Prevalence of Preinvasive and Invasive Lesions of the Cervix in Sexual Workers José T. Nu ´n ˜ ez, MD, 1 Mariela Delgado, MD, 2 Gloria Pino, Mg Sc, 3 Hugo Giro ´ n, MD, 4 and Bárbara Bolet, MD 5 1 Department of Obstetrics and Gynecology, Manuel Noriega Trigo Hospital, School of Medicine, University of Zulia, Maracaibo, Venezuela; 2 Department of Pathology, Chiquinquira Hospital, Maracaibo, Venezuela; 3 Center of Psychological Research, Rafael Urdaneta University, Maracaibo, Venezuela; 4 Department of Obstetrics and Gynecology, Manuel Noriega Trigo Hospital, Maracaibo, Venezuela; and 5 Department of Obstetrics and Gynecology, Manuel Noriega Trigo Hospital, Maracaibo, Venezuela ■ Abstract: Objective. To determine the prevalence of pre- invasive and invasive lesions of the cervix in sexual workers. Materials and Methods. A total of 438 prostitutes were analyzed. Each prostitute had a clinical history, gynecological examination, Pap smear, and a colposcopic examination of the cervix. A cervical biopsy was taken under colposcopic guidance when there was abnormal epithelium. Results. The sexual workers’ mean age was 32.2  8 years (mean  SD), age of first sexual intercourse was 15.9  2 years, parity mean was 4.1  2, births were 3  3, and age of first delivery was 16.6  4.7 years. Cervical biopsies were taken from 84 patients because of atypical epithelium under colposcopic examination. Sixty-four (76.2%) patients had preinvasive and invasive lesions: 41(64%) had cervical intra- epithelial neoplasia (CIN) 1, 12 (18.8%) had CIN 2, 8 (12.5%) had CIN 3, 2 (3.2%) had microinvasive carcinoma (Ca), and 1 (1.5%) had invasive Ca 1. Sexual workers with cervical pathology were younger (p < .05) and had their first sexual intercourse experience earlier than those sexual workers who did not have lesions (p < .02). Preinvasive lesions were found in sexual workers in their 30s, and invasive lesions were found in sexual workers under the age of 40. Conclusions. Preinvasive lesions of the cervix have in- creased 2-fold in Venezuelan sexual workers and the invasive lesions are stable but found in younger sexual workers. ■ Key Words: sexual worker, cervical intraepithelial neoplasia, invasive cancer C ervical cancer is still a worldwide threat even though the Pap test was introduced more than 50 years ago [1]. It is estimated that there are over 400,000 new cases of cervical cancer every year worldwide, at least three fourths of them in developing countries [1]. Using a world standardized population, the age- adjusted incidence of cervical cancer is estimated to be between 10 and 40 × 100,000 [2]. In Finland [1, 3], the incidence rate is as low as 4.4 × 100,000. Brazil has a higher incidence rate of 48.9 cases × 100,000 [1]. In Venezuela, the mortality rate of cervical cancer was 11.5 × 100,000 women between 1990 and 1995 [4]. Cervical cancer has a prolonged preclinical phase that lasts many years, and the number of premalignant and carcinoma in situ (CIS) cases is much higher than invasive cervical cancer [5]. Cervical cancer is associated with several risk factors Reprint requests to: Jose ´ Nu ´n ˜ ez, MD, Apartado 525, Co ´ digo Postal 2001-A, Maracaibo, Venezuela. E-mail: jnunezt@telcel.net.ve © 2002, American Society for Colposcopy and Cervical Pathology Journal of Lower Genital Tract Disease, Volume 6, Number 2, 2002, 76–79