ASM  Vol.5 No.4 , October 2015
Association between Early Marriage and Other Sociomedical Characteristics with the Cervical Pap Smear Results in Iraqi Women
Abstract: Background: The standard screening test for cervical cancer is the Pap smear and cervical cancer is a significant health issue worldwide. Early sexual activity, multiple sexual partnerships, parity, young age at first pregnancy and early marriage are traditional risk factors for developing cervical cancer. The aim of the present study was to assess the effect of early marriage in on the results of Pap smear in Iraqi women. Methods: A cross-sectional study was carried out on 200 women who attended the Women Health Clinic of Al-Elwiya Maternity Teaching Hospital, Baghdad for the period from November 2013 to April 2014. Data were collected through direct interview and a prepared questionnaire including patients’ characteristics and Pap smear results. Results: Mean age of studied women was 39.9 ± 11.4 years and mean age of marriage was 19 ± 5 years. Abnormal Pap results were reported in 63.5% of them. A significant association was observed between abnormal Pap smear and each of age 20 - 30 years, ≤18 years age at marriage, marriage duration >10 years, irregular menstrual cycle, tubal ligation and abnormal medical history (P < 0.05). Conclusions: Early marriage was strongly associated with abnormal Pap smear results in Iraqi women.
Cite this paper: Khalaf, M. , Rasheed, F. and Hussain, S. (2015) Association between Early Marriage and Other Sociomedical Characteristics with the Cervical Pap Smear Results in Iraqi Women. Advances in Sexual Medicine, 5, 73-82. doi: 10.4236/asm.2015.54009.

[1]   Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelom, M., et al. (2015) Cancer Incidence and Mortality Worldwide: Sources, Methods and Major Patterns in GLOBOCAN 2012. International Journal of Cancer, 136, E359-E386.

[2]   Nawal, M.N. (2009) Child Marriage: A Silent Health and Human Rights Issue. Reviews in Obstetrics and Gynecology, 2, 51-56.

[3]   ICO Information Centre on HPV and Cancer (2014) Iraq Human Papilloma Virus and Related Cancers, Fact Sheet 2013.

[4]   Al-Alwan, N.A. (2001) Colposcopy, Cervical Cytology and Human Papilloma Virus Detection as Screening Tools for Cervical Cancer. East Mediterranean Health, 7, 100-105.

[5]   Sreedevi, A., Javed, R. and Dinesh, A. (2015) Epidemiology of Cervical Cancer with Special Focus on India. International Journal of Women’s Health, 7, 405-414.

[6]   Thakur, A., Gupta, B., Gupta, A. and Chauhan, R. (2015) Risk Factors for Cancer Cervix among Rural Women of a Hilly State: A Case-Control Study. Indian Journal of Public Health, 59, 45-48.

[7]   UNICEF Innocenti Research Centre. Early Marriage: Child Spouses, 2001.

[8]   Goodman, A. (2015) HPV Testing as a Screen for Cervical Cancer. British Medical Journal, 350, h2372.

[9]   Rodriguez, A.C., Schiffman, M., Herrero, R., Hildesheim, A., Bratti, C., Sherman, M.E., et al. (2010) Longitudinal Study of Human Papilloma Virus Persistence and Cervical Intraepithelial Neoplasia Grade 2/3: Critical Role of Duration of Infection. Journal of National Cancer Institute, 102, 315-324.

[10]   Edelstein, Z.R., Madeleine, M.M., Hughes, J.P., Johnson, L.G., Schwartz, S.M., Galloway, D.A., et al. (2009) Age of Diagnosis of Squamous Cell Cervical Carcinoma and Early Sexual Experience. Cancer Epidemiology Biomarkers and Prevention, 18, 1070-1076.

[11]   Getahun, F., Mazengia, F., Abuhay, M. and Birhanu, Z. (2013) Comprehensive Knowledge about Cervical Cancer Is Low among Women in Northwest Ethiopia. BMC Cancer, 13, 2.

[12]   Chumnan-Kietpeerakool, Y.P., Kriangsak, J., Usanee, S. and Jatupol, S. (2009) Knowledge, Awareness, and Attitudes of Female Sex Workers toward HPV Infection, Cervical Cancer, and Cervical Smears in Thailand. International Journal of Gynecology and Obstetrics, 107, 216-219.

[13]   Sriplung, H., Singkham, P., Iamsirithaworn, S., Jiraphongsa, C. and Bilheem, S. (2014) Success of a Cervical Cancer Screening Program: Trends in Incidence in Songkhla, Southern Thailand, 1989-2010, and Prediction of Future Incidences to 2030. Asian Pacific Journal of Cancer Prevention, 15, 10003-10008.

