Family history as a co‐factor for adenocarcinoma and squamous cell carcinoma of the uterine cervix: Results from two studies conducted in Costa Rica and the United States

Dear Sir,The role of family history on the risk of cervical cancer has been investigated in an article including data from 2 studies, from Costa Rica and the Eastern United States (US). 1 In the case-control study from Costa Rica, women with a family history of cervical cancer had a 2.4 times (95% confidence Interval [CI] 1.2-4.7) higher risk of developing cervical cancer or severe cervical dysplasia than women without affected firstdegree relatives. 1 In the case-control study from the Eastern US, the odds ratio (OR) in women with a family history of cervical cancer in first-degree relatives was 2.6 (95% CI 1.1-6.4) for squamous cell carcinoma (SCC) of the cervix and 1.3 (95% CI 0.4-3.9) for cervical adenocarcinoma. 1 In the latter study, women with a family history of noncervical gynaecological malignancies had an OR of cervical SCC of 1.2 (95% CI 0.4-3.6), whereas the OR of cervical adenocarcinoma was 1.8 (95% CI 0.7-4.9). 1 There is scant additional information on family history of cancer and risk of cervical cancer. In the Swedish Family-Cancer Database, having an affected daughter or mother doubled the risk of developing cervical cancer. 2 The risk of developing cervical SCC was 2.0 (95% CI 1.5-2.5) in women with a mother diagnosed with the same cancer and 1.5 (95% CI 0.4-3.3) in women whose mother had had an adenocarcinoma of the cervix. 3 We analysed the issue using data from an Italian case-control study. A hospital-based case-control study of invasive cervical cancer was conducted from 1981-1993 in the greater Milan area on 786 women (median age 53, range 17-79 years) with histologically confirmed invasive cervical cancer. 4,5 The histology was adenocarcinoma for 96 cases, SCC for 471 cases and unknown for 219 cases. We grouped cases with unknown histology with SCC because the latter represented the vast majority of cervical cancers in Italy. 6 Controls were 917 women (median age 54, range 16-79 years) admitted to the same network of hospitals as cases for a wide spectrum of nongynaecological, nonneoplastic acute conditions unrelated to known or potential risk factors for cervical cancer. Among controls, 31% had traumatic conditions, 30% nontraumatic orthopedic disorders, 12% acute surgical conditions and 27% miscellaneous other illnesses.All interviews were conducted in hospital using a structured questionnaire including information on personal characteristics and habits. 4,5 Information on family history included number of sisters and if the mother or a sister had had a cancer of the breast, ovary, cervix uteri, corpus uteri or an unspecified uterine cancer.We estimated the OR of cervical cancer according to history of cancer at selected sites in first-degree relatives using unconditional multiple logistic regression models. 7 We present ORs adjusted for age, education and lifetime number of sexual partners. Further adjustment for area of residence, smoking, parity, number of pap smears (excluding the one(s) leading to the diagnosis), oral contraceptive use and number of sisters did not substantially...

Section: Dear Sirmentioning

confidence: 48%

Section: Dear Sirmentioning

confidence: 99%

Section: Dear Sirmentioning

confidence: 99%

Section: Dear Sirmentioning

confidence: 99%

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Risk of cervical cancer in women with a family history of breast and female genital tract neoplasms

Negri

Vecchia

Bosetti

et al. 2005

“…16 Recent work on family history as a co-factor for cervical cancer supports the importance of host factors, although environmental effects cannot be ruled out. 17 Allergy is a state of hypersensitivity caused by an immunological reaction towards a particular antigen, the allergen. Common symptoms of allergy are allergic rhinoconjunctivitis, asthma and eczema.…”

mentioning

confidence: 99%

Reduced incidence of cervical cancer in mothers of sons with allergic rhinoconjunctivitis, asthma or eczema

