Causes of Cervical Cancer in the Philippines: a Case-Control Study

Ngelange, Cora; Muñóz, Núbia; Bosch, F. Xavier; Festin, Mario; Deacon, Judith; Jacobs, Marcel V.; Santamaria, M.; Meijer, Chris J.L.M.; Walboomers, Jan M. M.

doi:10.1093/jnci/90.1.43

Cited by 157 publications

(116 citation statements)

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“…Thus, the prevalence of HPV DNA in the male genital tract seems similar to that in the cervix uteri of control women in the same populations and age groups, if not higher (Muñoz et al, 1992;Eluf-Neto et al, 1994;Chichareon et al, 1998;Ngelangel et al, 1998). In agreement with findings in women without cervical neoplasia (Herrero et al, 2000b), HPV 16 and 18 types were relatively rare (i.e., less than one third of penile HPV infections) with the notable exception of Brazilian men, among whom these types accounted for the majority of penile HPV infections.…”

Section: Discussionmentioning

confidence: 61%

“…The fieldwork was conducted from 1985 through 1993 in Spain (two studies), Colombia (two studies), Brazil, Thailand, and the Philippines. The detailed methods of each of these studies have been described elsewhere (Muñoz et al, 1992;Bosch et al, 1993;Eluf-Neto et al, 1994;Chichareon et al, 1998;Ngelangel et al, 1998;Castelssague et al, 2002). In brief, case women had newly diagnosed, histologically confirmed ICC or CIS.…”

Section: Methodsmentioning

confidence: 99%

“…A smear was prepared for cytology and the remaining cells were eluted in phosphate-buffered saline, pelleted and stored at 7208C. Cervical exfoliated cells were also collected from the women as described for each study (Muñoz et al, 1992;Bosch et al, 1993;Eluf-Neto et al, 1994;Chichareon et al, 1998;Ngelangel et al, 1998).…”

Section: Biological Samples and Hpv Dna Detectionmentioning

confidence: 99%

“…The detailed protocols used for HPV DNA detection by PCR in the cervical and penile specimens were described elsewhere (Muñoz et al, 1992;Eluf-Neto et al, 1994;Ngelangel et al, 1998). Briefly, amplification of a fragment of the beta-globin gene served as an internal control for sufficiency of each specimen for amplification.…”

Section: Biological Samples and Hpv Dna Detectionmentioning

confidence: 99%

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Prevalence and determinants of human papillomavirus genital infection in men

et al. 2002

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Four-hundred-forty-five husbands of women with invasive cervical carcinoma, 165 of women with in situ cervical cancer, and 717 of control women (age range 19 -82 years) were interviewed and a sample of exfoliated cells from the penis obtained in seven case -control studies conducted by the International Agency for Research on Cancer. The characteristics of human papillomavirus-positive and human papillomavirus-negative husbands were compared using odds ratios and 95% confidence intervals. Thirteen per cent of the husbands of control women, 18% of the husbands of women with invasive cervical carcinoma, and 21% of the husbands of in situ cervical carcinoma women were positive for penile human papillomavirus DNA. Human papillomavirus 16 was detected in 45 husbands, human papillomavirus 18, 31 or 33 in 19, and human papillomavirus 6/11 in 6, but the majority of human papillomavirus infection (158) was with other or unspecified human papillomavirus types. The same human papillomavirus type was seldom identified in both husband and wife. The strongest variation in penile human papillomavirus infection was by country, with percentages among the husbands of control women ranging between 3% in Spain and 39% in Brazil. Having had over 50 lifetime sexual partners, compared with only one, was associated with an odds ratio of 2.3. British Journal of Cancer (2002) The importance of the 'male factor' (Skegg et al, 1982) in the aetiology of cervical carcinoma (CC) in women was suggested years before the identification of a sexually-transmitted virus, human papillomavirus (HPV), as the central cause of these tumours (Dürst et al, 1983;Muñoz et al, 1992). A close correlation has been reported between the frequency of cervical and penile carcinoma in populations (Bosch and Cardis, 1990) and in individual couples (Smith et al, 1980). The development of increasingly accurate assays for HPV detection has brought a clearer understanding of the prevalence of, and risk factors for, cervical HPV infection in women. Human papillomavirus DNA has been identified in 99% of CC specimens (Walboomers et al, 1999). Among women with a normal Pap smear, between a few per cent and more than 50% of women with a normal Pap smear harbour HPV DNA in their cervix, depending upon age and country (Herrero et al, 2000a;Woodman et al, 2001). Conversely, progress in understanding the prevalence and natural history of genital HPV infection in men has been limited. Most surveys of penile HPV infection so far have included a few hundred men at most and have generally been restricted to young individuals (Hippeläinen et al, 1993a,b,c;Baldwin et al, 2001;Kjaer et al, 2001;Lazcano-Ponce et al, 2001).The present study examines the prevalence and determinants of penile HPV infection, according to PCR-based assays, among 1143 husbands of women enrolled in seven case -control studies coordinated by the International Agency for Research on Cancer (IARC). MATERIALS AND METHODSThe combined data included in these analyses were collected in five case-control studies of i...

