Human papillomavirus, Herpes simplex virus and other potential risk factors for cervical cancer in a high-risk area (Greenland) and a low-risk area (Denmark) – a second look

Abstract

Summary The prevalence of human papillomavirus (HPV) infection and other risk factors were studied in a high risk area for cervical cancer (Greenland) Epidemiological research has long pointed to cancer of the cervix uteri as a sexually transmitted disease (Brinton & Fraumeni, 1986). For more than a decade, human papillomavirus (HPV) has been suggested to play an important role in cervical carcinogenesis (zur Hausen, 1989). Not only has HPV DNA been detected in more than 90% of all cervical carcinoma samples tested, but it has also recently been shown that human keratinocytes immortalised with HPV DNA, turn malignant after prolonged cultivation (Hurlin et al., 1991;Pecoraro et al., 1991). If HPV is a main causal agent, one would anticipate a geographical accordance between incidence of cervical cancer and prevalence of HPV infection. On this background we were surprised that our population-based comparison showed that the prevalence of HPV 16/18 detection was higher in Denmark (13.0%) than in Greenland (8.8%) in spite of the cervical cancer incidence being five times higher in Greenland (Kjaer et al., 1988). By contrast, the high risk Greenlandic women were characterised by e.g. a higher number of sexual partners and earlier age at first intercourse compared with Danish women (Kjaer et al., 1989). Because of the surprising lack of correspondence between HPV 16/18 prevalence and incidence of cervical cancer and in view of the further development of new DNA hybridisation techniques, we decided to undertake a renewed comparative study in the same geographical areas. In addition, we reinvestigated the association between HPV and HSV infection and the number of sexual partners like in the previous investigation (Kjaer et al., 1990

Risk factors for HPV infection in women from sexually transmitted disease clinics: Comparison between two areas with different cervical cancer incidence

“…Substantial differences were found between Greenlandic and Danish women with high-risk sexual behavior, as has previously been observed in women from the general populations living in the 2 areas (Kjaer et al, 1988(Kjaer et al, , 1993. Consistent with the higher cervical cancer incidence in Greenland, all known and suspected behavioral risk factors for the disease were more prevalent in women from this area, including young age at first sexual intercourse, multiple sexual partners and STDs.…”

“…In the previous Denmark/Greenland studies of women from the general population, we found a corresponding age pattern in HPV prevalence, but as the decline in the Greenlandic prevalence curve appears at a very early age, the pattern was less obvious because women younger than 20 years were not included in those studies (Kjaer et al, 1988(Kjaer et al, , 1993. The high HPV DNA prevalence among the youngest Greenlandic women may have important implications in relation to the epidemiology of cervical cancer, as the adolescent cervical epithelium has been suggested to be more susceptible to HPV-induced neoplastic changes than the more mature epithelium of the adult woman (Muñoz et al, 1993).…”

“…We have previously studied random samples of the female populations from 2 areas with an almost 4-fold difference in cervical cancer incidence, i.e., Greenland and Denmark (Kjaer et al, 1988(Kjaer et al, , 1993. The cervical cancer incidence is, respectively, 45.8 (Kjaer and Nielsen, 1996) and 12.6/100,000/year (Storm et al, 1996) in Greenland and Denmark.…”

Infecção pelo Papilomavírus Humano em Adolescentes: Relação com o Método Anticoncepcional, Gravidez, Fumo e Achados Citológicos

“…A perpetuação da infecção pode ser reduzida com o uso consistente e apropriado, particularmente se as lesões estiverem dentro da proteção do látex 24 . No entanto, outros estudos não demonstraram o efeito protetor do condom 9,13,25 e o seu efeito protetor ainda está para ser comprovado.…”

Human papillomavirus and invasive cervical cancer in Brazil

“…That in the current study no statistically significant association was found, despite using PCR, may be because only 33% of the women in this control group reported having had more than one sexual partner compared with 81% of those in their investigation. Kjaer et al, 1993). Another explanation could be the partners' sexual behaviour.…”