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Prospective Study of Human Papillomavirus (HPV) Types, HPV Persistence, and Risk of Squamous Cell Carcinoma of the Cervix

Sundstrom, Karin; Eloranta, Sandra; Sparen, Par; Dahlstrom, Lisen Arnheim; Gunnell, Anthony; Lindgren, Anders; Palmgren, Juni; Ploner, Alexander; Sanjeevi, Carani B. and Melbye, Mads, et al. (2010) In Cancer Epidemiology Biomarkers & Prevention 19(10). p.2469-2478
Abstract
Background: The link between squamous cell cervical carcinoma and human papillomavirus (HPV) 16/18 is well established, but the magnitude of the risk association is uncertain and the importance of other high-risk HPV (HRHPV) types is unclear. Methods: In two prospective nested case-control series among women participating in cytologic screening in Sweden, we collected 2,772 cervical smears from 515 women with cancer in situ (CIS), 315 with invasive squamous cell carcinoma (SCC), and individually matched controls. All smears were tested for HPV with PCR assays, and the median follow-up until diagnosis was 5 to 7 years. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (95% CI). Results:... (More)
Background: The link between squamous cell cervical carcinoma and human papillomavirus (HPV) 16/18 is well established, but the magnitude of the risk association is uncertain and the importance of other high-risk HPV (HRHPV) types is unclear. Methods: In two prospective nested case-control series among women participating in cytologic screening in Sweden, we collected 2,772 cervical smears from 515 women with cancer in situ (CIS), 315 with invasive squamous cell carcinoma (SCC), and individually matched controls. All smears were tested for HPV with PCR assays, and the median follow-up until diagnosis was 5 to 7 years. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (95% CI). Results: The presence of HPV16/18 in the first smear was associated with 8.5-fold (95% CI, 5.3-13.7) and 18.6-fold (95% CI, 9.0-38.9) increased risks of CIS and SCC, respectively, compared with women negative for HPV. Infection with other HRHPV types in the first smear was also associated with significantly increased risks for both CIS and SCC. Persistence of HPV16 infection conferred a RR of 18.5 (95% CI, 6.5-52.9) for CIS and 19.5 (95% CI, 4.7-81.7) for SCC. The HPV16/18 attributable risk proportion was estimated at 30% to 50% for CIS, and 41% to 47% for SCC. Other HRHPV types also conferred significant proportions. Conclusions: Our large population-based study provides quantification of risks for different HPV types and prospective evidence that non-16/18 HRHPV types increase the risk for future cervical cancer. Impact: This study gives further insights into cervical cancer risk stratification with implications for HPV-based prevention strategies. Cancer Epidemiol Biomarkers Prev; 19(10); 2469-78. (C) 2010 AACR. (Less)
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Cancer Epidemiology Biomarkers & Prevention
volume
19
issue
10
pages
2469 - 2478
publisher
American Association for Cancer Research
external identifiers
  • wos:000282590500008
  • scopus:77958068161
ISSN
1538-7755
DOI
10.1158/1055-9965.EPI-10-0424
language
English
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yes
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68094767-5e15-4116-8532-de1e6bbf7fff (old id 1727982)
date added to LUP
2010-11-23 09:09:47
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2018-11-11 03:53:10
@article{68094767-5e15-4116-8532-de1e6bbf7fff,
  abstract     = {Background: The link between squamous cell cervical carcinoma and human papillomavirus (HPV) 16/18 is well established, but the magnitude of the risk association is uncertain and the importance of other high-risk HPV (HRHPV) types is unclear. Methods: In two prospective nested case-control series among women participating in cytologic screening in Sweden, we collected 2,772 cervical smears from 515 women with cancer in situ (CIS), 315 with invasive squamous cell carcinoma (SCC), and individually matched controls. All smears were tested for HPV with PCR assays, and the median follow-up until diagnosis was 5 to 7 years. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (95% CI). Results: The presence of HPV16/18 in the first smear was associated with 8.5-fold (95% CI, 5.3-13.7) and 18.6-fold (95% CI, 9.0-38.9) increased risks of CIS and SCC, respectively, compared with women negative for HPV. Infection with other HRHPV types in the first smear was also associated with significantly increased risks for both CIS and SCC. Persistence of HPV16 infection conferred a RR of 18.5 (95% CI, 6.5-52.9) for CIS and 19.5 (95% CI, 4.7-81.7) for SCC. The HPV16/18 attributable risk proportion was estimated at 30% to 50% for CIS, and 41% to 47% for SCC. Other HRHPV types also conferred significant proportions. Conclusions: Our large population-based study provides quantification of risks for different HPV types and prospective evidence that non-16/18 HRHPV types increase the risk for future cervical cancer. Impact: This study gives further insights into cervical cancer risk stratification with implications for HPV-based prevention strategies. Cancer Epidemiol Biomarkers Prev; 19(10); 2469-78. (C) 2010 AACR.},
  author       = {Sundstrom, Karin and Eloranta, Sandra and Sparen, Par and Dahlstrom, Lisen Arnheim and Gunnell, Anthony and Lindgren, Anders and Palmgren, Juni and Ploner, Alexander and Sanjeevi, Carani B. and Melbye, Mads and Dillner, Joakim and Adami, Hans-Olov and Ylitalo, Nathalie},
  issn         = {1538-7755},
  language     = {eng},
  number       = {10},
  pages        = {2469--2478},
  publisher    = {American Association for Cancer Research},
  series       = {Cancer Epidemiology Biomarkers & Prevention},
  title        = {Prospective Study of Human Papillomavirus (HPV) Types, HPV Persistence, and Risk of Squamous Cell Carcinoma of the Cervix},
  url          = {http://dx.doi.org/10.1158/1055-9965.EPI-10-0424},
  volume       = {19},
  year         = {2010},
}