title: Comparison of human papillomavirus genotypes, sexual, and reproductive risk factors of cervical adenocarcinoma and squamous cell carcinoma: Northeastern United States.
abstract: 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.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Md 20892, USA. altekrus@mail.nih.gov
authors.forename: Sean F
authors.initials: SF
authors.lastname: Altekruse
authors.forename: James V
authors.initials: JV
authors.lastname: Lacey
authors.forename: Louise A
authors.initials: LA
authors.lastname: Brinton
authors.forename: Patti E
authors.initials: PE
authors.lastname: Gravitt
authors.forename: Steven G
authors.initials: SG
authors.lastname: Silverberg
authors.forename: Willard A
authors.initials: WA
authors.lastname: Barnes
authors.forename: Mitchell D
authors.initials: MD
authors.lastname: Greenberg
authors.forename: Olympia C
authors.initials: OC
authors.lastname: Hadjimichael
authors.forename: Larry
authors.initials: L
authors.lastname: McGowan
authors.forename: Rodrigue
authors.initials: R
authors.lastname: Mortel
authors.forename: Peter E
authors.initials: PE
authors.lastname: Schwartz
authors.forename: Allan
authors.initials: A
authors.lastname: Hildesheim
mesh_terms: 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*