Ivansson

Rasmussen

Gyllensten

et al. 2006

Because infection with human papillomavirus is a necessary cause of cervical cancer, it is likely that host immunological factors involved in defense against such infections are important for susceptibility to this cancer. By examining associations between allergy in sons and cervical cancer in their mothers, we aimed to test for genetic components involved in both allergy and cervical cancer development. Women born in Sweden between 1932 and 1960 with at least 1 son with medical records from military conscription examination were included in the study (N 5 717,963). Among these women there were 41,910 in situ and 3,618 invasive cases of cervical cancer. Hazard ratios of in situ and invasive cervical cancer were estimated as functions of allergic rhinoconjunctivitis, asthma and eczema diagnoses in sons. Adjustment was made for the possible confounders: age, year of birth, education, socio-economic index, geography, number of conscripted sons and total number of offspring. The risk of in situ and invasive cervical cancer was lower for women having sons diagnosed with hypersensitivity (allergic rhinoconjunctivitis, asthma or eczema). Fully adjusted hazard ratios for women with 1 hypersensitive son were for in situ 0.86 (95% CI 0.84-0.88) and for invasive cervical cancer 0.82 (95% CI 0.74-0.91). The protective effects were similar between the 3 allergic diagnoses and increased with number of sons with a diagnosis. There was no significant association between non-cervical cancer in mothers and allergy in sons. These results strengthen the hypothesis that inherited immunological factors are important in determining risk of cervical cancer, probably by affecting mechanisms for viral persistence. ' 2006 Wiley-Liss, Inc.Key words: cervical cancer; allergy; rhinoconjunctivitis; asthma; eczema Cervical cancer is the second most common cancer among women worldwide, with 470,000 women diagnosed each year. 1 Infection with human papillomavirus (HPV) is considered a necessary but not sufficient cause of cervical cancer. 2 The reason why some women clear an HPV infection while others develop cervical lesions is still unknown. A key question is therefore what host and viral risk factors affect the persistence of infection and subsequent progression to cervical cancer?Other environmental risk factors for cervical cancer are cigarette smoking, long-term use of oral contraceptives and high parity. [3][4][5] However, these factors do not explain why, once an HPV infection has occurred, some women progress to cervical cancer while others clear the virus.The majority of studies on cervical neoplasias among immunesuppressed women suggest that impaired immunologic activity increases the risk of cervical cancer. Immune-suppressed individuals such as HIV patients or organ transplant recipients have increased risk for developing HPV-associated anogenital cancers. 6 Elevated risk of cervical cancer is reported for HIV/AIDS patients 7 and recipients of renal transplants. 8 An increased risk of cervical cytological abnormalities is seen in ...

Heritable and environmental components in cervical tumors

Couto

Hemminki²

2006

The familial risk of 18,199 women with invasive and/or in situ cervix cancers when compared with that of 72,796 women free of cervical tumors was analyzed. The risk of cervical tumors was significantly higher for women with a mother and/or sister(s) with cervical tumors (odds ratio (OR) 5 1.79, 95% CI: 1.71-1.88) than with an affected grandmother and/or aunt(s) (OR 5 1.28, 1.22-1.35). This risk did not differ according to the family side of the affected relative. Taking the familial risk of 1.28 for second-degree relatives as the best estimate of a true heritable effect for 25% of gene sharing, the calculated heritable effect for full siblings, sharing 50% of their genes, would correspond to an OR of 1.56. This model suggests, as a best estimate, a heritable component of 71% and an environmental component of 29% in young familial cervical tumors. The data imply that familial risks for cervical tumors are best explained by complex multifactorial mechanisms. ' 2006 Wiley-Liss, Inc.Key words: family history; heredity; genetics; gene sharing; environmental effects Cervical cancer is the second most common cancer among women worldwide, and the leading neoplasm in developing countries.1,2 Infection with human papilloma virus (HPV) is the main causal factor of cervical cancer and the risks have been estimated to be over 60. 3,4 Familial aggregation for cervical cancer has been observed in most but not all studies, [5][6][7][8][9] and also the heritability estimates differ extensively.10-12 Sexual behavior is a major attribute of HPV infections, and this is related to many life-style and socioeconomic factors, which family members have in common. [13][14][15] We use here the nation-wide Swedish Family-Cancer Database, by far the largest ever used to study familial cancer. 16,17 This database has previously been used to study the effect of first-degree family history in invasive and in situ cervical cancers risk, both showing a familial risk of about 1.8-2.0.6,18 Here we investigate familial cervical tumors considering family histories of these tumors both in first-and second-degree relatives in order to distinguish the possible genetic component in familial cervical cancer, influenced by an assumed strong environmental factor. Material and methodsThe Swedish Family-Cancer Database was described previously. 16,17 The information was gathered from the Multigeneration Register, censuses, Swedish Cancer Registry and national death notifications. Histories of invasive and in situ cervical tumors among mothers, sisters, grandmothers and aunts were extracted from the Multigeneration registry. Information from 1960, 1970, 1980 and 1990 censuses was considered. The information provided by the different registries was linked together using the national 10-digit personal number. Information on both maternal and paternal grandmothers was available for 1,550,374 women. Among those, 18,199 women, born between 1950 and 1983, had been diagnosed with invasive (N 5 597) and/or in situ (N 5 17,650) cervical cancer. Each case was matche...