CIN or Not to Sin

Cervical neoplasia has been extensively studied with respect to its pathological and epidemiologic factors. There is a continuum of disease that ranges from cervical intraepithelial neoplasia (CIN) 1 to widespread metastatic disease. The risk factors for CIN or invasive cancers developing appear to be similar. The epidemiology of cervical neoplasia was first studied by Gagnon, 2 who showed that this disease was absent in a population of Canadian nuns. Since this initial study, it is clear that cervical cancer is related to a number of identifiable risk factors, including early sexual activity, multiple pregnancies, multiple sexual partners, early age at first pregnancy or first marriage, promiscuity, and exposure to a "high-risk" male sexual partner. When all of the epidemiologic risk factors are analyzed, one finds that they have in common the degree of sexual activity engaged in by the women with cervical neoplasia or by their sexual partner(s) and that