Limited education as a risk factor in cervical cancer.

To investigate the association between formal education and cervical cancer incidence the 2204 cervical cancer cases from Quito Ecuador reported to the National Tumor Registry for the 1985-94 period were reviewed. The incidence of cervical cancer (in situ and invasive) per 100000 women was 88.3 among women with no education 52.6 among those with a primary education 28.8 among women with a secondary education and 14.9 among those with a university education. Invasive cervical cancer incidence among women with no more than a primary education rose sharply from the 20-24 year group to the 55-59 year group declined slightly in the 60-64 year group then peaked at 123 cases/100000 women 65 years and over. Among those with a secondary education incidence peaked at 72.5 cases/100000 in the 55-59-year group. Among women with higher education the incidence was only 8.6/100000 in the 40-44 year group remained under 30 in the 45-49 and 50-54-year groups and peaked at 44/100000 in women 65 years and over. A similar pattern was observed for in situ carcinoma. Among illiterate women only 13.1% of cancers were detected at stage I compared with 48.5% among women with a secondary or higher education; conversely 51.7% of cancers among illiterate women were detected in the advanced stages III and IV compared with 21.8% among those with a secondary or higher education. These findings suggest the feasibility of considering womens education a significant factor in defining risk groups for cervical cancer.