title: Reproductive factors, oral contraceptive use, and human papillomavirus infection: pooled analysis of the IARC HPV prevalence surveys.
abstract: High parity, early age at first full-term pregnancy (FTP), and long-term oral contraceptive (OC) use increase cervical cancer risk, but it is unclear whether these variables are also associated with increased risk of acquisition and persistence of human papillomavirus (HPV) infection, the main cause of cervical cancer. Information on reproductive and menstrual characteristics and OC use were collected from 14 areas worldwide, among population-based, age-stratified random samples of women aged 15 years or older. HPV testing was done using PCR-based enzyme immunoassay. Unconditional logistic regression was used to estimate the odds ratios (OR) of being HPV-positive according to reproductive and menstrual factors and corresponding 95% confidence intervals (CI). When more than two groups were compared, floating CIs (FCI) were estimated. A total of 15,145 women (mean age, 40.9 years) were analyzed. Women with >or=5 FTPs (OR, 0.90; 95% FCI, 0.76-1.06) showed a similar risk of being HPV-positive compared with women with only one FTP (OR, 1.00; 95% FCI, 0.86-1.16). However, nulliparous women showed an OR of 1.40 (95% CI, 1.16-1.69) compared with parous women. Early age at first FTP was not significantly related to HPV positivity. HPV positivity was similar for women who reported >or=10 years of use of OCs (OR, 1.16; 95% FCI, 0.85-1.58) and never users of OCs (OR, 1.00; 95% FCI, 0.90-1.12). Our study suggests, therefore, that high parity, early age at first FTP, and long-term OC use are not associated with HPV prevalence, but rather these factors might be involved in the transition from HPV infection to neoplastic cervical lesions.
authors.affiliation: International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France. vaccarella@iarc.fr
authors.forename: Salvatore
authors.initials: S
authors.lastname: Vaccarella
authors.forename: Rolando
authors.initials: R
authors.lastname: Herrero
authors.forename: Min
authors.initials: M
authors.lastname: Dai
authors.forename: Peter J F
authors.initials: PJ
authors.lastname: Snijders
authors.forename: Chris J L M
authors.initials: CJ
authors.lastname: Meijer
authors.forename: Jaiye O
authors.initials: JO
authors.lastname: Thomas
authors.forename: Pham Thi
authors.initials: PT
authors.lastname: Hoang Anh
authors.forename: Catterina
authors.initials: C
authors.lastname: Ferreccio
authors.forename: Elena
authors.initials: E
authors.lastname: Matos
authors.forename: Hector
authors.initials: H
authors.lastname: Posso
authors.forename: Silvia
authors.initials: S
authors.lastname: de Sanjosé
authors.forename: Hai-Rim
authors.initials: HR
authors.lastname: Shin
authors.forename: Sukhon
authors.initials: S
authors.lastname: Sukvirach
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Ronco
authors.forename: Raj
authors.initials: R
authors.lastname: Rajkumar
authors.forename: You-Lin
authors.initials: YL
authors.lastname: Qiao
authors.forename: Nubia
authors.initials: N
authors.lastname: Muñoz
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D052685:Alphapapillomavirus / Q000378:metabolism*; D003276:Contraceptives, Oral / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology; D010298:Parity; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*
chemical_list: D003276:Contraceptives, Oral