Risk factors for cervical cancer in Morocco: a case-control study.
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INTRODUCTION: Cervical cancer (CC) is one of the most common malignancies among women in Morocco. This study aims to evaluate the risk factors associated with CC in Moroccan women aged 18 to 62. METHODS: this was a case-control study of 169 women who received radio-chemotherapy and 100 controls. Statistical analyses were performed using SPSS version 29.0.10 to determine associated factors at a significance level of ≤0.05. RESULTS: significant associations were found between CC and the following factors: educational level (OR= 9.167), sexual activity during menstruation (OR= 2.351), previous occurrences of sexually transmitted infections (OR= 2.173), and history of multiple sexual partners by the husband (OR= 6.305). However, family history of cancer, consanguinity, number of sleeping hours, and stress did not show any significant association with CC. HPV infection was detected in 33.81% of cases and 8% of controls, with HPV16 being the most prevalent genotype (59.57%), followed by HPV53 (14.79%). Other genotypes were found at lower frequencies. The phylogenetic analysis of HPV isolates showed that the distribution of HPV sequences in Moroccan women with cervical cancer is mainly linked to European, Saudi Arabian and North African epidemiological conditions, suggesting recombinant HPV forms. Additionally, American isolates formed two distinct outgroups, likely due to geographical distance, indicating variations in HPV strains by region. CONCLUSION: Morocco faces a significant burden of CC, with HPV being the primary cause. Lifestyle risk factors like low education, male sexual behavior, multiple pregnancies, and sexual intercourse also contribute.