Chlamydia trachomatis and invasive cervical cancer: A pooled analysis of the IARC multicentric case‐control study

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Abstract
To determine whether Chlamydia trachomatis infection is consistently associated with an increased risk of invasive cervical carcinoma (ICC) after accounting for the strong effect of human papillomavirus (HPV) infection, a case‐control study of 1,238 cases of ICC and 1,100 control women from 7 countries was carried out (hospital‐based studies in Thailand, the Philippines, Morocco, Peru, Brazil and population‐based studies in Colombia and Spain, all coordinated by the International Agency for Research on Cancer, Lyon, France). C. trachomatis serum antibody detection was made by means of a microfluorescence assay. Among HPV DNA‐positive cases and controls, the risk of squamous cell ICC was elevated in C. trachomatis seropositive women (OR = 1.8; 95% CI = 1.2–2.7) after adjustment for age, center, oral contraceptive use, history of Pap smears, number of full‐term pregnancies and herpes simplex virus 2 seropositivity. The effect of C. trachomatis seropositivity on squamous cell ICC risk increased with increasing C. trachomatis antibody titers and was higher in women under 55 years of age. C. trachomatis antibodies were not associated with adeno‐ or adenosquamous cell carcinoma (OR = 1.0; 95% CI = 0.53–1.9) in HPV DNA‐positive women. An association of C. trachomatis with squamous cell ICC was found among all cases and control women with or without adjustment for HPV.
Funding Information
  • European Community (CI 1-0371-F(CD))
  • Fondo de Investigaciones Sanitarias, Spain (86/753, 87/1513, 88/2049, 90/0901, 95/0955, 01/1237, 01/1236, BAE 01/5013)
  • International Agency for Research on Cancer, Lyon, France (FI/92/3-2 PAR)
  • Preventiefonds, The Netherlands (28-1502.1)
  • Programa Interministerial de Investigación y Desarrollo, Spain (SAF 96/0323)
  • Conselho Nacional de Desenvolvimiento Cientifico e Tecnologico, Brazil (JEN-204453/88.7)
  • Department of Reproductive Health and Research at the World Health Organization (98.101)
  • Yamagiwa-Yoshida Memorial Union Internationale Contre le Cancer International Cancer Study Grant