Adolescent coitus and cervical cancer: associations of related events with increased risk.

Five subsamples of cervical cancer patients and matched con trols, totaling 416 subjects in each group, were compared with respect to selected sexual variables. All samples were drawn from the same hospital population as part of a larger multidimensional procedure. Age at first coitus was the variable of greatest discriminatory power, strongly overshadowing all other significant differences, and is postulated as the pivotal variable. Twice as many patients as controls began coitus at ages 15-17, comparatively few began after age 21, and almost none as late as age 27. Patients also differed strongly from controls with respect to age at first marriage, number of husbands, and total number of coital mates. About f of patients compared to J of controls were married by age 21. Twice as many patients had multiple mar riages, and many more patients than controls had multiple sexual mates. Circumcision in mates, a moderately significant variable, was interpreted as a peripheral supporting factor. Sexual frequencies were similar for patients and controls. Parity and gravidity studies resulted only in borderline differences. Results support a host-agent-donor hypothesis, with an unde termined agent (or agents) contributed by the donor male to the host female. Speculation conforms this hypothesis to a multi stage model of oncogenesis. Latency studies show a mean 30-year interval between first coitus prior to age 20 and tumor detection, decreasing linearly thereafter. On the basis of these findings, sug gestions are advanced for clinical detection of those at greatest risk, and for prevention in populations.