Antibodies Against Chlamydia trachomatis and Ovarian Cancer Risk in Two Independent Populations

Britton Trabert, Tim Waterboer, Annika Idahl, Nicole Brenner, Louise A. Brinton, Julia Butt, Sally B. Coburn, Patricia Hartge, Katrin Hufnagel, Federica Inturrisi, Jolanta Lissowska, Alexander Mentzer, Beata Peplonska, Mark E. Sherman, Gillian S. Wills, Sarah C. Woodhall, Michael Pawlita, Nicolas Wentzensen

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Pelvic inflammatory disease (PID) has been associated with ovarian cancer risk. To clarify the role of Chlamydia trachomatis and other infectious agents in the development of ovarian cancer, we evaluated the association of serologic markers with incident ovarian cancer using a staged approach in two independent populations. METHODS: Studies included: 1) a case-control study in Poland (244 ovarian cancers/556 control subjects) and 2) a prospective nested case-control study in the PLCO Cancer Screening Trial (160 ovarian cancers/159 control subjects). Associations of serologic marker levels with ovarian cancer risk at diagnostic as well as higher thresholds, identified in Poland and independently evaluated in PLCO, were estimated using multivariable adjusted logistic regression. RESULTS: In the Polish study, antibodies (based on laboratory cut-point) against the chlamydia plasmid-encoded Pgp3 protein (serological gold standard) were associated with increased ovarian cancer risk (adjusted odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.20 to 2.22); when a positive result was redefined at higher levels, ovarian cancer risk was increased (cut-point 2: OR = 2.00, 95% CI = 1.38 to 2.89; cut-point 3 [max OR]: OR = 2.19, 95% CI = 1.29 to 3.73). In the prospective PLCO study, Pgp3 antibodies were associated with elevated risk at the laboratory cut-point (OR = 1.43, 95% CI = 0.78 to 2.63) and more stringent cut-points (cut-point 2: OR = 2.25, 95% CI = 1.07 to 4.71); cut-point 3: OR = 2.53, 95% CI = 0.63 to 10.08). In both studies, antibodies against other infectious agents measured were not associated with risk. CONCLUSIONS: In two independent populations, antibodies against prior/current C. trachomatis (Pgp3) were associated with a doubling in ovarian cancer risk, whereas markers of other infectious agents were unrelated. These findings lend support for an association between PID and ovarian cancer.

Original languageEnglish (US)
Pages (from-to)129-136
Number of pages8
JournalJournal of the National Cancer Institute
Volume111
Issue number2
DOIs
StatePublished - Feb 1 2019

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Chlamydia trachomatis
Ovarian Neoplasms
Antibodies
Odds Ratio
Population
Confidence Intervals
Pelvic Inflammatory Disease
Poland
Case-Control Studies
Chlamydia
Early Detection of Cancer
Plasmids
Logistic Models
Prospective Studies

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Trabert, B., Waterboer, T., Idahl, A., Brenner, N., Brinton, L. A., Butt, J., ... Wentzensen, N. (2019). Antibodies Against Chlamydia trachomatis and Ovarian Cancer Risk in Two Independent Populations. Journal of the National Cancer Institute, 111(2), 129-136. https://doi.org/10.1093/jnci/djy084

Antibodies Against Chlamydia trachomatis and Ovarian Cancer Risk in Two Independent Populations. / Trabert, Britton; Waterboer, Tim; Idahl, Annika; Brenner, Nicole; Brinton, Louise A.; Butt, Julia; Coburn, Sally B.; Hartge, Patricia; Hufnagel, Katrin; Inturrisi, Federica; Lissowska, Jolanta; Mentzer, Alexander; Peplonska, Beata; Sherman, Mark E.; Wills, Gillian S.; Woodhall, Sarah C.; Pawlita, Michael; Wentzensen, Nicolas.

In: Journal of the National Cancer Institute, Vol. 111, No. 2, 01.02.2019, p. 129-136.

