting. Prevention and control of sexually transmitted diseases/acquired immuno-deficiency syndrome in young people, Geneva: World Health Organization, 1987.Google Scholar
  122. 122.
    McCance DJ. A vaccine to genital papilloma viruses: is it feasible? In: Meheus A, Spier R, eds. Vaccines for sexually transmitted diseases, London: Butterworths, 1989; 147–65.Google Scholar

Copyright information

© Springer Science+Business Media New York 1992

Authors and Affiliations

  • André Meheus
    • 1
  1. 1.Programme of Sexually Transmitted DiseasesWorld Health OrganizationGeneva 27Switzerland

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