title: Human papillomavirus and the incidence of nonmelanoma and melanoma skin cancer using cervical conization as a surrogate marker: a nationwide population-based Danish cohort study.
abstract: OBJECTIVE
  Human papillomavirus' (HPV's) role in skin cancer is controversial. To examine whether an individual is prone to develop a chronic oncogenic infection, we conducted a nationwide population-based cohort study of the risk of skin cancer after another HPV-related neoplasia-that is, cervical high-grade dysplasia or carcinoma-using cervical conization as a surrogate marker.
  
  
  METHODS
  Using Danish registries, we identified all women who underwent conization from 1978 to 2011 (n = 87,164) and followed them until first-time skin cancer diagnosis, death, emigration, or 31 December 2011, whichever came first. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM) according to national incidence rates.
  
  
  RESULTS
  The 1-year absolute risks were 0.0012%, 0.045%, and 0.029% for SCC, BCC, and MM, respectively. Conization was clearly associated with increased incidence of SCC (SIR = 1.37; 95% CI: 1.13-1.65), but not MM (SIR = 1.00; 95% CI: 0.91-1.11). BCC risk was slightly increased (SIR = 1.08; 95% CI: 1.02-1.13).
  
  
  CONCLUSIONS
  The association between conization and cutaneous SCC provides evidence for conization as a marker of underlying general susceptibility to oncogenic HPV.
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark. Electronic address: saj@clin.au.dk.
authors.forename: Sigrun Alba Johannesdottir
authors.initials: SA
authors.lastname: Schmidt
authors.affiliation: Institute of Pathology, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Hamilton-Dutoit
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.
authors.forename: Dóra Körmendiné
authors.initials: DK
authors.lastname: Farkas
authors.affiliation: Institute of Pathology, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Steiniche
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sørensen
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D002280:Basal Cell Carcinoma / Q000209:etiology / Q000821:virology; D002584:Cervix Uteri / Q000473:pathology* / Q000821:virology; D015331:Cohort Studies; D019092:Conization; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008545:Melanoma / Q000209:etiology* / Q000821:virology; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000209:etiology / Q000821:virology; D030361:Papillomavirus Infections / Q000150:complications*; D012307:Risk Factors; D012878:Skin Neoplasms / Q000209:etiology* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000821:virology
chemical_list: D015415:Biomarkers
keywords: Cohort studies; Conization; Papillomaviridae; Skin neoplasms