Research output: Contribution to journalArticle

Trabert, B, Waterboer, T, Idahl, A, Brenner, N, Brinton, LA, Butt, J, Coburn, SB, Hartge, P, Hufnagel, K, Inturrisi, F, Lissowska, J, Mentzer, A, Peplonska, B, Sherman, ME, Wills, GS, Woodhall, SC, Pawlita, M & Wentzensen, N 2019, 'Antibodies Against Chlamydia trachomatis and Ovarian Cancer Risk in Two Independent Populations', Journal of the National Cancer Institute, vol. 111, no. 2, pp. 129-136. https://doi.org/10.1093/jnci/djy084
Trabert, Britton ; Waterboer, Tim ; Idahl, Annika ; Brenner, Nicole ; Brinton, Louise A. ; Butt, Julia ; Coburn, Sally B. ; Hartge, Patricia ; Hufnagel, Katrin ; Inturrisi, Federica ; Lissowska, Jolanta ; Mentzer, Alexander ; Peplonska, Beata ; Sherman, Mark E. ; Wills, Gillian S. ; Woodhall, Sarah C. ; Pawlita, Michael ; Wentzensen, Nicolas. / Antibodies Against Chlamydia trachomatis and Ovarian Cancer Risk in Two Independent Populations. In: Journal of the National Cancer Institute. 2019 ; Vol. 111, No. 2. pp. 129-136.
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abstract = "BACKGROUND: Pelvic inflammatory disease (PID) has been associated with ovarian cancer risk. To clarify the role of Chlamydia trachomatis and other infectious agents in the development of ovarian cancer, we evaluated the association of serologic markers with incident ovarian cancer using a staged approach in two independent populations. METHODS: Studies included: 1) a case-control study in Poland (244 ovarian cancers/556 control subjects) and 2) a prospective nested case-control study in the PLCO Cancer Screening Trial (160 ovarian cancers/159 control subjects). Associations of serologic marker levels with ovarian cancer risk at diagnostic as well as higher thresholds, identified in Poland and independently evaluated in PLCO, were estimated using multivariable adjusted logistic regression. RESULTS: In the Polish study, antibodies (based on laboratory cut-point) against the chlamydia plasmid-encoded Pgp3 protein (serological gold standard) were associated with increased ovarian cancer risk (adjusted odds ratio [OR] = 1.63, 95{\%} confidence interval [CI] = 1.20 to 2.22); when a positive result was redefined at higher levels, ovarian cancer risk was increased (cut-point 2: OR = 2.00, 95{\%} CI = 1.38 to 2.89; cut-point 3 [max OR]: OR = 2.19, 95{\%} CI = 1.29 to 3.73). In the prospective PLCO study, Pgp3 antibodies were associated with elevated risk at the laboratory cut-point (OR = 1.43, 95{\%} CI = 0.78 to 2.63) and more stringent cut-points (cut-point 2: OR = 2.25, 95{\%} CI = 1.07 to 4.71); cut-point 3: OR = 2.53, 95{\%} CI = 0.63 to 10.08). In both studies, antibodies against other infectious agents measured were not associated with risk. CONCLUSIONS: In two independent populations, antibodies against prior/current C. trachomatis (Pgp3) were associated with a doubling in ovarian cancer risk, whereas markers of other infectious agents were unrelated. These findings lend support for an association between PID and ovarian cancer.",
author = "Britton Trabert and Tim Waterboer and Annika Idahl and Nicole Brenner and Brinton, {Louise A.} and Julia Butt and Coburn, {Sally B.} and Patricia Hartge and Katrin Hufnagel and Federica Inturrisi and Jolanta Lissowska and Alexander Mentzer and Beata Peplonska and Sherman, {Mark E.} and Wills, {Gillian S.} and Woodhall, {Sarah C.} and Michael Pawlita and Nicolas Wentzensen",
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T1 - Antibodies Against Chlamydia trachomatis and Ovarian Cancer Risk in Two Independent Populations

AU - Trabert, Britton

AU - Waterboer, Tim

AU - Idahl, Annika

AU - Brenner, Nicole

AU - Brinton, Louise A.

AU - Butt, Julia

AU - Coburn, Sally B.

