No abstract

To estimate the effects of consuming hot beverages, including mate (an infusion of the herb Ilex paraguayensis), tea, coffee and coffee with milk, and other food items on esophageal cancer risk, we analyzed data from 830 cases and 1,779 controls participating in a series of 5 hospital‐based case‐control studies of squamous‐cell carcinoma of the esophagus conducted in high‐risk areas of South America. After adjusting for the strong effects of tobacco and alcohol consumption, both heavy mate drinking (>1 l/day) and self‐reported very hot mate drinking were significantly associated with esophageal cancer risk in men and women. The magnitude and strength of the association for mate amount and, to a lesser extent, mate temperature were higher for women than men. The joint effects of mate amount and mate temperature were more than multiplicative, following a statistically significant synergistic interaction (p = 0.02) which was particularly evident among heavy drinkers (>1.50 l/day) of very hot mate (odds ratio = 4.14, 95% confidence interval: 2.24–7.67) compared to light drinkers (<0.50 l/day) of cold/warm/hot mate. Consumption of other very hot beverages, such as tea and coffee with milk but not coffee alone, was also significantly associated with an increased risk, in the 2‐ to 4‐fold range. Statistically significant protective associations were identified for high consumption of vegetables, fruits, cereals and tea. In contrast, frequent consumption of meat, animal fats and salt was associated with a moderately increased risk. This pooled analysis adds evidence for a carcinogenic effect of chronic thermal injury in the esophagus induced by the consumption of very hot drinks, including mate. Our study further confirms the protective effect of a dietary pattern characterized by daily consumption of fruits and vegetables and low consumption of meat and animal fats. Int. J. Cancer 88:658–664, 2000. © 2000 Wiley‐Liss, Inc.

HPV types 16 and 18 have been categorized as human carcinogens based on their strong associations with cervical cancer in previous case-control studies. Recent IARC studies in the Philippines, Thailand and Morocco show strong associations between invasive cervical cancer and less common HPV types, including HPV 31, 33, 45, 51, 52 and 58. We present results of a further IARC case-control study conducted in Asunció n, Paraguay, to examine the association between specific HPV types and invasive cervical cancer as well as risk factors other than HPV. One-hundred thirteen incident histologically confirmed invasive cervical cancer cases and 91 age-matched hospital controls were recruited. A standardized questionnaire was administered to investigate known and suspected risk factors for cervical cancer. For HPV status determination, cervical biopsy specimens from case subjects and exfoliated cervical cells from control subjects were obtained. HPV DNA was ascertained using a GP5؉/6؉ PCR-based assay capable of detecting more than 33 HPV types. Overall HPV prevalence was 97% in the cervical cancer cases and 20% in the control subjects. As a single infection, HPV 16 was the predominant type with a prevalence of 48% among case subjects and 5.5% among control subjects. Cervical cancer is the second most common cancer among women in the world and in developing countries. In the early 1990s, the worldwide age-standardized incidence rates of cervical cancer ranged from 2.6/100,000 women in Qidong, China, to 67.2/100,000 women in Harare, Zimbabwe (Parkin et al., 1997). Paraguay, a South American country with an estimated population of 4.8 million, had a notably high cervical cancer incidence rate of 41.1/100,000 in 1990. This is the second highest cervical cancer incidence rate in South America after Bolivia yet higher than in Brazil, Ecuador and Colombia. (IARC, 1998) Certain human papillomavirus (HPV) types have been demonstrated to be the primary etiological agents for cervical cancer (IARC, 1995). HPV types 16 and 18 have been categorized as human carcinogens based on their strong associations with cervical cancer (Munoz et al., 1992; IARC, 1995). IARC-conducted invasive cervical cancer case-control studies in the Philippines (Ngelangel et al., 1998), Thailand (Chichareon et al., 1998, Brazil (Eluf-Neto et al., 1994) and Morocco (Chaouki et al., 1998) confirmed the strong associations between invasive cervical cancer and HPV types 16 and 18 and showed similar strong associations with less common HPV types, including HPV 31, 33, 45, 51, 52 and 58. Further data on the association between these less common HPV types and invasive cervical cancer risk are currently needed.We present results of an IARC study of invasive cervical cancer conducted in Asunción, Paraguay. Our report examines the association between invasive cervical cancer and specific HPV types as well as other risk factors of invasive cervical cancer. MATERIAL AND METHODS SubjectsBetween December 1988 and May 1990, 116 patients with invasive cervical cancer and 1...

