Cofactors With Human Papillomavirus in a Population-Based Study of Vulvar Cancer
Open Access
- 15 October 1997
- journal article
- research article
- Published by Oxford University Press (OUP) in JNCI Journal of the National Cancer Institute
- Vol. 89 (20) , 1516-1523
- https://doi.org/10.1093/jnci/89.20.1516
Abstract
Background: Human papillomavirus (HPV) has been previously associated with vulvar cancer. In a population-based study, we examined whether exposure to HPV, cigarette smoking, or herpes simplex virus 2 (HSV2) increases the risk of this cancer. Methods: Incident cases of in situ (n = 400) and invasive (n = 110) squamous cell vulvar cancer diagnosed among women living in the Seattle area from 1980 through 1994 were identified. Serum samples were analyzed for antibodies against specific HPV types and HSV2. HPV DNA in tumor tissue was detected by means of the polymerase chain reaction. In most analyses, case subjects were compared with population-based control subjects (n = 1403). Relative risks of developing vulvar cancer were estimated by use of adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: Increased risks of in situ or invasive vulvar cancer were associated with HPV16 seropositivity (ORs = 3.6 [95% CI = 2.6-4.8] and 2.8 [95% CI = 1.7-4.7], respectively), current cigarette smoking (ORs = 6.4 [95% CI = 4.4-9.3] and 3.0 [95% CI = 1.7-5.3], respectively), and HSV2 seropositivity (ORs = 1.9 [95% CI = 1.4-2.6] and 1.5 [95% CI = 0.9-2.6], respectively). When the analysis was restricted to HPV16 DNA-positive tumors ( in situ or invasive), the OR associated with HPV16 seropositivity was 4.5 (95% CI = 3.0-6.8). The OR for vulvar cancer was 18.8 (95% CI = 11.9-29.8) among current smokers who were HPV16 seropositive in comparison with never smokers who were HPV16 seronegative. Conclusions: Current smoking, infection with HPV16, and infection with HSV2 are risk factors for vulvar cancer. Risk appears particularly strong among women who are both current smokers and HPV16 seropositive.Keywords
This publication has 32 references indexed in Scilit:
- Vulvar intraepithelial neoplasia: Age, morphological phenotype, papillomavirus DNA, and coexisting invasive carcinomaPublished by Elsevier ,2004
- Heterogeneous etiology of squamous carcinoma of the vulvaPublished by Wolters Kluwer Health ,1999
- Multifocal vulvar intraepithelial neoplasia grade III and multicentric lower genital tract neoplasia is associated with transcriptionally active human papillomavirusCancer, 1995
- Human papillomavirus (HPV) in vulvar dysplasia and carcinoma in situAPMIS, 1995
- Vulvar Squamous Cell Carcinoma and Papillomaviruses: Indications for Two Different EtiologiesGynecologic Oncology, 1994
- In situ and invasive vulvar cancer incidence trends (1973 to 1987)American Journal of Obstetrics and Gynecology, 1992
- Correlation of histology and detection of human papillomavirus DNA in vulvar cancersGynecologic Oncology, 1991
- Clinical and histologic features of vulvar carcinomas analyzed for human papillomavirus status: Evidence that squamous cell carcinoma of the vulva has more than one etiologyHuman Pathology, 1991
- Probable Nonpapillomavirus Etiology of Squamous Cell Carcinoma of the Vulva in Older WomenInternational Journal of Gynecological Pathology, 1991
- Possible etiologic heterogeneity of vulvar intraepithelial neoplasia. A correlation of pathologic characteristics with human papillomavirus detection by in situ hybridization and polymerase chain reactionCancer, 1991