review · PLOS Global Public Health
Cervical cancer represents the leading cause of cancer incidence and death among women across most African countries. While the disease primarily appears after middle age, previous research offered conflicting evidence regarding the role of early sexual activity. A review of ten studies published between 2000 and 2022 evaluated this relationship across major academic databases. Although subgroup analyses detected no significant link, the overall pooled analysis confirmed a statistically significant association between early sexual debut and cervical cancer. Women who initiated sexual intercourse before the age of 18 faced nearly three times higher odds of developing cervical cancer compared with women who started in adulthood. Consequently, strategies focused on delaying the age of first sexual activity among adolescents could contribute to reducing the occurrence of cervical cancer.
Cervical cancer causes severe health burdens for women across Africa. By resolving conflicting evidence regarding early sexual activity, these findings confirm a specific behavioural risk factor. This evidence assists public health planners, educators, and healthcare organisations in designing targeted preventative initiatives and adolescent health programmes to reduce long-term cancer rates.
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INTRODUCTION: In most African countries, cervical cancer is the most common cancer among women, both in terms of incidence and fatality. In the existing literature, age is risk factor for developing cervical cancer since it occurs mainly after the middle life of women. However, there have been contradictory findings in the literature on whether early sexual intercourse is linked to cervical cancer, with some studies indicating no relationship and others reporting an increased risk. Hence, this review analyzed data from recently published studies on cervical cancer. METHODS: Seven databases (MEDLINE via PubMed, Google Scholar, Scopus, Medscape, EMBASE, African Journals Online and Science Direct) were searched for papers published from January 2000 to March 2022 in English. Ten studies were included in analysis. The statistical analysis was performed using STATA 11. Heterogeneity between-study was explored by forest plot and inconsistency index (I2). The publication bias was checked by a funnel plot and Egger's test. The pooled estimates of odds ratios were calculated by a random-effects model. RESULTS: In the subgroup analysis, there was no significant association between early sexual activity and cervical cancer. However, the overall pooled analysis of these ten studies revealed that there is an association between early sexual debut and cervical cancer. In the random effect model, we found a pooled odds ratio of 2.95 (95% CI = 1.06, 4.83), indicating that women who began sexual intercourse before the age of 18 had a higher risk of getting cervical cancer than adult women. CONCLUSION: In this analysis, women who began having early sexual debut had a greater risk of developing cervical cancer than those who initiated sexual intercourse later in life. Delaying the age of first sexual activity among adolescents could help prevent the occurrence of cervical cancer.
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DOI: 10.1371/journal.pgph.0000941
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