Prospective study of human papillomavirus and risk of cervical adenocarcinoma

Lisen Arnheim Dahlström, Nathalie Ylitalo, Karin Sundström, Juni Palmgren, Alexander Ploner, Sandra Eloranta, Carani B. Sanjeevi, Sonia Andersson, Thomas E. Rohan, Joakim Dillner, Hans Olov Adami, Pär Sparén

Research output: Contribution to journalArticle

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Abstract

Human papillomaviruses (HPV) are established as a major cause of cervical carcinoma. However, causality inference is dependent on prospective evidence showing that exposure predicts risk for future disease. Such evidence is available for squamous cell carcinoma, but not for cervical adenocarcinoma. We followed a population-based cohort of 994,120 women who participated in cytological screening in Sweden for a median of 6.7 years. Baseline smears from women who developed adenocarcinoma during follow-up (118 women with in situ disease and 164 with invasive disease) and their individually matched controls (1,434 smears) were analyzed for HPV using PCR. Conditional logistic regression was used to estimate odds ratios (OR) of future adenocarcinoma with 95% confidence intervals (CI). Being positive for HPV 16 in the first cytologically normal smear was associated with increased risks for both future adenocarcinoma in situ (OR: 11.0, 95% CI: 2.646.8) and invasive adenocarcinoma (OR: 16.0, 95% CI: 3.866.7), compared to being negative for HPV 16. Similarly, an HPV 18 positive smear was associated with increased risks for adenocarcinoma in situ (OR: 26.0, 95% CI: 3.5192) and invasive adenocarcinoma (OR: 28.0, 95% CI: 3.8206), compared to an HPV 18 negative smear. Being positive for HPV 16/18 in 2 subsequent smears was associated with an infinite risk of both in situ and invasive adenocarcinoma. In conclusion, infections with HPV 16 and 18 are detectable up to at least 14 years before diagnosis of cervical adenocarcinoma. Our data provide prospective evidence that the association of HPV 16/18 with cervical adenocarcinoma is strong and causal.

Original languageEnglish (US)
Pages (from-to)1923-1930
Number of pages8
JournalInternational Journal of Cancer
Volume127
Issue number8
DOIs
StatePublished - Oct 15 2010

Fingerprint

Human papillomavirus 18
Human papillomavirus 16
Adenocarcinoma
Prospective Studies
Odds Ratio
Confidence Intervals
Sweden
Causality
Squamous Cell Carcinoma
Logistic Models
Carcinoma
Polymerase Chain Reaction
Infection
Population
Adenocarcinoma in Situ

Keywords

  • adenocarcinoma
  • adenocarcinoma in situ
  • cervical cancer
  • HPV
  • prospective

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Dahlström, L. A., Ylitalo, N., Sundström, K., Palmgren, J., Ploner, A., Eloranta, S., ... Sparén, P. (2010). Prospective study of human papillomavirus and risk of cervical adenocarcinoma. International Journal of Cancer, 127(8), 1923-1930. https://doi.org/10.1002/ijc.25408

Prospective study of human papillomavirus and risk of cervical adenocarcinoma. / Dahlström, Lisen Arnheim; Ylitalo, Nathalie; Sundström, Karin; Palmgren, Juni; Ploner, Alexander; Eloranta, Sandra; Sanjeevi, Carani B.; Andersson, Sonia; Rohan, Thomas E.; Dillner, Joakim; Adami, Hans Olov; Sparén, Pär.

In: International Journal of Cancer, Vol. 127, No. 8, 15.10.2010, p. 1923-1930.

Research output: Contribution to journalArticle

Dahlström, LA, Ylitalo, N, Sundström, K, Palmgren, J, Ploner, A, Eloranta, S, Sanjeevi, CB, Andersson, S, Rohan, TE, Dillner, J, Adami, HO & Sparén, P 2010, 'Prospective study of human papillomavirus and risk of cervical adenocarcinoma', International Journal of Cancer, vol. 127, no. 8, pp. 1923-1930. https://doi.org/10.1002/ijc.25408
Dahlström LA, Ylitalo N, Sundström K, Palmgren J, Ploner A, Eloranta S et al. Prospective study of human papillomavirus and risk of cervical adenocarcinoma. International Journal of Cancer. 2010 Oct 15;127(8):1923-1930. https://doi.org/10.1002/ijc.25408
Dahlström, Lisen Arnheim ; Ylitalo, Nathalie ; Sundström, Karin ; Palmgren, Juni ; Ploner, Alexander ; Eloranta, Sandra ; Sanjeevi, Carani B. ; Andersson, Sonia ; Rohan, Thomas E. ; Dillner, Joakim ; Adami, Hans Olov ; Sparén, Pär. / Prospective study of human papillomavirus and risk of cervical adenocarcinoma. In: International Journal of Cancer. 2010 ; Vol. 127, No. 8. pp. 1923-1930.
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abstract = "Human papillomaviruses (HPV) are established as a major cause of cervical carcinoma. However, causality inference is dependent on prospective evidence showing that exposure predicts risk for future disease. Such evidence is available for squamous cell carcinoma, but not for cervical adenocarcinoma. We followed a population-based cohort of 994,120 women who participated in cytological screening in Sweden for a median of 6.7 years. Baseline smears from women who developed adenocarcinoma during follow-up (118 women with in situ disease and 164 with invasive disease) and their individually matched controls (1,434 smears) were analyzed for HPV using PCR. Conditional logistic regression was used to estimate odds ratios (OR) of future adenocarcinoma with 95{\%} confidence intervals (CI). Being positive for HPV 16 in the first cytologically normal smear was associated with increased risks for both future adenocarcinoma in situ (OR: 11.0, 95{\%} CI: 2.646.8) and invasive adenocarcinoma (OR: 16.0, 95{\%} CI: 3.866.7), compared to being negative for HPV 16. Similarly, an HPV 18 positive smear was associated with increased risks for adenocarcinoma in situ (OR: 26.0, 95{\%} CI: 3.5192) and invasive adenocarcinoma (OR: 28.0, 95{\%} CI: 3.8206), compared to an HPV 18 negative smear. Being positive for HPV 16/18 in 2 subsequent smears was associated with an infinite risk of both in situ and invasive adenocarcinoma. In conclusion, infections with HPV 16 and 18 are detectable up to at least 14 years before diagnosis of cervical adenocarcinoma. Our data provide prospective evidence that the association of HPV 16/18 with cervical adenocarcinoma is strong and causal.",
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