© 1998 by Oxford University Press
Journal Of The National Cancer Institute, Vol 90, 50-57, Copyright © 1998 by Oxford University Press
S Chichareon, R Herrero, N Munoz, FX Bosch, MV Jacobs, J Deacon, M Santamaria, V Chongsuvivatwong, CJ Meijer and JM Walboomers
BACKGROUND: Human papillomaviruses (HPV) types 16 and 18 are clearly
involved in the etiology of cervical cancer, but the evidence for the
carcinogenicity of other HPV types is limited. Cofactors involved in the
progression from infection with HPV to high-grade precursors and cancer
have not been clearly defined by the results of previous studies. METHODS:
We conducted a hospital-based, case-control study of invasive cervical
cancer to investigate risk in relation to HPV infection and its
epidemiologic cofactors in Hat-Yai, Thailand. A total of 338 patients with
squamous cell carcinoma, 39 patients with adenocarcinoma/adenosquamous
carcinoma, and 261 control subjects were included in the study and were
interviewed to obtain information with regard to cervical cancer risk
factors. HPV DNA presence in cervical exfoliated cells or frozen biopsy
specimens was determined by a polymerase chain reaction assay. RESULTS: HPV
DNA was detected in 95% of patients with squamous cell carcinoma, 90% of
those with adenocarcinoma/adenosquamous carcinoma, and 16% of control
subjects. For patients with squamous cell carcinoma, the most common types
of HPV found were type 16 (60% of the positives), type 18 (18%), type 58
(3%), type 52 (3%), and type 31 (2%). For patients with
adenocarcinoma/adenosquamous carcinoma, the most common HPV types found
were type 18 (60% of the positives), type 16 (37%), and type 45 (3%). The
risk factors that remained associated with risk of both histologic types
after adjustment for HPV and their mutual confounding effects were limited
education, increasing number of sexual partners, history of venereal
diseases, and interval since last Pap smear (i.e., cytologic) test. Among
patients with squamous cell carcinoma, some association with smoking was
also observed. CONCLUSION: New preventive strategies for cervical cancer
will require the consideration of multiple HPV types.
ARTICLES
Risk factors for cervical cancer in Thailand: a case-control study
Department of Obstetrics-Gynecology, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Thailand.
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