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Section: Discussionmentioning

confidence: 61%

Section: Methodsmentioning

confidence: 99%

Section: Biological Samples and Hpv Dna Detectionmentioning

confidence: 99%

Section: Biological Samples and Hpv Dna Detectionmentioning

confidence: 99%

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Prevalence and determinants of human papillomavirus genital infection in men

et al. 2002

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“…The highest prevalence was found at the follicular phase (55%), whereas the cumulative prevalence was 75%. (Schiffman et al, 1993;Chichareon et al, 1998;Ngelangel et al, 1998; Liaw et al, 1999;Walboomers et al, 1999;Andersson et al, 2001;Lehtinen et al, 2001). A systematic review on the role of HPV testing within a cervical cancer screening program showed that the high risk HPV prevalence in CIN 1 ranged from 30 to 65%, in CIN 2 from 40 to 70% and in CIN 3 from 60 to 90% (Cuzick et al, 1999).…”

mentioning

confidence: 99%

Fluctuations in prevalence of cervical human papillomavirus in women frequently sampled during a single menstrual cycle

et al. 2002

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In the last few years much attention has been focused on the implementation of human papillomavirus detection in population based screening programmes to identify women at risk for cervical cancer. Short-term fluctuations in prevalence of human papillomavirus were investigated within a single menstrual cycle. The highest prevalence was found at the follicular phase (55%), whereas the cumulative prevalence was 75%. (Schiffman et al, 1993;Chichareon et al, 1998;Ngelangel et al, 1998; Liaw et al, 1999;Walboomers et al, 1999;Andersson et al, 2001;Lehtinen et al, 2001). A systematic review on the role of HPV testing within a cervical cancer screening program showed that the high risk HPV prevalence in CIN 1 ranged from 30 to 65%, in CIN 2 from 40 to 70% and in CIN 3 from 60 to 90% (Cuzick et al, 1999). Furthermore, HPV can be detected in almost all cervical carcinomas (Walboomers et al, 1999).The estimated point prevalences of genital HPV infections detected by PCR based methods among populations of women with cytological normal cervical smears range from 1.5 to 44.3%, with a weighted average of 16.2% (Xi and Koutsky, 1997) and show an age-related pattern (Melkert et al, 1993). The highest prevalences are found in women in their early twenties (de Villiers et al, 1992;Melkert et al, 1993). Newly acquired genital HPV is usually transient in women with normal cervical cytology (Evander et al, 1995). The mean duration of cervical HPV infection in a healthy population varies between 8.2 -13.5 months (Ho et al, 1998;Franco et al, 1999). Short-term fluctuations of an individual's HPV status, however, are still a matter of debate. Several studies have reported a fluctuating expression of HPV (Ho et al, 1998;Schneider et al, 1992;Wheeler et al, 1996), probably due to differences in viral load, inadequate sampling or reactivation of endogenous infection (Woodman et al, 2001). Single point measurements of HPV 16 in cervical smears are of limited value for assessment of an individual's HPV status .Before incorporation of HPV testing in screening programs for prevention of cervical cancer it is important to gain more insight in the actual prevalence of HPV, influenced by short-term fluctuations. The aim of this study was to investigate the presence of cervical HPV in the different phases of a single menstrual cycle in women with regular cycles. MATERIALS AND METHODSCervical samples for HPV detection and cytological examination were obtained from 20 women visiting the outpatient clinic for fertility problems at the University Medical Centre Nijmegen, the Netherlands. Only women with regular menstrual cycles were included. Patients with cervical treatment for abnormal cervical cytology in the past 10 years were not included in the study. After giving informed consent, patients were interviewed regarding their medical history, smoking habits, use of contraceptives and sexual behaviour.Cervical smears for HPV detection and cytological classification were obtained using the Cervex brush (Rovers, Oss, the Netherlands).On a weekly bas...

