Measuring cervical cancer risk: development and validation of the CARE Risky Sexual Behavior Index

Cancer Causes Control. 2009 Dec;20(10):1865-71. doi: 10.1007/s10552-009-9380-5.


Objectives: To develop and validate a risky sexual behavior index specific to cervical cancer research.

Methods: Sexual behavior data on 428 women from the Community Awareness Resources and Education (CARE) study were utilized. A weighting scheme for eight risky sexual behaviors was generated and validated in creating the CARE Risky Sexual Behavior Index. Cutpoints were then identified to classify women as having a low, medium, or high level of risky sexual behavior.

Results: Index scores ranged from 0 to 35, with women considered to have a low level of risky sexual behavior if their score was less than six (31.3% of sample), a medium level if their score was 6–10 (30.6%), or a high level if their score was 11 or greater (38.1%). A strong association was observed between the created categories and having a previous abnormal Pap smear test (p < 0.001).

Conclusions: The CARE Risky Sexual Behavior Index provides a tool for measuring risky sexual behavior level for cervical cancer research. Future studies are needed to validate this index in varied populations and test its use in the clinical setting.

Publication types

  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / epidemiology
  • Carcinoma / etiology*
  • Female
  • Humans
  • Middle Aged
  • Reproductive History
  • Risk Factors
  • Risk-Taking*
  • Sexual Behavior / physiology*
  • Sexual Behavior / statistics & numerical data
  • Surveys and Questionnaires*
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / etiology*
  • Young Adult