Reproductive factors, oral contraceptive use, and human papillomavirus infection: pooled analysis of the IARC HPV prevalence surveys.
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.
Vaccarella
Salvatore
S
International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France. vaccarella@iarc.fr
Herrero
Rolando
R
Dai
Min
M
Snijders
Peter J F
PJ
Meijer
Chris J L M
CJ
Thomas
Jaiye O
JO
Hoang Anh
Pham Thi
PT
Ferreccio
Catterina
C
Matos
Elena
E
Posso
Hector
H
de Sanjosé
Silvia
S
Shin
Hai-Rim
HR
Sukvirach
Sukhon
S
Lazcano-Ponce
Eduardo
E
Ronco
Guglielmo
G
Rajkumar
Raj
R
Qiao
You-Lin
YL
Muñoz
Nubia
N
Franceschi
Silvia
S
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*
D003276:Contraceptives, Oral