title: A population-based study of cervical carcinoma and HPV infection in Latvia.
abstract: OBJECTIVE
  We wished to quantify the population-based importance of cervical carcinoma risk factors in Latvia.
  
  
  METHODS
  Totally, 223 of 224 eligible cases of incident invasive cervical carcinoma were enrolled during July 1998-February 2001 in Latvia. An age-matched sample of 300 healthy control women was selected from the Latvian population registry and 239 of these women (79%) were enrolled. A demographic and life-style questionnaire was completed, cervical brush samples were analyzed for human papillomavirus (HPV) DNA by PCR and serum samples for HPV antibodies.
  
  
  RESULTS
  Risk factors for cervical cancer in multivariate analysis were HPV type 16 or 18 DNA positivity (OR = 32.4; CI 95% 16.5-63.6) and living in the capital (OR = 2.4; CI 95% 1.2-4.7). Oral contraceptive use was not a risk factor (OR = 0.4; CI 95% 0.2-1.1). A strong protective effect was found for having had more than three Pap smears in the last 5 years (OR = 0.07 CI 95% 0.03-0.19).
  
  
  CONCLUSIONS
  Inadequate population coverage of Pap smears, in spite of excessive smear usage, caused 28.4% of cervical cancers in age groups eligible for screening. HPV type 16 infection was the most important risk factor for cervical cancer in Latvia, with a population-attributable risk percent for all ages of 58.5%.
authors.affiliation: Oncology Center of Latvia, Riga.
authors.forename: Ilvars
authors.initials: I
authors.lastname: Silins
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Wang
authors.forename: Amha
authors.initials: A
authors.lastname: Tadesse
authors.forename: Kathrin U
authors.initials: KU
authors.lastname: Jansen
authors.forename: John T
authors.initials: JT
authors.lastname: Schiller
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Avall-Lundqvist
authors.forename: Bo
authors.initials: B
authors.lastname: Frankendal
authors.forename: Joakim
authors.initials: J
authors.lastname: Dillner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood; D016022:Case-Control Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007844:Latvia / Q000453:epidemiology; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000276:immunology; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000821:virology*
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral