HPV co-factors related to the development of cervical cancer: Results from a population-based study in Costa Rica

A. Hildesheim; R. Herrero; P. E. Castle; S. Wacholder; M. C. Bratti; M. E. Sherman; A. T. Lorincz; R. D. Burk; J. Morales; A. C. Rodriguez; K. Helgesen; M. Alfaro; M. Hutchinson; I. Balmaceda; M. Greenberg; M. Schiffman

doi:10.1054/bjoc.2001.1779

HPV co-factors related to the development of cervical cancer: Results from a population-based study in Costa Rica

A. Hildesheim, R. Herrero, P. E. Castle, S. Wacholder, M. C. Bratti, M. E. Sherman, A. T. Lorincz, R. D. Burk, J. Morales, A. C. Rodriguez, K. Helgesen, M. Alfaro, M. Hutchinson, I. Balmaceda, M. Greenberg, M. Schiffman

Quantitative Health Sciences

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183 Scopus citations

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 (P_trend = 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.

Original language	English (US)
Pages (from-to)	1219-1226
Number of pages	8
Journal	British journal of cancer
Volume	84
Issue number	9
DOIs	https://doi.org/10.1054/bjoc.2001.1779
State	Published - May 4 2001

Keywords

Cancer
Cervix
Human papillomavirus
Parity
Smoking

ASJC Scopus subject areas

Oncology
Cancer Research

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10.1054/bjoc.2001.1779

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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

Hildesheim, A, Herrero, R, Castle, PE, Wacholder, S, Bratti, MC, Sherman, ME, Lorincz, AT, Burk, RD, Morales, J, Rodriguez, AC, 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, vol. 84, no. 9, pp. 1219-1226. https://doi.org/10.1054/bjoc.2001.1779

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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.",

keywords = "Cancer, Cervix, Human papillomavirus, Parity, Smoking",

author = "A. Hildesheim and R. Herrero and Castle, {P. E.} and S. Wacholder and Bratti, {M. C.} and Sherman, {M. E.} and Lorincz, {A. T.} and Burk, {R. D.} and J. Morales and Rodriguez, {A. C.} and K. Helgesen and M. Alfaro and M. Hutchinson and I. Balmaceda and M. Greenberg and M. Schiffman",

note = "Funding Information: This project was supported by a series of National Cancer Institute contracts. We wish to acknowledge the collaboration of Julie Buckland (IMS, Rockville, MD) for data management. We thank Deidra Kelly (Johns Hopkins University) and Dr Laurie Mango (Neuromedical Systems, NY) for their collaboration in the interpretation of cytological specimens. Reagents and services were supplied or discounted by Cytyc Inc (Boxborough, MA), National Testing Laboratories (Fenton, MO), Utah Medical (Midvale, UT), and Neuromedical Systems (Suffern, NY). We offer special recognition for the excellent work of the study staff in Costa Rica, in particular Fernando Cardenas, Manuel Barrantes, Elmer Perez, Lidia Ana Morera and Iris Ugarte. We also acknowledge the collaboration of health authorities in Costa Rica for their enthusiastic support of this project and of the outreach workers of the Ministry of Health of Costa Rica who carried out the population census for their dedication to the health of the people of Guanacaste. We thank Dr Sophia Wang (NCI) for her critical review of this manuscript. Dr Lorincz is scientific director of Digene and holds Digene stock and stock options.",

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doi = "10.1054/bjoc.2001.1779",

language = "English (US)",

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T1 - HPV co-factors related to the development of cervical cancer

T2 - Results from a population-based study in Costa Rica

AU - Hildesheim, A.

AU - Herrero, R.

AU - Castle, P. E.

AU - Wacholder, S.

AU - Bratti, M. C.

AU - Sherman, M. E.

AU - Lorincz, A. T.

AU - Burk, R. D.

AU - Morales, J.

AU - Rodriguez, A. C.

AU - Helgesen, K.

AU - Alfaro, M.

AU - Hutchinson, M.

AU - Balmaceda, I.

AU - Greenberg, M.

AU - Schiffman, M.

N1 - Funding Information: This project was supported by a series of National Cancer Institute contracts. We wish to acknowledge the collaboration of Julie Buckland (IMS, Rockville, MD) for data management. We thank Deidra Kelly (Johns Hopkins University) and Dr Laurie Mango (Neuromedical Systems, NY) for their collaboration in the interpretation of cytological specimens. Reagents and services were supplied or discounted by Cytyc Inc (Boxborough, MA), National Testing Laboratories (Fenton, MO), Utah Medical (Midvale, UT), and Neuromedical Systems (Suffern, NY). We offer special recognition for the excellent work of the study staff in Costa Rica, in particular Fernando Cardenas, Manuel Barrantes, Elmer Perez, Lidia Ana Morera and Iris Ugarte. We also acknowledge the collaboration of health authorities in Costa Rica for their enthusiastic support of this project and of the outreach workers of the Ministry of Health of Costa Rica who carried out the population census for their dedication to the health of the people of Guanacaste. We thank Dr Sophia Wang (NCI) for her critical review of this manuscript. Dr Lorincz is scientific director of Digene and holds Digene stock and stock options.

PY - 2001/5/4

Y1 - 2001/5/4

N2 - 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.

AB - 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.

KW - Cancer

KW - Cervix

KW - Human papillomavirus

KW - Parity

KW - Smoking

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ER -

HPV co-factors related to the development of cervical cancer: Results from a population-based study in Costa Rica

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Keywords

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