Human papillomavirus and invasive cervical cancer in Brazil

Abstract

Summary A hospital-based case-control study was undertaken to examine the role of human papillomavirus (HPV) (e.g. HPV 6, 11, 42, 43, 44) have been associated with condylomata acuminata and CIN I (Howley, 1991;Lorincz et al., 1992).Epidemiological studies investigating the relation between HPV and cervical neoplasia have found strong associations . However, some of these studies are difficult to interpret because of methodological flaws in study design (Munoz et al., 1988) or because of the inaccuracy of the hybridisation techniques used to detect HPV DNA (Schiffman, 1992). Recently a reliable and sensitive HPV detection strategy based on the polymerase chain reaction (PCR) has been developed in several laboratories (Manos et al., 1989;van den Brule et al., 1990) and is now considered the technique of choice for epidemiological studies (Schiffman, 1992). Employing this technique, two recent studies have found high risks of cervical cancer associated with HPV (Peng et al., 1991;Munoz et al., 1992).In developing countries cancer of the cervix is the leading cancer even when sites common to both sexes are combined (Parkin et al., 1988). This hospital-based case-control study using PCR was undertaken to examine the role of HPV in the development of invasive cervical cancer in Sao Paulo, Brazil, a city with one of the highest incidence rates of this disease worldwide (Muir et al., 1987). Patients and methods Study populationBetween June 1990 and June 1991 women with a diagnosis of invasive cervical cancer and women selected as controls were recruited from seven hospitals in Sao Paulo City. Five of these are general hospitals, and two are hospitals for the treatment of cancer. The cases were women between 25 and 79 years of age, whose diagnosis was confirmed by histopathology and who had had no previous treatment for the disease. Controls were enrolled from the same five general hospitals from which the cases were recruited. For cases from the hospitals in which only cancer patients are treated (n = 48), controls were selected from the largest general hospital included in the study. This was because had the cancer cases had another disease it is likely that they would have been treated there as it is the most commonly used referral hospital in the city. Controls were frequency matched to cases in 5-year age groups. Those with diseases associated with known risk factors for cervical neoplasia were excluded (sexually transmitted diseases, coronary heart disease, cerebrovascular disease, arterial thromboembolism, thrombophlebitis, chronic bronchitis, emphysema, neoplasia of the breast, reproductive and respiratory organs, anus, oral cavity, oesophagus, bladder and liver). Women who were admitted for treatment of a gynaecological condition or who had had a hysterectomy or conisation were ineligible as controls. Women with a psychiatric illness were ineligible as cases or as controls. Evidence of a gynaecological or cytological abnormality detected on examination after recruitment was not a criterion for exclusion.A ...

Prevalence and determinants of human papillomavirus genital infection in men

“…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.…”

“…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).…”

“…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.…”

Prevalence of human papillomavirus in cervical cancer: A multicenter study in China

“…[1][2][3][4] The women positive for HPV DNA have a risk of developing cervical cancer 15-50 times higher than those without HPV DNA. 1,2,4,5 Although HPV infection is common among young women, only a small minority go on to develop cervical cancer.…”

“…[1][2][3][4] The women positive for HPV DNA have a risk of developing cervical cancer 15-50 times higher than those without HPV DNA. 1,2,4,5 Although HPV infection is common among young women, only a small minority go on to develop cervical cancer. This situation was reviewed by a group of researchers, who concluded that viral persistence of oncogenic HPV appears to be crucial for the development of cervical cancer.…”