HPV and cervical adenocarcinoma : An IARC based multicentric case- control study

F. Xavier Bosch, Servei dÕ Epidemiologia i Registre del Cncer, Institut Catal dÕ Oncologia, Barcelona, Spain
Nubia Muoz, International Agency for Research on Cancer, Lyon, France
Saibua Chichareon, Assoc. Prof., D. of Obstetrics and Gynecology, F. of Medicine, PSU.
Cora Ngelangel, Clinical Epidemiology Unit, Philippine General Hospital. Manila, The Philippines
Eduardo Caceres, Centro de Investigacin del Cncer, Inst. Nacional de Enfermeades Neoplsicas, Lima, Peru
Joseph Eluf-Neto, Depto. Medicina Preventiva, Faculdade Medicina, University Sao Paulo, Brazil Brahim EL Gueddari, Institut Nacional dÕ Oncologie, Rabat, Morocco
Pedro Anibal Rolon, Registro Nacional de Patologia, Asuncion, Paraguay.
Mireia Dia, Servei dÕ Epidemiologia i Registre del Cncer, Institut Catal dÕ Oncologia, Barcelona, Spain
Chris J.L.M. Meijer, Pathology D., Free U., Amsterdam, The Netherlands
Jan M.M. Walboomers, Pathology D., Free U., Amsterdam, The Netherlands
Corresponding e-mail : csaibua@ratree.psu.ac.th

Grant : International Agency for Research on Cancer
Published : The 18th International Papillomavirus Conference, 23rd - 28th July 2000, Barcelona, Spain
Key words : HPV, cervical adenocancinoma

Objective : To assess the relationship between HPV DNA and cervical adenocarcinoma. The quantify the risk linked to type specific HPV.

Methods : An international hospital-based case control study on cervical adenocarcinoma. Cases included 141 adenocarcinomas from Thailand (41), The Philippines (34), Peru (25), Brazil (18), Morocco (16) and Paraguay (7). Controls included 1466 women age and center matched to the distribution of cervical cancer cases. HPV DNA detection was performed centrally using a well-established PCR-based system, which included a general primer (GP5+/6+), and 33 type specific oligoprobes. Other risk factors for cervical cancer were evaluated using extensive questionnaires and specially trained interviewers. Lack of specimens included 2.1% of the cases and 6.8% of the controls and inadequate specimens by the B globin amplification test accounted for 2.1% of the cases and 5.9% of the controls.

Results : HPV DNA prevalence (including in the denominator subjects with adequate specimens) was 88.9% in cases (range by country 71.4%-92.0%) and 15.4% in controls (range by country 9.2%-21.6%). Type distribution among the 108 single HPV-type adenocarcinoma cases included only 8 types as follows : HPV 16 (49.1%) HPV 18 (38.0%) HPV 45 (4.6%) and HPV X (3.7%) other types (4.6%). Among controls 27 HPV types were identified and again HPV 16(25.0%) and 18 (9.5%) were the most common. The estimated OR for HPV DNA detection, adjusted for age and country was OR = 47.5 (95%CI 27.0-83.7). Risk estimates for the most frequent HPV types were OR HPV 16 = 95.4 (48.6-187.3); OR HPV 18 = 179.5 (81.2-396-7); OR HPV 45 = 41.1 (12.0-140.6). Multiple HPV types were detected in 8.9% of cases and 2.3% of controls and did not show any increased risk over single type cases. 11 out of 12 cases with multiple types included HPV 16 or 18.

Conclusions : Cervical adenocarcinoma is strongly related to HPV in six geographical areas at different background risk of cervical cancer. HPV 18 is found in cases almost as frequently as HPV 16, which is in contrast with the predominance of the latter in squamous cell cervical carcinomas.

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