title: Joint effects of different human papillomaviruses and Chlamydia trachomatis infections on risk of squamous cell carcinoma of the cervix uteri.
abstract: This case-control study based in Nordic serum banks evaluated the joint effects of infections with genital human papillomavirus (HPV) types, and Chlamydia trachomatis in the aetiology of cervical squamous cell carcinoma. Through a linkage with the cancer registries, 144 cases were identified and 420 controls matched to them. Exposure to past infections was defined by the presence of specific IgG antibodies. The odds ratio (OR) for the second-order interaction of HPV16, HPV6/11 and C. trachomatis was small (1.0) compared to the expected multiplicative OR, 57, and the additive OR, 11. The interactions were not materially different among HPV16 DNA-positive squamous cell carcinomas. When HPV16 was replaced with HPV18/33 in the analysis of second-order interactions with HPV6/11 and C. trachomatis, there was no evidence of interaction, the joint effect being close to the expected additive OR. Possible explanations for the observed antagonism include misclassification, selection bias or a true biological phenomenon with HPV6/11 and C. trachomatis exposures antagonizing the carcinogenic effects of HPV16.
authors.affiliation: Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Box 169, FIN-00171 Helsinki, Finland. tapio.luostarinen@cancer.fi
authors.forename: T
authors.initials: T
authors.lastname: Luostarinen
authors.forename: M
authors.initials: M
authors.lastname: Lehtinen
authors.forename: T
authors.initials: T
authors.lastname: Bjørge
authors.forename: V
authors.initials: V
authors.lastname: Abeler
authors.forename: M
authors.initials: M
authors.lastname: Hakama
authors.forename: G
authors.initials: G
authors.lastname: Hallmans
authors.forename: E
authors.initials: E
authors.lastname: Jellum
authors.forename: P
authors.initials: P
authors.lastname: Koskela
authors.forename: P
authors.initials: P
authors.lastname: Lenner
authors.forename: A K
authors.initials: AK
authors.lastname: Lie
authors.forename: J
authors.initials: J
authors.lastname: Paavonen
authors.forename: E
authors.initials: E
authors.lastname: Pukkala
authors.forename: P
authors.initials: P
authors.lastname: Saikku
authors.forename: E
authors.initials: E
authors.lastname: Sigstad
authors.forename: S
authors.initials: S
authors.lastname: Thoresen
authors.forename: L D
authors.initials: LD
authors.lastname: Youngman
authors.forename: J
authors.initials: J
authors.lastname: Dillner
authors.forename: T
authors.initials: T
authors.lastname: Hakulinen
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000821:virology*; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000382:microbiology / Q000821:virology; D002690:Chlamydia Infections / Q000150:complications* / Q000453:epidemiology; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009664:Norway / Q000453:epidemiology; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology; D012044:Regression Analysis; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000382:microbiology* / Q000821:virology
chemical_list: D004279:DNA, Viral