Chlamydia trachomatis and risk of prevalent and incident cervical premalignancy in a population-based cohort

Mahboobeh Safaeian, Koen Quint, Mark Schiffman, Ana Cecilia Rodriguez, Sholom Wacholder, Rolando Herrero, Allan Hildesheim, Raphael P. Viscidi, Wim Quint, Robert D. Burk

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Abstract

BackgroundCofactors might affect the risk of the rare progression from infection with carcinogenic human papillomavirus (HPV) to cervical premalignancy to invasive cancer. Some studies have observed that Chlamydia trachomatis infection is associated with increased risk for cervical cancer. In a large prospective cohort, we assessed the role of C trachomatis in cervical premalignancy and addressed confounding by HPV.MethodsWe identified 182 women with prevalent and 132 women with incident histological cervical intraepithelial neoplasia grade 2 (CIN2), grade 3 (CIN3), or cervical cancer (CIN2+) in the Costa Rica HPV Natural History Study. Control subjects were 995 (approximately 10% of the 10049) subjects who were randomly selected from the same study. Cervical HPV status at enrollment was determined by MY09/MY11 polymerase chain reaction amplification and dot-blot hybridization. The presence of C trachomatis DNA in cervical exfoliated cells at enrollment was determined by a novel serovar-specific polymerase chain reaction-based C trachomatis detection and genotyping assay. Plasma drawn at enrollment from each subject was used to determine C trachomatis immunoglobulin G (IgG) status. Logistic regression was used to examine the association between C trachomatis and CIN2+, taking into account possible confounding by HPV.ResultsC trachomatis positivity at enrollment was associated with CIN2+ and concurrent and subsequent carcinogenic HPV infection. To account for confounding by HPV status, we restricted the analysis to women positive for carcinogenic HPV DNA at enrollment and found no association between C trachomatis status (as assessed by DNA or IgG) at enrollment and combined prevalent and/or incident CIN2+ (for C trachomatis DNA positivity, odds ratio = 0.77, 95% confidence interval = 0.42 to 1.41; for C trachomatis seropositivity, odds ratio = 1.09, 95% confidence interval = 0.85 to 1.41).ConclusionsWe found no association between C trachomatis status, as assessed by DNA or IgG, and risk of cervical premalignancy, after controlling for carcinogenic HPV-positive status. Previous positive associations between C trachomatis and cervical premalignancy could have been caused, in part, by an increased susceptibility to HPV infection.

Original languageEnglish (US)
Pages (from-to)1794-1804
Number of pages11
JournalJournal of the National Cancer Institute
Volume102
Issue number23
DOIs
StatePublished - Dec 2010

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Chlamydia trachomatis
Cervical Intraepithelial Neoplasia
Population
DNA
Papillomavirus Infections
Immunoglobulin G
Uterine Cervical Neoplasms
Odds Ratio
Confidence Intervals
Costa Rica
Polymerase Chain Reaction
Chlamydia Infections
Natural History
Logistic Models

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Chlamydia trachomatis and risk of prevalent and incident cervical premalignancy in a population-based cohort. / Safaeian, Mahboobeh; Quint, Koen; Schiffman, Mark; Rodriguez, Ana Cecilia; Wacholder, Sholom; Herrero, Rolando; Hildesheim, Allan; Viscidi, Raphael P.; Quint, Wim; Burk, Robert D.

In: Journal of the National Cancer Institute, Vol. 102, No. 23, 12.2010, p. 1794-1804.

Research output: Contribution to journalArticle

Safaeian, M, Quint, K, Schiffman, M, Rodriguez, AC, Wacholder, S, Herrero, R, Hildesheim, A, Viscidi, RP, Quint, W & Burk, RD 2010, 'Chlamydia trachomatis and risk of prevalent and incident cervical premalignancy in a population-based cohort', Journal of the National Cancer Institute, vol. 102, no. 23, pp. 1794-1804. https://doi.org/10.1093/jnci/djq436
Safaeian, Mahboobeh ; Quint, Koen ; Schiffman, Mark ; Rodriguez, Ana Cecilia ; Wacholder, Sholom ; Herrero, Rolando ; Hildesheim, Allan ; Viscidi, Raphael P. ; Quint, Wim ; Burk, Robert D. / Chlamydia trachomatis and risk of prevalent and incident cervical premalignancy in a population-based cohort. In: Journal of the National Cancer Institute. 2010 ; Vol. 102, No. 23. pp. 1794-1804.
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abstract = "BackgroundCofactors might affect the risk of the rare progression from infection with carcinogenic human papillomavirus (HPV) to cervical premalignancy to invasive cancer. Some studies have observed that Chlamydia trachomatis infection is associated with increased risk for cervical cancer. In a large prospective cohort, we assessed the role of C trachomatis in cervical premalignancy and addressed confounding by HPV.MethodsWe identified 182 women with prevalent and 132 women with incident histological cervical intraepithelial neoplasia grade 2 (CIN2), grade 3 (CIN3), or cervical cancer (CIN2+) in the Costa Rica HPV Natural History Study. Control subjects were 995 (approximately 10{\%} of the 10049) subjects who were randomly selected from the same study. Cervical HPV status at enrollment was determined by MY09/MY11 polymerase chain reaction amplification and dot-blot hybridization. The presence of C trachomatis DNA in cervical exfoliated cells at enrollment was determined by a novel serovar-specific polymerase chain reaction-based C trachomatis detection and genotyping assay. Plasma drawn at enrollment from each subject was used to determine C trachomatis immunoglobulin G (IgG) status. Logistic regression was used to examine the association between C trachomatis and CIN2+, taking into account possible confounding by HPV.ResultsC trachomatis positivity at enrollment was associated with CIN2+ and concurrent and subsequent carcinogenic HPV infection. To account for confounding by HPV status, we restricted the analysis to women positive for carcinogenic HPV DNA at enrollment and found no association between C trachomatis status (as assessed by DNA or IgG) at enrollment and combined prevalent and/or incident CIN2+ (for C trachomatis DNA positivity, odds ratio = 0.77, 95{\%} confidence interval = 0.42 to 1.41; for C trachomatis seropositivity, odds ratio = 1.09, 95{\%} confidence interval = 0.85 to 1.41).ConclusionsWe found no association between C trachomatis status, as assessed by DNA or IgG, and risk of cervical premalignancy, after controlling for carcinogenic HPV-positive status. Previous positive associations between C trachomatis and cervical premalignancy could have been caused, in part, by an increased susceptibility to HPV infection.",
author = "Mahboobeh Safaeian and Koen Quint and Mark Schiffman and Rodriguez, {Ana Cecilia} and Sholom Wacholder and Rolando Herrero and Allan Hildesheim and Viscidi, {Raphael P.} and Wim Quint and Burk, {Robert D.}",
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AU - Safaeian, Mahboobeh