[14]   Kjaer, S.K., van den Brule, A.J.C., Svare, E.I., Engholm, G., Sherman, M.E., Poll, P.A., et al. (1998) Different Risk Factor Patterns for High-Grade and Low-Grade Intraepithelial Lesions on the Cervix among HPV-Positive and HPV-Negative Young Women. International Journal of Cancer, 76, 613-619.<613::AID-IJC1>3.0.CO;2-T

[15]   IARC (2007) IARC Monograph for Evaluation of Carcinogen Risks in Human. International Agency for Research on Cancer, Lyon.

[16]   Solomon, D., Davey, D., Kurman, R., Moriarty, A., O’Connor, D., Prey, M., et al. (2002) The 2001 Bethesda System: Terminology for Reporting Results of Cervical Cytology. Journal of American Medical Association, 287, 2114-2119.

[17]   Nour, N.M. (2006) Health Consequences of Child Marriage in Africa. Emergency Infectious Diseases, 12, 1644-1649.

[18]   Kuhn, L., Denny, L., Pollack, A., Lorincz, A., Richart, R. and Wright, T. (2000) Human Papillomavirus DNA Testing for Cervical Cancer Screening in Low Resource Settings. Journal of National Cancer Institute, 92, 818-825.

[19]   Barzanjy, B.K., Talat, L.M. and Ismail, S.A. (2013) Cervical Dysplasia: Assessment and Risk Factors among Women Attending the Maternity Teaching Hospital in Erbil, Kurdistan-Iraq. Zanco Journal of Medical Sciences, 17, 286-293.

[20]   Kritpetcharat, O., Wutichouy, W., Sirijaichingkul, S. and Kritpetcharat, P. (2012) Comparison of Pap Smear Screening Results between Akha Hill Tribe and Urban Women in Chiang Rai Province, Thailand. Asian Pacific Journal of Cancer Prevention, 13, 5501-5504.

[21]   Sasieni, P., Castanon, A. and Cuzick, J. (2009) Effectiveness of Cervical Screening with Age: Population Based Case-Control Study of Prospectively Recorded Data. British Medical Journal, 339, b2968.

[22]   Uribe-Perez, C.J., Diaz-Martinez, L.A., Ortiz-Serrano, R. and Meza-Duran, E.E. (2006) Pap Smear Prevalence and That of Pre-Malignant and Malignant Cervical Lesions amongst Women Living in the Carmen Initiative Demonstration Area, Bucarmanga, Colombia. Revista Colombiana de Obstetricia y Ginecologia, 57, 10-18.

[23]   Baram, D.A. and Basson, R. (2007) Sexuality, Sexual Dysfunction, and Sexual Assault. In: Berek, J.S., Ed., Berek & Novak’s Gynecology, 14th Edition, Lippincott Williams & Wilkins, Philadelphia, 313-349.

[24]   Sultana, R. and Sultana, N. (2012) Clinical Profile and Treatment Protocol of Invasive Carcinoma of Cervix. Bangladesh Medical Journal (Khulna), 45, 11-14.

[25]   Singh, S. and Badaya, S. (2012) Factors Influencing Uptake of Cervical Cancer Screening among Women in India: A Hospital Based Pilot Study. Journal of Community Medicine and Health Education, 2, 1-6.

[26]   Tay, S.K. and Tay, K.J. (2004) Passive Cigarette Smoking Is a Risk Factor in Cervical Neoplasia. Gynecology Oncology, 93, 116-120.

[27]   Cleland, J., Conde-Agudelo, A., Peterson, H., Ross, J. and Tsui, A. (2012) Contraception and Health. The Lancet, 380, 149-156.

[28]   Fouda, L.M. and Elkazeh, E.A. (2014) The Impact of an Educational Intervention on Women’s Knowledge and Perception Regarding Cervical Cancer and Human Papilloma Virus Vaccines in Tanta City: Applying Health Belief Model. Life Science Journal, 11, 289-297.

[29]   Raj, A., Saggurti, N., Winter, M., Labonte, A., Decker, M.R., Balaiah, D. and Silverman, J.G. (2010) The Effect of Maternal Child Marriage on Morbidity and Mortality of Children under 5 in India: Cross Sectional Study of a National Representative Sample. British Medical Journal, 340, b4258.

[30]   Osakinle, E.O., Babatunde, J.O. and Alade, F.A. (2013) Youths and Their Choice of Contraceptives towards an Effective Reproductive Health: The Case of Ekiti State, Nigeria. European Scientific Journal, 9, 193-202.