The incidence of cervical cancer in Germany remains high in relation to other countries in Western Europe. Germany currently does not have an organized cervical cancer screening (CCS) program and screening efforts with the Pap smear remain opportunistic. Recent studies have shown levels of physical activity and sport to be associated with cancer prevention, although data on the association with cervical cancer remain limited. The TeQaZ study is a case-control study investigating participation in CCS. Associations between cervical cancer and other risk factors, such as physical activity and obesity, were investigated.
Incident cases of cervical cancer, diagnosed between 2012 and 2016 in different regions in Germany, were recruited. Cases were matched with three population-based controls, recruited via population registries, based on age and region of residence. Gynecologists were asked to report frequency of CCS participation during the past ten years. Socio-demographic and other risk factors were assessed in cases and controls via telephone interviews. Physical activity was defined as engaging in any form of movement such as walking stairs and doing housework. Additionally, sport activity was documented and Body Mass Index (BMI) calculated. Conditional logistic regression analyses were performed.
A total of 218 cases and 654 controls were included in the analysis. 94.5% of cases engaged in any kind of physical activity at least 30 minutes a day compared to 92.2% of controls. 21.2% of cases and 21.1% of controls participated in sport at least three times a week. With regards to obesity, 20.6% of cases versus 12.2% of controls had a BMI over 30. When adjusting for additional factors, participating in sport at least three times a week and engaging in any physical activity at least 30 minutes a day did not show any preventive effect. However, BMI >=30 and participation in CCS less frequently than every three years were strong risk factors for cervical cancer. However, only 52.1% of women with a BMI over 30 participated in CCS at least every three years, compared to 71.6% of women who were not overweight (p<0.05). Results of the conditional logistic regression will be presented.
Initial findings suggest that physical activity and sport are not associated with developing cervical cancer. An association between BMI and cervical cancer was found, although this may be due to decreased participation in CCS among overweight women.