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Serologically diagnosed infection with human papillomavirus type 16 and risk for subsequent development of cervical carcinoma: nested case-control study

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7030.537 (Published 02 March 1996) Cite this as: BMJ 1996;312:537
  1. Matti Lehtinen, senior research fellowa,
  2. Joakim Dillner, senior investigatorb,
  3. Paul Knekt, senior scientistc,
  4. Tapio Luostarinen, research fellowd,
  5. Arpo Aromaa, director of medical researchc,
  6. Reinhard Kirnbauer, senior research fellowe,
  7. Pentti Koskela, senior scientista,
  8. Jorma Paavonen, associate professor of obstetrics and gynaecologyf,
  9. Richard Peto, professor of medical statisticsg,
  10. John T Schiller, senior investigatorh,
  11. Matti Hakama, professor of epidemiologyi
  1. a National Public Health Institute, Helsinki and Oulu, Finland
  2. b Microbiology and Tumorbiology Centre, Karolinska Institute, Sweden
  3. c Research and Development Centre, Social Insurance Institution, Helsinki, Finland
  4. d Finnish Cancer Registry, Helsinki, Finland
  5. e Department of Immunodermatology, University of Vienna Medical School, Vienna, Austria
  6. f University of Helsinki, Finland
  7. g Clinical Trial Service Unit and ICRF Cancer Studies Unit, University of Oxford, Oxford
  8. h Laboratory of Cellular Oncology, National Cancer Institute, Bethesda, maryland, United States
  9. i Tampere School of Public Health, University of Tampere, Tampere, Finland
  1. Correspondence to: Dr Lehtinen, Department of Chronic Viral Diseases, NPHI, Mannerheimintie 166, FIN-00300 Helsinki, Finland.
  • Accepted 30 November 1995

Abstract

Objective: To study human papillomavirus type 16 in the aetiology of cervical carcinoma.

Design: Within a cohort of 18814 Finnish women followed for up to 23 years a nested case-control study was conducted based on serological diagnosis of past infection with human papillomavirus type 16.

Subjects: 72 women (27 with invasive carcinoma and 45 with in situ carcinoma) and 143 matched controls were identified during the follow up.

Main outcome measure: Relative risk of cervical carcinoma in presence of IgG antibodies to human papillomavirus type 16.

Results: After adjustment for smoking and for antibodies to various other agents of sexually transmitted disease, such as herpes simplex virus type 2 and Chlamydia trachomatis, the only significant association was with infection with human papillomavirus type 16 (odds ratio 12.5; 95% confidence interval 2.7 to 57, 2P<0.001).

Conclusion: This prospective study provides epidemiological evidence that infection with human papillomavirus type 16 confers an excess risk for subsequent development of cervical carcinoma.

Key messages

  • Key messages

  • Human papillomavirus type 16 is the main micro-organism linked to the development of cervical cancer

  • Prospective studies of infection with this virus and cervical cancer have not been reported because of ethical and clinical difficulties and because diagnosis of past infections with the virus has not been possible

  • In this nested case-control study in over 18000 Finnish women who donated blood to a serum bank 25 years ago we were able to measure past infection with human papillomavirus type 16 with new serological tools

  • The results show that infection with the virus confers an increased risk of developing cervical cancer

Footnotes

  • Funding ML is supported by research grants from the Nordic Cancer Union and Finnish Cancer Organisations.

  • Conflict of interest None.

  • Accepted 30 November 1995
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