Evidence for<i>Chlamydia trachomatis</i>as a Human Papillomavirus Cofactor in the Etiology of Invasive Cervical Cancer in Brazil and the Philippines

Smith, Jennifer S.; Muñóz, Núbia; Herrero, Rolando; Eluf-Neto, José; Ngelangel, Corazon A.; Franceschi, Silvia; Bosch, F. Xavier; Walboomers, Jan M. M.; Peeling, Rosanna W.

doi:10.1086/338569

Cited by 208 publications

(123 citation statements)

References 23 publications

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“…Our finding suggests a plausible mechanism whereby C. trachomatis infection could be associated with increased risk for cervical cancer, as has been reported in several epidemiological studies. 7,[10][11][12]23,24 It has been reported that C. trachomatis infection may induce large local amounts of pro-inflammatory chemokines, including IL-1, IL-8 and granulocyte-macrophage colony-stimulating factor 25 producing a chronic inflammatory background that may conceivably contribute to HPV DNA persistence in the cervix.…”

Section: Discussionmentioning

confidence: 99%

Chlamydia trachomatis infection and persistence of human papillomavirus

Silins

Ryd

Strand

et al. 2005

Intl Journal of Cancer

139

108

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Human papillomavirus (HPV) persistence is the major cause of cervical cancer, but most HPV infections will not persist and risk factors for HPV persistence are not well known. Chlamydia (C.) trachomatis infection seems to also be associated with cervical cancer. We investigated whether C. trachomatis infection is a risk factor for HPV persistence. In a cohort of 12,527 women participating in a population-based HPV screening trial in Sweden, 6,418 women completed testing for HPV DNA by general primer PCR and typing by reverse dot blot hybridization. On average 19 months later, 303 women that had been HPV-positive and had normal cytology at enrollment completed a new HPV test. Environmental exposures were assessed by an 87-item questionnaire. Previous sexually transmitted infections were also investigated by serology. At follow-up, 44% of the women were positive for the same type of HPV DNA as at enrollment. Persistence correlated with length of follow-up (p < 0.01) and condom use seemed to protect against HPV persistence (p < 0.05). The most significant risk factor for persistent presence of HPV DNA was self-reported history of previous C. trachomatis infection (relative risk in multivariate model = 2.09; 95% confidence interval = 1.05-4.18). We conclude that persistence of oncogenic HPV infections is more likely among women with a previous C. trachomatis infection. ' 2005 Wiley-Liss, Inc.Key words: HPV infection; HPV persistence; Chlamydia trachomatis; epidemiology Persistent oncogenic HPV infection is recognized as a necessary factor in development of high grade cervical intraepithelial neoplasia and invasive cervical cancer. 1 Genital infections with oncogenic HPV types are very common among sexually active women, but only a minority of infected women will have a persistent HPV infection. 2-4 Type-specific persistence of HPV (defined as repeated detectability of the same type of HPV DNA in serial samples) is a much stronger risk factor for high-grade CIN 5 and cervical cancer 6 than HPV infection per se.Chlamydia (C.) trachomatis has been found repeatedly to associate with cervical neoplasia and invasive cancer in cross-sectional case-control studies, 7,8 although the association has commonly been thought to be the result of confounding by HPV. During recent years, an association with C. trachomatis has also been found in several biobank-based longitudinal studies with invasive cervical cancer as endpoint. [9][10][11][12] The vexed question of whether the association could be due to confounding by HPV infection is, however, only possible to address in cohort studies comprising only HPV-infected women.A possible explanation for the association of C. trachomatis and cervical cancer might be that the C. trachomatis-induced inflammation results in an impaired ability to clear HPV infections.To investigate these issues, we carried out a prospective, population-based cohort study restricted to HPV-infected women with HPV persistence as the endpoint. Subjects and methods Study settingA population-based randomized mul...

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Section: Discussionmentioning

confidence: 99%

Chlamydia trachomatis infection and persistence of human papillomavirus

Silins

Ryd

Strand

et al. 2005

Intl Journal of Cancer

139

108

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“…Recent studies have linked sexually transmitted infections (STIs) other than HPV with cervical cancer. 25 Herpes simplex type 2, 26 Chlamydia trachomatis 27,28 and Neisseria gonorrhoea 29 have all been associated with an increased risk for cervical intraepithelial neoplasia (CIN) and invasive cervical cancer, after accounting for infection with high-risk types of HPV. These infections excite chronic inflammatory response which causes the generation of free radicals, which are thought to play an important role in the generation and progression of cancers.…”

Section: Biological Factorsmentioning

confidence: 99%

Cervical cancer: the sub-Saharan African perspective

Anorlu¹

2008

Reproductive Health Matters

265

243

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Cervical cancer is the second most common cancer in women worldwide and the leading cause of cancer deaths in developing countries. While incidence and mortality rates of cervical cancer have fallen significantly in developed countries, 83% of all new cases that occur annually and 85% of all deaths from the disease occur in developing countries. Cervical cancer is the most common cancer among women in sub-Saharan Africa. The incidence is on the increase in some countries. Knowledge and awareness of this disease on the continent are very poor and mortality still very high. Facilities for the prevention and treatment of cervical cancer are still very inadequate in many countries in the region. Governments in sub-Saharan Africa must recognise cervical cancer as a major public health concern and allocate appropriate resources for its prevention and treatment, and for research. Indeed, cervical cancer in this region must be accorded the same priority as HIV, malaria, tuberculosis and childhood immunisations.

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“…It has been shown that there may be a role for infection as a co-factor in carcinogenesis e.g. inflammation, probably due to Chlamydia, may contribute to of cervical cancer [14]. Recently, demonstration of an exaggerated response to inflammation due to polymorphisms of IL6 and TNF alpha has been noted in some HNSCC patients that may result in a carcinogenic effect at a site of inflammation [15].…”

Section: Minor Risk Factorsmentioning

confidence: 99%

Head and Neck Squamous Cell Carcinoma in the Young: A Spectrum or a Distinct Group? Part 1

Toner

O’Regan²

2009

Head and Neck Pathol

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While most head and neck squamous carcinoma (HNSCC) occurs in older people, an increasing number of young patients are being affected worldwide, with up to 5.5% \40. These are predominantly oral and oropharyngeal cancers. Some patients have heavy exposure to the usual risk factors, but an increasing number do not. Part of this trend appears to be due to rising numbers of HPV associated tonsil carcinoma, particularly in males (smokers and non-smokers).

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Evidence forChlamydia trachomatisas a Human Papillomavirus Cofactor in the Etiology of Invasive Cervical Cancer in Brazil and the Philippines

Cited by 208 publications

References 23 publications

Chlamydia trachomatis infection and persistence of human papillomavirus

Chlamydia trachomatis infection and persistence of human papillomavirus

Cervical cancer: the sub-Saharan African perspective

Head and Neck Squamous Cell Carcinoma in the Young: A Spectrum or a Distinct Group? Part 1

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