AU - Quint, Koen

AU - Schiffman, Mark

AU - Rodriguez, Ana Cecilia

AU - Wacholder, Sholom

AU - Herrero, Rolando

AU - Hildesheim, Allan

AU - Viscidi, Raphael P.

AU - Quint, Wim

AU - Burk, Robert D.

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N2 - BackgroundCofactors might affect the risk of the rare progression from infection with carcinogenic human papillomavirus (HPV) to cervical premalignancy to invasive cancer. Some studies have observed that Chlamydia trachomatis infection is associated with increased risk for cervical cancer. In a large prospective cohort, we assessed the role of C trachomatis in cervical premalignancy and addressed confounding by HPV.MethodsWe identified 182 women with prevalent and 132 women with incident histological cervical intraepithelial neoplasia grade 2 (CIN2), grade 3 (CIN3), or cervical cancer (CIN2+) in the Costa Rica HPV Natural History Study. Control subjects were 995 (approximately 10% of the 10049) subjects who were randomly selected from the same study. Cervical HPV status at enrollment was determined by MY09/MY11 polymerase chain reaction amplification and dot-blot hybridization. The presence of C trachomatis DNA in cervical exfoliated cells at enrollment was determined by a novel serovar-specific polymerase chain reaction-based C trachomatis detection and genotyping assay. Plasma drawn at enrollment from each subject was used to determine C trachomatis immunoglobulin G (IgG) status. Logistic regression was used to examine the association between C trachomatis and CIN2+, taking into account possible confounding by HPV.ResultsC trachomatis positivity at enrollment was associated with CIN2+ and concurrent and subsequent carcinogenic HPV infection. To account for confounding by HPV status, we restricted the analysis to women positive for carcinogenic HPV DNA at enrollment and found no association between C trachomatis status (as assessed by DNA or IgG) at enrollment and combined prevalent and/or incident CIN2+ (for C trachomatis DNA positivity, odds ratio = 0.77, 95% confidence interval = 0.42 to 1.41; for C trachomatis seropositivity, odds ratio = 1.09, 95% confidence interval = 0.85 to 1.41).ConclusionsWe found no association between C trachomatis status, as assessed by DNA or IgG, and risk of cervical premalignancy, after controlling for carcinogenic HPV-positive status. Previous positive associations between C trachomatis and cervical premalignancy could have been caused, in part, by an increased susceptibility to HPV infection.

AB - BackgroundCofactors might affect the risk of the rare progression from infection with carcinogenic human papillomavirus (HPV) to cervical premalignancy to invasive cancer. Some studies have observed that Chlamydia trachomatis infection is associated with increased risk for cervical cancer. In a large prospective cohort, we assessed the role of C trachomatis in cervical premalignancy and addressed confounding by HPV.MethodsWe identified 182 women with prevalent and 132 women with incident histological cervical intraepithelial neoplasia grade 2 (CIN2), grade 3 (CIN3), or cervical cancer (CIN2+) in the Costa Rica HPV Natural History Study. Control subjects were 995 (approximately 10% of the 10049) subjects who were randomly selected from the same study. Cervical HPV status at enrollment was determined by MY09/MY11 polymerase chain reaction amplification and dot-blot hybridization. The presence of C trachomatis DNA in cervical exfoliated cells at enrollment was determined by a novel serovar-specific polymerase chain reaction-based C trachomatis detection and genotyping assay. Plasma drawn at enrollment from each subject was used to determine C trachomatis immunoglobulin G (IgG) status. Logistic regression was used to examine the association between C trachomatis and CIN2+, taking into account possible confounding by HPV.ResultsC trachomatis positivity at enrollment was associated with CIN2+ and concurrent and subsequent carcinogenic HPV infection. To account for confounding by HPV status, we restricted the analysis to women positive for carcinogenic HPV DNA at enrollment and found no association between C trachomatis status (as assessed by DNA or IgG) at enrollment and combined prevalent and/or incident CIN2+ (for C trachomatis DNA positivity, odds ratio = 0.77, 95% confidence interval = 0.42 to 1.41; for C trachomatis seropositivity, odds ratio = 1.09, 95% confidence interval = 0.85 to 1.41).ConclusionsWe found no association between C trachomatis status, as assessed by DNA or IgG, and risk of cervical premalignancy, after controlling for carcinogenic HPV-positive status. Previous positive associations between C trachomatis and cervical premalignancy could have been caused, in part, by an increased susceptibility to HPV infection.

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