RT Journal Article
T1 The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort.
A1 Roura, Esther
A1 Travier, Noémie
A1 Waterboer, Tim
A1 de Sanjosé, Silvia
A1 Bosch, F Xavier
A1 Pawlita, Michael
A1 Pala, Valeria
A1 Weiderpass, Elisabete
A1 Margall, Núria
A1 Dillner, Joakim
A1 Gram, Inger T
A1 Tjønneland, Anne
A1 Munk, Christian
A1 Palli, Domenico
A1 Khaw, Kay-Tee
A1 Overvad, Kim
A1 Clavel-Chapelon, Françoise
A1 Mesrine, Sylvie
A1 Fournier, Agnès
A1 Fortner, Renée T
A1 Ose, Jennifer
A1 Steffen, Annika
A1 Trichopoulou, Antonia
A1 Lagiou, Pagona
A1 Orfanos, Philippos
A1 Masala, Giovanna
A1 Tumino, Rosario
A1 Sacerdote, Carlotta
A1 Polidoro, Silvia
A1 Mattiello, Amalia
A1 Lund, Eiliv
A1 Peeters, Petra H
A1 Bueno-de-Mesquita, H B As
A1 Quirós, J Ramón
A1 Sanchez-Perez, Maria-Jose
A1 Navarro, Carmen
A1 Barricarte, Aurelio
A1 Larrañaga, Nerea
A1 Ekström, Johanna
A1 Lindquist, David
A1 Idahl, Annika
A1 Travis, Ruth C
A1 Merritt, Melissa A
A1 Gunter, Marc J
A1 Rinaldi, Sabina
A1 Tommasino, Massimo
A1 Franceschi, Silvia
A1 Riboli, Elio
A1 Castellsagué, Xavier
K1 Estudios de Casos y Controles
K1 Neoplasia Intraepitelial Cervical
K1 Anticonceptivos
K1 Femenino
K1 Humanos
K1 Papillomaviridae
K1 Paridad
K1 Embarazo
K1 Estudios retrospectivos
K1 Neoplasias del cuello uterino
AB BACKGROUNDIn addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC). However, most of the evidence comes from retrospective case-control studies. The aim of this study is to prospectively evaluate associations between hormonal factors and risk of developing cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ (CIS) and invasive cervical cancer (ICC).METHODS AND FINDINGSWe followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. At enrollment, participants completed a questionnaire and provided serum. After a 9-year median follow-up, 261 ICC and 804 CIN3/CIS cases were reported. In a nested case-control study, the sera from 609 cases and 1,218 matched controls were tested for L1 antibodies against HPV types 11,16,18,31,33,35,45,52,58, and antibodies against Chlamydia trachomatis and Human herpesvirus 2. Multivariate analyses were performed to estimate hazard ratios (HR), odds ratios (OR) and corresponding 95% confidence intervals (CI). The cohort analysis showed that number of full-term pregnancies was positively associated with CIN3/CIS risk (p-trend = 0.03). Duration of oral contraceptives use was associated with a significantly increased risk of both CIN3/CIS and ICC (HR = 1.6 and HR = 1.8 respectively for ≥15 years versus never use). Ever use of menopausal hormone therapy was associated with a reduced risk of ICC (HR = 0.5, 95%CI: 0.4-0.8). A non-significant reduced risk of ICC with ever use of intrauterine devices (IUD) was found in the nested case-control analysis (OR = 0.6). Analyses restricted to all cases and HPV seropositive controls yielded similar results, revealing a significant inverse association with IUD for combined CIN3/CIS and ICC (OR = 0.7).CONCLUSIONSEven though HPV is the necessary cause of CC, our results suggest that several hormonal factors are risk factors for cervical carcinogenesis. Adherence to current cervical cancer screening guidelines should minimize the increased risk of CC associated with these hormonal risk factors.
PB Public Library of Science
YR 2016
FD 2016-01-25
LK http://hdl.handle.net/10668/2223
UL http://hdl.handle.net/10668/2223
LA en
NO Roura E, Travier N, Waterboer T, de Sanjosé S, Bosch FX, Pawlita M, et al. The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort. PLoS ONE 2016; 11(1):e0147029
NO Journal Article;Corrección en: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0151427
DS RISalud
RD Apr 4, 2025