HPV co-factors related to the development of cervical cancer: results from a population-based study in Costa Rica
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Authors
Hildesheim, A.
Herrero, R.
Castle, P. E.
Wacholder, S.
Bratti, M. C.
Sherman, M. E.
Lorincz, A. T.
Burk, R. D.
Morales, J.
Rodriguez, A. C.
Issue Date
2001-05
Type
Article
Language
en_US
Keywords
Cervix , Human Papillomavirus , Cancer , Smoking , Parity
Alternative Title
Abstract
We examined factors associated with high-grade squamous intraepithelial lesions (HSIL) and cervical cancer among human papillomavirus (HPV)-infected women in a prevalent case–control study conducted within a population-based cohort of 10 077 women in Costa Rica. We compared 146 women with HPV-positive HSIL or cancer (HSIL/CA) against 843 HPV-positive women without evidence of HSIL/CA. Subjects completed a risk factor questionnaire. We evaluated the associations between exposures and HSIL/CA among women positive for any HPV and restricted to those positive for high-risk HPV types. Risk of HSIL/CA increased with increasing number of live births (Ptrend= 0.04). Women who smoked 6+ cigarettes/day had a RR for HSIL/CA of 2.7 (95% CI = 1.1–6.7) compared to non-smokers. Current use of barrier contraceptives was associated with a reduction in risk of HSIL/CA (RR = 0.39; 95% CI = 0.16–0.96). Sexual behaviour and a self-reported history of sexually transmitted diseases (STDs) other than HPV were not associated with HSIL/CA. Oral contraceptive use was associated with HSIL/CA among women with <3 pregnancies. Effects were similar in analysis restricted to women positive for high-risk HPV types. Among women positive for high-risk HPV types, 44% of HSIL/CA could be attributed to multiparity (≥3 pregnancies) and/or smoking. Among HPV-positive women, multiparity and smoking are risk factors for HSIL/CA. Oral contraceptive use may be associated with HSIL/CA in subgroups of women. © 2001 Cancer Research Campaign http://www.bjcancer.com
Description
Citation
Hildesheim, A., Herrero, R., Castle, P. E., Wacholder, S., Bratti, M. C., Sherman, M. E., Lorincz, A. T., Burk, R. D., Morales, J., Rodriguez, A. C., Helgesen, K., Alfaro, M., Hutchinson, M., Balmaceda, I., Greenberg, M., & Schiffman, M. (2001). HPV co-factors related to the development of cervical cancer: results from a population-based study in Costa Rica. British journal of cancer, 84(9), 1219–1226. https://doi.org/10.1054/bjoc.2001.1779
Publisher
British Journal of Cancer