Prospective study of human papillomavirus (HPV) types, HPV persistence, and risk of squamous cell carcinoma of the cervix.
Prospective study of human papillomavirus (HPV) types, HPV persistence, and risk of squamous cell carcinoma of the cervix.
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DOI：
10.1158/1055-9965.epi-10-0424
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发表时间：
2010-10
期刊：
影响因子：
--
通讯作者：
Ylitalo N
中科院分区：
文献类型：
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作者：
Sundström K;Eloranta S;Sparén P;Arnheim Dahlström L;Gunnell A;Lindgren A;Palmgren J;Ploner A;Sanjeevi CB;Melbye M;Dillner J;Adami HO;Ylitalo N
The link between squamous cell cervical carcinoma and HPV 16/18 is well-established but the magnitude of the risk association is uncertain and the importance of other high-risk HPV types unclear. In two prospective nested case-control series among women participating in cytological screening in Sweden, we collected 2772 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 5-7 years. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (CI). 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 to women negative for HPV. Infection with other high-risk HPV 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 to 30-50% of CIS, and 41-47% of SCC. Other high-risk HPV types also conferred significant proportions. Our large population-based study provides quantification of risks for different HPV types and prospective evidence that non-16/18 high-risk HPV types increase the risk for future cervical cancer. This study gives further insights into cervical cancer risk stratification with implications for HPV-based prevention strategies.
