Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection:: the IARC multicentric case-control study
Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection:: the IARC multicentric case-control study
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DOI：
10.1016/s0140-6736(02)08150-3
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发表时间：
2002-03-30
期刊：
影响因子：
168.9
通讯作者：
Franceschi, S
中科院分区：
文献类型：
--
作者：
Moreno, V;Bosch, FX;Franceschi, S
背景 使用口服避孕药可能会增加患宫颈癌的风险；然而，宫颈癌的主要原因——人乳头瘤病毒（HPV）的影响通常没有被考虑到。我们的目的是评估口服避孕药的使用如何影响 HPV DNA 检测呈阳性的女性患宫颈癌的风险。 方法 我们汇总了八项针对经组织学证实的浸润性宫颈癌 (ICC) 患者的病例对照研究和两项针对原位癌 (ISC) 患者的研究的数据。有关使用口服避孕药的信息是通过个人访谈获得的。效果以比值比的形式进行评估，并根据可能的混杂因素调整了逻辑回归模型。结果显示，1561 名 ICC 患者中的 1465 名（94%）、292 名 ISC 患者中的 211 名（72%）以及 1916 名对照者中的 255 名（13%）HPV DNA 呈阳性。与从未使用过口服避孕药的患者相比，使用口服避孕药少于 5 年的患者： 患宫颈癌的风险没有增加（比值比 0.73；95% CI 0.52-1-03）。使用口服避孕药 5-9 年的比值比为 2.82 (95% Cl 1.46-5-42)，使用 10 年或更长时间的比值比为 4.03 (2.09-8.02)，并且这些风险自首次或最后一次使用以来并没有随时间变化。 解释 长期使用口服避孕药可能是使女性患宫颈癌的风险增加四倍的辅助因素宫颈 HPV DNA 呈阳性。由于缺乏有关 HPV 状况的全球信息，应付出额外努力，将长期服用口服避孕药的人纳入宫颈筛查计划。
Background Use of oral contraceptives could increase risk of cervical cancer; however the effect of human papillomavirus (HPV), the main cause of cervical cancer, is not usually taken into account. We aimed to assess how use of oral contraceptives affected risk of cervical cancer in women who tested positive for HPV DNA.Methods We pooled data from eight case-control studies of patients with histologically confirmed invasive cervical carcinoma (ICC) and from two studies of patients with carcinoma in situ (ISC). Information about use of oral contraceptives was obtained from personal interviews. Effects were estimated as odds ratios, with logistic-regression models adjusted for possible confounders.Findings 1465 of 1561 (94%) patients with ICC, 211 of 292 (72%) with ISC, and 255 of 1916 (13%) controls were positive for HPV DNA. Compared with never-users, patients who had used oral contraceptives for fewer than 5 years did: not have increased risk of cervical cancer (odds ratio 0.73; 95% CI 0.52-1-03). The odds ratio for use of oral contraceptives was 2.82 (95% Cl 1.46-5-42) for 5-9 years, and 4.03 (2.09-8.02) for use for 10 years or longer, and these risks did not vary by time since first or last use.Interpretation Long-term use of oral contraceptives could be a cofactor that increases risk of cervical carcinoma by up to four-fold in women who are positive for cervical HPV DNA. In the absence of worldwide information about HPV status, extra effort should be made to include long-term users of oral contraceptives in cervical screening programmes.