Human papillomavirus infection and incidence of squamous cell and basal cell carcinomas of the skin.
BACKGROUND
Although infection with human papillomaviruses (HPVs) is a major risk factor for several epithelial cancers, an etiologic relationship between HPV and keratinocyte cancers, such as squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs), remains unclear.


METHODS
In a population-based case-control study of 252 SCC case patients, 525 BCC case patients, and 461 control subjects, we used multiplex serology to detect antibodies in plasma samples against 16 HPV types from phylogenetic genera alpha, beta, and mu. Multiplex serology is a new method that is based on fluorescent bead technology and allows simultaneous detection of antibodies against up to 100 different in situ affinity-purified recombinant HPV proteins. Data on sun sensitivity, outdoor exposure, and other risk factors for keratinocyte cancers were collected through personal interviews. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated via unconditional logistic regression models.


RESULTS
Overall, we detected HPV antibodies more frequently in SCC patients than in control subjects (OR = 1.6, 95% CI = 1.2 to 2.3), but we found no difference in HPV seropositivity between BCC case patients and control subjects (OR = 0.8, 95% CI = 0.6 to 1.1). Among HPV types, seropositivity to HPV types in genus beta (OR = 1.5, 95% CI = 1.0 to 2.1), particularly HPV 5 (OR = 1.8, 95% CI = 1.0 to 3.1), was associated with SCC risk. Individuals with tumors on chronically sun exposed sites were more likely to be seropositive for beta HPV types than individuals with SCC at other anatomic sites. The highest SCC risk was associated with positivity for multiple HPV types and, among individuals seropositive for HPV beta, a tendency to sunburn; however, the associations had limited statistical precision.


CONCLUSIONS
Our findings support a role for HPV types from the genus beta in the pathogenesis of SCC.
Department of Community and Family Medicine, Center for Environmental Health Sciences, Dartmouth Medical School, Lebanon, NH 03756, USA. margaret.karagas@dartmouth.edu
Margaret R
MR
Karagas
Heather H
HH
Nelson
Peter
P
Sehr
Tim
T
Waterboer
Therese A
TA
Stukel
Angeline
A
Andrew
Adele C
AC
Green
Jan Nico Bouwes
JN
Bavinck
Ann
A
Perry
Steven
S
Spencer
Judy R
JR
Rees
Leila A
LA
Mott
Michael
M
Pawlita
D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000821:virology*; D002294:Carcinoma, Squamous Cell / Q000821:virology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications* / Q000821:virology; D012307:Risk Factors; D012878:Skin Neoplasms / Q000821:virology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology