title: Chlamydia trachomatis and invasive cervical cancer: a pooled analysis of the IARC multicentric case-control study.
abstract: 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.
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
authors.forename: Cristina
authors.initials: C
authors.lastname: Bosetti
authors.forename: Nubia
authors.initials: N
authors.lastname: Muñoz
authors.forename: Rolando
authors.initials: R
authors.lastname: Herrero
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Bosch
authors.forename: José
authors.initials: J
authors.lastname: Eluf-Neto
authors.forename: Chris J L M
authors.initials: CJ
authors.lastname: Meijer
authors.forename: Adriaan J C
authors.initials: AJ
authors.lastname: Van Den Brule
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
authors.forename: Rosanna W
authors.initials: RW
authors.lastname: Peeling
mesh_terms: 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
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G