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. 2001 May;84(9):1219–1226. doi: 10.1054/bjoc.2001.1779

HPV co-factors related to the development of cervical cancer: results from a population-based study in Costa Rica

A Hildesheim 1, R Herrero 2, P E Castle 1, S Wacholder 1, M C Bratti 2, M E Sherman 1,3, A T Lorincz 4, R D Burk 5, J Morales 2, A C Rodriguez 2, K Helgesen 6, M Alfaro 2, M Hutchinson 7, I Balmaceda 2, M Greenberg 8, M Schiffman 1
PMCID: PMC2363883  PMID: 11336474

Abstract

 We examined factors associated with high-grade squamous intraepithelial lesions (HSIL) and cervical cancer among human papillomavirus (HPV)-infected women in a prevalent case–control study conducted within a population-based cohort of 10 077 women in Costa Rica. We compared 146 women with HPV-positive HSIL or cancer (HSIL/CA) against 843 HPV-positive women without evidence of HSIL/CA. Subjects completed a risk factor questionnaire. We evaluated the associations between exposures and HSIL/CA among women positive for any HPV and restricted to those positive for high-risk HPV types. Risk of HSIL/CA increased with increasing number of live births (Ptrend= 0.04). Women who smoked 6+ cigarettes/day had a RR for HSIL/CA of 2.7 (95% CI = 1.1–6.7) compared to non-smokers. Current use of barrier contraceptives was associated with a reduction in risk of HSIL/CA (RR = 0.39; 95% CI = 0.16–0.96). Sexual behaviour and a self-reported history of sexually transmitted diseases (STDs) other than HPV were not associated with HSIL/CA. Oral contraceptive use was associated with HSIL/CA among women with <3 pregnancies. Effects were similar in analysis restricted to women positive for high-risk HPV types. Among women positive for high-risk HPV types, 44% of HSIL/CA could be attributed to multiparity (≥3 pregnancies) and/or smoking. Among HPV-positive women, multiparity and smoking are risk factors for HSIL/CA. Oral contraceptive use may be associated with HSIL/CA in subgroups of women. © 2001 Cancer Research Campaign http://www.bjcancer.com

Keywords: cervix, human papillomavirus, cancer, smoking, parity

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Selected References

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