Cervical carcinoma and reproductive factors: Collaborative reanalysis of individual data on 16,563 women with cervical carcinoma and 33,542 women without cervical carcinoma from 25 epidemiological studies International Collaboration of Epidemiological Studies of Cervical CancerThe International Collaboration of Epidemiological Studies of Cervical Cancer has combined individual data on 11,161 women with invasive carcinoma, 5,402 women with cervical intraepithelial neoplasia (CIN)3/carcinoma in situ and 33,542 women without cervical carcinoma from 25 epidemiological studies. Relative risks (RRs) and 95% confidence intervals (CIs) of cervical carcinoma in relation to number of full-term pregnancies, and age at first fullterm pregnancy, were calculated conditioning by study, age, lifetime number of sexual partners and age at first sexual intercourse. Number of full-term pregnancies was associated with a risk of invasive cervical carcinoma. After controlling for age at first fullterm pregnancy, the RR for invasive cervical carcinoma among parous women was 1.76 (95% CI: 1.53-2.02) for 7 full-term pregnancies compared with 1-2. For CIN3/carcinoma in situ, no significant trend was found with increasing number of births after controlling for age at first full-term pregnancy among parous women. Early age at first full-term pregnancy was also associated with risk of both invasive cervical carcinoma and CIN3/carcinoma in situ. After controlling for number of full-term pregnancies, the RR for first full-term pregnancy at age <17 years compared with 25 years was 1.77 (95% CI: 1.42-2.23) for invasive cervical carcinoma, and 1.78 (95% CI: 1.26-2.51) for CIN3/carcinoma in situ. Results were similar in analyses restricted to high-risk human papilloma virus (HPV)-positive cases and controls. No relationship was found between cervical HPV positivity and number of fullterm pregnancies, or age at first full-term pregnancy among controls. Differences in reproductive habits may have contributed to differences in cervical cancer incidence between developed and developing countries. ' 2006 Wiley-Liss, Inc.Key words: cervical carcinoma; cervical intraepithelial neoplasia; reproductive factors; full-term pregnancy; age at first full-term pregnancy; collaborative reanalysis; relative risk Parity was one of the earliest risk factors to be associated with cancer risk. Already in 1842, on the basis of death certificates in Verona, Italy, Rigoni-Stern observed that cancers of the uterus (which at that time chiefly originated from the cervix) were more frequent in married women, who tended to be multiparous, whereas breast neoplasms were more common in nulliparae, including nuns. 1Epidemiological studies conducted in the 1950's and 1960's pointed to sexual habits, and subsequent studies to sexual infections, specifically high-risk human papillomavirus (HPV) types, 2 as the key factor in cervical carcinogenesis. Consequently, they tended to consider that the association between reproductive factors and cervical cancer was chiefly accounted for by...

HPV types 16 and 18 have been categorized as human carcinogens based on their strong associations with cervical cancer in previous case‐control studies. Recent IARC studies in the Philippines, Thailand and Morocco show strong associations between invasive cervical cancer and less common HPV types, including HPV 31, 33, 45, 51, 52 and 58. We present results of a further IARC case‐control study conducted in Asunción, Paraguay, to examine the association between specific HPV types and invasive cervical cancer as well as risk factors other than HPV. One‐hundred thirteen incident histologically confirmed invasive cervical cancer cases and 91 age‐matched hospital controls were recruited. A standardized questionnaire was administered to investigate known and suspected risk factors for cervical cancer. For HPV status determination, cervical biopsy specimens from case subjects and exfoliated cervical cells from control subjects were obtained. HPV DNA was ascertained using a GP5+/6+ PCR‐based assay capable of detecting more than 33 HPV types. Overall HPV prevalence was 97% in the cervical cancer cases and 20% in the control subjects. As a single infection, HPV 16 was the predominant type with a prevalence of 48% among case subjects and 5.5% among control subjects. Significant associations with the risk of cervical cancer were detected as follows: any HPV type (OR = 114; 95% CI: 36–361); HPV 16 (OR = 910); HPV 18 (infinite OR); HPV 31 (OR = 110); HPV 33 (OR = 261); HPV 45 (OR = 129); and HPV 58 (OR = 36). In the multivariate model, risk factors other than HPV significantly associated with cervical cancer risk were a higher number of lifetime sexual partners, lower educational status and never having had a Pap smear. Strong associations were found between invasive cervical cancer and specific HPV types 16, 18, 31, 33, 45 and 58. Int. J. Cancer 85:486–491, 2000. © 2000 Wiley‐Liss, Inc.