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Human papillomavirus is a necessary cause of invasive cervical cancer worldwide

et al. 1999

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A recent report that 93 per cent of invasive cervical cancers worldwide contain human papillomavirus (HPV) may be an underestimate, due to sample inadequacy or integration events affecting the HPV L1 gene, which is the target of the polymerase chain reaction (PCR)‐based test which was used. The formerly HPV‐negative cases from this study have therefore been reanalysed for HPV serum antibodies and HPV DNA. Serology for HPV 16 VLPs, E6, and E7 antibodies was performed on 49 of the 66 cases which were HPV‐negative and a sample of 48 of the 866 cases which were HPV‐positive in the original study. Moreover, 55 of the 66 formerly HPV‐negative biopsies were also reanalysed by a sandwich procedure in which the outer sections in a series of sections are used for histological review, while the inner sections are assayed by three different HPV PCR assays targeting different open reading frames (ORFs). No significant difference was found in serology for HPV 16 proteins between the cases that were originally HPV PCR‐negative and ‐positive. Type‐specific E7 PCR for 14 high‐risk HPV types detected HPV DNA in 38 (69 per cent) of the 55 originally HPV‐negative and amplifiable specimens. The HPV types detected were 16, 18, 31, 33, 39, 45, 52, and 58. Two (4 per cent) additional cases were only HPV DNA‐positive by E1 and/or L1 consensus PCR. Histological analysis of the 55 specimens revealed that 21 were qualitatively inadequate. Only two of the 34 adequate samples were HPV‐negative on all PCR tests, as against 13 of the 21 that were inadequate ( p< 0·001). Combining the data from this and the previous study and excluding inadequate specimens, the worldwide HPV prevalence in cervical carcinomas is 99·7 per cent. The presence of HPV in virtually all cervical cancers implies the highest worldwide attributable fraction so far reported for a specific cause of any major human cancer. The extreme rarity of HPV‐negative cancers reinforces the rationale for HPV testing in addition to, or even instead of, cervical cytology in routine cervical screening. Copyright © 1999 John Wiley & Sons, Ltd.

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Causes of Cervical Cancer in the Philippines: a Case-Control Study

Abstract: As has been shown for squamous cell carcinoma, HPV is the central cause of adenocarcinoma/adenosquamous carcinoma of the uterine cervix. The observed associations of less prevalent HPV types with cervical cancer have important implications for cervical cancer prevention strategies.

Cited by 157 publications

References 14 publications

Prevalence and determinants of human papillomavirus genital infection in men

Prevalence and determinants of human papillomavirus genital infection in men

Fluctuations in prevalence of cervical human papillomavirus in women frequently sampled during a single menstrual cycle

Human papillomavirus is a necessary cause of invasive cervical cancer worldwide

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