Chlamydia trachomatis and invasive cervical cancer: a pooled analysis of the IARC multicentric case-control study.
To determine whether Chlamydia trachomatis infection is consistently associated with an increased risk of invasive cervical carcinoma (ICC) after accounting for the strong effect of human papillomavirus (HPV) infection, a case-control study of 1,238 cases of ICC and 1,100 control women from 7 countries was carried out (hospital-based studies in Thailand, the Philippines, Morocco, Peru, Brazil and population-based studies in Colombia and Spain, all coordinated by the International Agency for Research on Cancer, Lyon, France). C. trachomatis serum antibody detection was made by means of a microfluorescence assay. Among HPV DNA-positive cases and controls, the risk of squamous cell ICC was elevated in C. trachomatis seropositive women (OR = 1.8; 95% CI = 1.2-2.7) after adjustment for age, center, oral contraceptive use, history of Pap smears, number of full-term pregnancies and herpes simplex virus 2 seropositivity. The effect of C. trachomatis seropositivity on squamous cell ICC risk increased with increasing C. trachomatis antibody titers and was higher in women under 55 years of age. C. trachomatis antibodies were not associated with adeno- or adenosquamous cell carcinoma (OR = 1.0; 95% CI = 0.53-1.9) in HPV DNA-positive women. An association of C. trachomatis with squamous cell ICC was found among all cases and control women with or without adjustment for HPV.
Smith
Jennifer S
JS
International Agency for Research on Cancer, Lyon, France.
Bosetti
Cristina
C
Muñoz
Nubia
N
Herrero
Rolando
R
Bosch
F Xavier
FX
Eluf-Neto
José
J
Meijer
Chris J L M
CJ
Van Den Brule
Adriaan J C
AJ
Franceschi
Silvia
S
Peeling
Rosanna W
RW
D000328:Adult; D000367:Age Factors; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D016022:Case-Control Studies; D002692:Chlamydia trachomatis; D002694:Chlamydiaceae Infections / Q000453:epidemiology*; D005260:Female; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D065006:Papanicolaou Test; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology; D014626:Vaginal Smears
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G