Type 2 Diabetes Mellitus and Habits Lifestyle Increases the Risk of Cervical Cancer: a Cross-Sectional Population-Based Study

Background: Timely detection allows the inclusion of vulnerable populations into the cervical cancer (CC) screening programs, particularly in low- and middle-income countries. The aim was determine both the prevalence and the risk of CC in patients who have type 2 diabetes mellitus (T2DM). Methods: A cross-sectional population-based survey in Mexico was conducted using a probabilistic, multistage, and stratified cluster sampling design. The structured questionnaire included information on geographic region, personal history, and life styles, and anthropometric measures. A total of 160 cases of CC (median age 48 years, range 24-81) and 25,262 control females (median age 39 years, range 20-99) were included. Results: The prevalence of CC in women with T2DM was significantly higher compared with females without diabetes (1,336 vs. 576 subjects per 100,000 inhabitants, p<0.001). In all univariate (U) and multivariate (M) logistic regression models (LRM), the ORs for CC displayed a significant association with diabetes (ULRM OR=2.338; 95% CI 1.511-3.618, p<0.001, MLRM1 OR=2.098; 95% CI 1.345-3.272, p=0.001, MLRM2 OR=1.719; 95% CI 1.0.33-2.862, p=0.001) and tobacco smoking (ULRM OR=1.979; 95% CI 1.368-2.863, p<0.001, MLRM1 OR=1.847; 95% CI 1.234-2.765, p=0.003, MLRM2 OR=1.859; 95% CI 1.191-2.902, p=0.006). The ULRM indicated a significant association for separate (OR=1.906; 95% CI 1.178-3.085, p=0.009), widowed (OR=1.615; 95% CI 1.059-2.462, p=0.026) and single MS (OR=3.297; 95% CI 1.618-6.717, p=0.001). The MLRM2 indicated a similar association for the variables sedentary (OR=8.676; 95% CI 1.204-62.497, p=0.032), physical activity (OR=0.115; 95% CI 0.016-0.827, p=0.032) and body fat percentage (OR=1.084; 95% CI 1.023-1.149, p=0.006). Conclusion: This study supports an association between personal history of diabetes and tobacco smoking and life styles with CC.