AU - Hartge, Patricia

AU - Hufnagel, Katrin

AU - Inturrisi, Federica

AU - Lissowska, Jolanta

AU - Mentzer, Alexander

AU - Peplonska, Beata

AU - Sherman, Mark E.

AU - Wills, Gillian S.

AU - Woodhall, Sarah C.

AU - Pawlita, Michael

AU - Wentzensen, Nicolas

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N2 - BACKGROUND: Pelvic inflammatory disease (PID) has been associated with ovarian cancer risk. To clarify the role of Chlamydia trachomatis and other infectious agents in the development of ovarian cancer, we evaluated the association of serologic markers with incident ovarian cancer using a staged approach in two independent populations. METHODS: Studies included: 1) a case-control study in Poland (244 ovarian cancers/556 control subjects) and 2) a prospective nested case-control study in the PLCO Cancer Screening Trial (160 ovarian cancers/159 control subjects). Associations of serologic marker levels with ovarian cancer risk at diagnostic as well as higher thresholds, identified in Poland and independently evaluated in PLCO, were estimated using multivariable adjusted logistic regression. RESULTS: In the Polish study, antibodies (based on laboratory cut-point) against the chlamydia plasmid-encoded Pgp3 protein (serological gold standard) were associated with increased ovarian cancer risk (adjusted odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.20 to 2.22); when a positive result was redefined at higher levels, ovarian cancer risk was increased (cut-point 2: OR = 2.00, 95% CI = 1.38 to 2.89; cut-point 3 [max OR]: OR = 2.19, 95% CI = 1.29 to 3.73). In the prospective PLCO study, Pgp3 antibodies were associated with elevated risk at the laboratory cut-point (OR = 1.43, 95% CI = 0.78 to 2.63) and more stringent cut-points (cut-point 2: OR = 2.25, 95% CI = 1.07 to 4.71); cut-point 3: OR = 2.53, 95% CI = 0.63 to 10.08). In both studies, antibodies against other infectious agents measured were not associated with risk. CONCLUSIONS: In two independent populations, antibodies against prior/current C. trachomatis (Pgp3) were associated with a doubling in ovarian cancer risk, whereas markers of other infectious agents were unrelated. These findings lend support for an association between PID and ovarian cancer.

AB - BACKGROUND: Pelvic inflammatory disease (PID) has been associated with ovarian cancer risk. To clarify the role of Chlamydia trachomatis and other infectious agents in the development of ovarian cancer, we evaluated the association of serologic markers with incident ovarian cancer using a staged approach in two independent populations. METHODS: Studies included: 1) a case-control study in Poland (244 ovarian cancers/556 control subjects) and 2) a prospective nested case-control study in the PLCO Cancer Screening Trial (160 ovarian cancers/159 control subjects). Associations of serologic marker levels with ovarian cancer risk at diagnostic as well as higher thresholds, identified in Poland and independently evaluated in PLCO, were estimated using multivariable adjusted logistic regression. RESULTS: In the Polish study, antibodies (based on laboratory cut-point) against the chlamydia plasmid-encoded Pgp3 protein (serological gold standard) were associated with increased ovarian cancer risk (adjusted odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.20 to 2.22); when a positive result was redefined at higher levels, ovarian cancer risk was increased (cut-point 2: OR = 2.00, 95% CI = 1.38 to 2.89; cut-point 3 [max OR]: OR = 2.19, 95% CI = 1.29 to 3.73). In the prospective PLCO study, Pgp3 antibodies were associated with elevated risk at the laboratory cut-point (OR = 1.43, 95% CI = 0.78 to 2.63) and more stringent cut-points (cut-point 2: OR = 2.25, 95% CI = 1.07 to 4.71); cut-point 3: OR = 2.53, 95% CI = 0.63 to 10.08). In both studies, antibodies against other infectious agents measured were not associated with risk. CONCLUSIONS: In two independent populations, antibodies against prior/current C. trachomatis (Pgp3) were associated with a doubling in ovarian cancer risk, whereas markers of other infectious agents were unrelated. These findings lend support for an association between PID and ovarian cancer.

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