Comparison of human papillomavirus genotypes, sexual, and reproductive risk factors of cervical adenocarcinoma and squamous cell carcinoma: Northeastern United States.
OBJECTIVE
Although human papillomavirus causes essentially all cervical carcinoma, cofactors may differ by cancer histologic type. We examined human papillomavirus genotypes and sexual and reproductive risk factors for cervical adenocarcinoma and squamous cell carcinoma.


METHODS
One hundred twenty-four women with adenocarcinoma, 139 women with squamous cell carcinoma, and 307 control subjects participated in this case-control study. Logistic regression analyses were performed to calculate odds ratios and CIs.


RESULTS
Human papillomavirus 18 was associated most strongly with adenocarcinoma (odds ratio, 105; 95% CI, 23-487). Human papillomavirus 16 was associated most strongly with squamous cell carcinoma (odds ratio, 30; 95% CI, 12-77). More than three lifetime sexual partners was a risk factor for adenocarcinoma (odds ratio, 2.1; 95% CI, 1.1-4.0) and squamous cell carcinoma (odds ratio, 3.0; 95% CI, 1.6-5.9). Even being pregnant was associated inversely with adenocarcinoma (odds ratio, 0.4; 95% CI, 0.2-0.8). Five or more pregnancies was associated with squamous cell carcinoma (odds ratio, 2.2; 95% CI, 0.9-5.4).


CONCLUSIONS
The relative importance of human papillomavirus genotypes 16 and 18 and the reproductive co-factor differences suggest distinct causes for cervical adenocarcinoma and squamous cell carcinoma.
Altekruse
Sean F
SF
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Md 20892, USA. altekrus@mail.nih.gov
Lacey
James V
JV
Brinton
Louise A
LA
Gravitt
Patti E
PE
Silverberg
Steven G
SG
Barnes
Willard A
WA
Greenberg
Mitchell D
MD
Hadjimichael
Olympia C
OC
McGowan
Larry
L
Mortel
Rodrigue
R
Schwartz
Peter E
PE
Hildesheim
Allan
A
D000230:Adenocarcinoma / Q000209:etiology*; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D016022:Case-Control Studies; D005260:Female; D005838:Genotype; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D009511:New England; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications; D011247:Pregnancy; D012098:Reproduction; D021841:Safe Sex; D014412:Tumor Virus Infections / Q000150:complications; D002583:Uterine Cervical Neoplasms / Q000209:etiology*