Reproductive Determinants of Histopathological Variants of Cervical Cancer in Eastern Indonesia: A Retrospective Observational Study
Anggia Mayangsari Wardhana *
Department of Obstetrics and Gynecology, Abdoel Wahab Sjahranie General Hospital, Samarinda, East Kalimantan, Indonesia.
*Author to whom correspondence should be addressed.
Abstract
Aims: To examine the association between reproductive factors and the histopathological type of cervical cancer, specifically comparing squamous cell carcinoma and adenocarcinoma.
Methodology: The study was carried out at Abdoel Wahab Sjahranie General Hospital using medical record data from January 2023 to December 2024, and is a retrospective observational study. Secondary data were obtained from medical records of cervical cancer patients who underwent biopsy during the study period. A total of 97 patients were included through simple random sampling. Histopathological findings were grouped into squamous cell carcinoma (including keratinizing and non-keratinizing subtypes) and adenocarcinoma. Reproductive factors analyzed included number of marriages, age at menarche, age at marriage, parity, and history of abortion and fetal death. Bivariate analysis was performed using the Mann–Whitney U test. Variables with a P < .25 were included in multivariate binary logistic regression analysis. Statistical significance was set at P < .05
Results: The mean age of patients was 49.00 10.00 years. Bivariate analysis showed that parity was significantly associated with histopathological type (mean 3.21 1.91; P = .005), while other reproductive factors were not. In multivariate analysis, parity remained the only independent predictor of histopathological type, with higher parity associated with a lower likelihood of adenocarcinoma compared with squamous cell carcinoma (OR = 0.68; 95% CI: 0.50–0.92; P = .01). Age at menarche and age at marriage were not independently associated with histopathological type. The regression model explained 14.5% of the variability in histopathological type.
Conclusion: Parity is the only reproductive factor independently associated with the histopathological type of cervical cancer. Higher parity is more strongly linked to squamous cell carcinoma, while adenocarcinoma is more frequently observed among women with lower parity. These findings may support risk stratification and more targeted counseling and screening strategies in clinical and public health settings.
Keywords: Adenocarcinoma, cervical cancer, reproductive factors, squamous cell carcinoma