A population-based seroepidemiological study of cervical cancer.
The epidemiology of cervical cancer indicates the presence of a sexually transmitted risk factor, attributable at least in part to infection with human papillomavirus (HPV) type 16 or 18. We performed a seroepidemiological study of HPV and cervical cancer in the counties of Västerbotten and Norrbotten in Northern Sweden, a low-risk area for cervical cancer. Sera from 94 cases of incident cervical cancer were matched against 188 age- and sex-matched controls derived from a population-based blood bank. IgG and IgA antibodies were measured against a panel of 12 antigens derived from HPV types 6, 11, 16, or 18, as well as against Herpes simplex virus type 1 and 2, Chlamydia trachomatis, cytomegalovirus, Epstein-Barr virus, and bovine papillomavirus. Significantly increased relative risks (RRs) were found for IgG to HPV 16- or 18-derived antigens from the L1 (RR = 3.1), E2 (RRs = 2.8 and 9.2), and E7 (RRs = 3.8 and 2.7) open reading frames and for IgA to HPV 16-derived antigens from the E2 (RR = 3.3) and E6 (RR = 2.7) open reading frames. The highest RR (9.2, confidence intervals 4.4-19.4) was associated with IgG to an HPV 18 E2 antigen. Antibodies against cytomegalovirus, Herpes simplex virus type 2, Epstein-Barr virus, or bovine papillomavirus were, on their own, not significantly associated with cervical cancer, but seropositivity against multiple infections was associated with a successively increased relative risk. An increased risk was also found for IgG to Chlamydia trachomatis (RR = 1.7, confidence interval = 1.0-2.7). The results indicate that several HPV antibodies are strongly associated with cervical cancer, providing further seroepidemiological support for an etiological role of HPV in cervical cancer.
Dillner
J
J
Department of Virology, Karolinska Institute, Stockholm, Sweden.
Lenner
P
P
Lehtinen
M
M
Eklund
C
C
Heino
P
P
Wiklund
F
F
Hallmans
G
G
Stendahl
U
U
D000328:Adult; D000367:Age Factors; D000595:Amino Acid Sequence; D000914:Antibodies, Viral / Q000032:analysis* / Q000276:immunology; D000956:Antigens, Viral / Q000276:immunology*; D016022:Case-Control Studies; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis* / Q000276:immunology; D007074:Immunoglobulin G / Q000032:analysis* / Q000276:immunology; D008875:Middle Aged; D008969:Molecular Sequence Data; D027383:Papillomaviridae / Q000276:immunology*; D010298:Parity; D016036:Seroepidemiologic Studies; D018139:Simplexvirus / Q000276:immunology; D012907:Smoking / Q000276:immunology; D013548:Sweden / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology / Q000473:pathology
D000914:Antibodies, Viral; D000956:Antigens, Viral; D007070:Immunoglobulin A; D007074:Immunoglobulin G