Vaccarella Salvatore, Herrero Rolando, Dai Min, Snijders Peter J F, Meijer Chris J L M, Thomas Jaiye O, Hoang Anh Pham Thi, Ferreccio Catterina, Matos Elena, Posso Hector, de Sanjosé Silvia, Shin Hai-Rim, Sukvirach Sukhon, Lazcano-Ponce Eduardo, Ronco Guglielmo, Rajkumar Raj, Qiao You-Lin, Muñoz Nubia, Franceschi Silvia
International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France.
Cancer Epidemiol Biomarkers Prev. 2006 Nov;15(11):2148-53. doi: 10.1158/1055-9965.EPI-06-0556.
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.
高生育次数、首次足月妊娠（FTP）年龄较早以及长期使用口服避孕药（OC）会增加患宫颈癌的风险，但目前尚不清楚这些变量是否也与人类乳头瘤病毒（HPV）感染（宫颈癌的主要病因）的获得和持续感染风险增加有关。在全球14个地区，从15岁及以上基于人群、按年龄分层的女性随机样本中收集了生殖和月经特征以及口服避孕药使用情况的信息。使用基于聚合酶链反应的酶免疫测定法进行HPV检测。采用无条件逻辑回归来估计根据生殖和月经因素HPV呈阳性的比值比（OR）以及相应的95%置信区间（CI）。当比较两组以上时，估计浮动置信区间（FCI）。总共分析了15145名女性（平均年龄40.9岁）。有≥5次足月妊娠的女性（OR，0.90；95% FCI，0.76 - 1.06）与仅有1次足月妊娠的女性相比，HPV呈阳性的风险相似（OR，1.00；95% FCI，0.86 - 1.16）。然而，未生育女性与已生育女性相比，OR为1.40（95% CI，1.16 - 1.69）。首次足月妊娠年龄较早与HPV阳性无显著相关性。报告使用口服避孕药≥10年的女性（OR，1.16；95% FCI，0.85 - 1.58）和从未使用过口服避孕药的女性（OR，1.00；95% FCI，0.90 - 1.12）的HPV阳性情况相似。因此，我们的研究表明，高生育次数、首次足月妊娠年龄较早以及长期使用口服避孕药与HPV感染率无关，而是这些因素可能参与了从HPV感染到宫颈肿瘤性病变的转变过程。
