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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Worldwide human papillomavirus etiology of cervical adenocarcinoma and its cofactors: Implications for screening and prevention
Journal of the National Cancer Institute, Volume 98, No. 5, Year 2006
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Description
Background: Most cancers of the uterine cervix are squamous cell carcinomas. Although the incidence of such carcinomas of the uterine cervix has declined over time, that of cervical adenocarcinoma has risen in recent years. The extent to which human papillomavirus (HPV) infection and cofactors may explain this differential trend is unclear. Methods: We pooled data from eight case-control studies of cervical can cer that were conducted on three continents. A total of 167 case patients with invasive cervical adenocarcinoma (112 with adenocarcinoma and 55 with adenosquamous carcinoma) and 1881 hospital-based control subjects were included. HPV DNA was analyzed in cervical specimens with the GP5+/6+ general primer system followed by type-specific hybridization for 33 HPV genotypes. Blood samples were analyzed for chlamydial and herpes simplex virus 2 (HSV-2) serology. Multivariable unconditional logistic regression modeling was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs). All tests of statistical significance were two-sided. Results: The adjusted overall odds ratio for cervical adenocarcinoma in HPV-positive women compared with HPV-negative women was 81.3 (95% CI = 42.0 to 157.1). HPV 16 and HPV 18 were the two most commonly detected HPV types in case patients and control subjects. These two types were present in 82% of the patients. Cofactors that showed clear statistically significant positive associations with cervical adenocarcinoma overall and among HPV-positive women included never schooling, poor hygiene, sexual behavior-related variables, long-term use of hormonal contraception, high parity, and HSV-2 seropositivity. Parity had a weaker association with adenocarcinoma and only among HPV-positive women. Use of an intrauterine device (IUD) had a statistically significant inverse association with risk of adenocarcinoma (for ever use of an IUD compared with never use, OR = .41 [95% CI = 0.18 to 0.93]). Smoking and chlamydial seropositivity were not associated with disease. Conclusions: HPV appears to be the key risk factor for cervical adenocarcinoma. HPV testing in primary screening using current mixtures of HPV types and HPV vaccination against main HPV types should reduce the incidence of this cancer worldwide. © 2006 Oxford University Press.
Authors & Co-Authors
Castellsagué, X.
Spain, Hospitalet de Llobregat
Institute Catala Oncologia
Diaz, Mireia
Spain, Hospitalet de Llobregat
Institute Catala Oncologia
de Sanjosé, Sílvia
Spain, Hospitalet de Llobregat
Institute Catala Oncologia
Muñoz, Nubia
Spain, Hospitalet de Llobregat
Institute Catala Oncologia
Herrero, Rolando
Costa Rica, Tres Rios
Instituto Costarricense de Investigacion y Ensenanza en Nutricion y Salud Costa Rica
Franceschi, Silvia F.
France, Lyon
Centre International de Recherche Sur le Cancer
Peeling, Rosanna Wai Wan
Canada, Ottawa
Health Canada
Ashley, Rhoda L.
United States, Seattle
University of Washington
Smith, Jennifer Susan
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Snijders, Peter Jf
Netherlands, Amsterdam
Amsterdam Umc - Vrije Universiteit Amsterdam
Meijer, Chris J.L.M.
Netherlands, Amsterdam
Amsterdam Umc - Vrije Universiteit Amsterdam
Bosch, Francisco Xavier
Spain, Hospitalet de Llobregat
Institute Catala Oncologia
Plummer, Martyn T.
France, Lyon
Centre International de Recherche Sur le Cancer
Moreno, Victor R.
Spain, Hospitalet de Llobregat
Institute Catala Oncologia
Alonso de Ruiz, P.
Mexico, Mexico
Hospital General de Mexico
Chichareon, Saibua Bunnag
Thailand, Hatyai
Prince of Songkla University
Ngelangel, Corazon A.
Philippines, Manila
University of the Philippines Manila
Eluf-Neto, Jose E.
Brazil, Sao Paulo
Universidade de São Paulo
Roló, A.
Paraguay, Asuncion
Laboratorio Privado de Anatomía Patológica
Caceres, Eduardo
Peru, Lima
Hospital Del Cancer-instituto Maes-heller
Santos, Carlos L.
Peru, Lima
Hospital Del Cancer-instituto Maes-heller
Chaouki, Noureddine
Morocco, Agdal Rabat
National Institute of Oncology, Rabat
Elgueddari, Brahim El Khalil
Morocco, Agdal Rabat
National Institute of Oncology, Rabat
Hammouda, Doudja
Algeria, Algiers
Institut National de Sante Publique
Rajkumar, Thangarajan
India, Chennai
Cancer Institute India
Statistics
Citations: 672
Authors: 25
Affiliations: 16
Identifiers
Doi:
10.1093/jnci/djj067
ISSN:
00278874
e-ISSN:
14602105
Research Areas
Cancer
Genetics And Genomics
Health System And Policy
Sexual And Reproductive Health
Study Design
Cohort Study
Case-Control Study
Participants Gender
Female