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01.12.2014 | Original paper | Ausgabe 12/2014

Cancer Causes & Control 12/2014

Conization as a marker of persistent cervical human papillomavirus (HPV) infection and risk of gastrointestinal cancer: a Danish 34-year nationwide cohort study

Zeitschrift:
Cancer Causes & Control > Ausgabe 12/2014
Autoren:
Jakob Kirkegård, Dora Körmendiné Farkas, Mette Søgaard, Sigrún Alba Jóhannesdóttir Schmidt, Eva Bjerre Ostenfeld, Deirdre Cronin-Fenton
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s10552-014-0473-4) contains supplementary material, which is available to authorized users.

Abstract

Purpose

Persistent cervical infection with human papillomavirus (HPV) may be a marker of poor immune function and thus associated with an increased cancer risk. HPV infection is implicated in all cases of cervical cancer, but except for anal and esophageal cancers, the association between persistent HPV infection and gastrointestinal cancer has not been investigated.

Methods

We performed a nationwide population-based cohort study of 83,008 women undergoing cervical conization between 1978 and 2011, using cervical conization as a marker of chronic HPV infection. We computed standardized incidence ratios (SIRs) as a measure of the relative risk of each cancer comparing women undergoing conization with that expected in the general population. We also calculated absolute risks.

Results

During follow-up, 988 GI cancers occurred versus 880 expected among 83,008 women followed for a median of 14.9 years, corresponding to a SIR of 1.1 (95 % CI 1.1–1.2). Risks were increased for anal (SIR 2.9; 95 % CI 2.3–3.5) and esophageal (SIR 1.5; 95 % CI 1.1–2.0) cancers, with suggested increased risks of cancers of the gallbladder and biliary tract (SIR 1.3; 95 % CI 0.90–1.8), pancreas (SIR 1.2; 95 % CI 0.97–1.4), and liver (SIR 1.1; 95 % CI 0.79–1.6). The SIRs decreased with increasing follow-up time. The risks of gastric, small intestinal, colon, or rectal cancers were not elevated. Overall, the absolute cancer risk was 0.18 % (95 % CI 0.15–0.21) after 5 years.

Conclusions

The relative risks of several gastrointestinal cancers were raised among women who underwent cervical conization for persistent HPV infection, but the absolute risks were low.

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Zusatzmaterial
Supplementary material 1 (PDF 78 kb)
10552_2014_473_MOESM1_ESM.pdf
Supplementary material 2 (PDF 65 kb)
10552_2014_473_MOESM2_ESM.pdf
Literatur
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