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Comparison of risk factors for invasive squamous cell carcinoma and adenocarcinoma of the cervix: collaborative reanalysis of individual data on 8,097 women with squamous cell carcinoma and 1,374 women with adenocarcinoma from 12 epidemiological studies.

Abstract

Squamous cell carcinomas account for about 80% of cancers of the uterine cervix, and the majority of the remainder are adenocarcinomas. There is limited evidence on the extent to which these histological types share a common etiology. The International Collaboration of Epidemiological Studies of Cervical Cancer has brought together and combined individual data on 8,097 women with invasive squamous cell carcinoma, 1,374 women with invasive adenocarcinoma and 26,445 women without cervical cancer (controls) from 12 epidemiological studies. Compared to controls, the relative risk of each histological type of invasive cervical cancer was increased with increasing number of sexual partners, younger age at first intercourse, increasing parity, younger age at first full-term pregnancy and increasing duration of oral contraceptive use. Current smoking was associated with a significantly increased risk of squamous cell carcinoma (RR = 1.50, 95% CI: 1.35-1.66) but not of adenocarcinoma (RR = 0.86 (0.70-1.05)), and the difference between the two histological types was statistically significant (case-case comparison p < 0.001). A history of screening (assessed as having had at least one previous nondiagnostic cervical smear) was associated with a reduced risk of both histological types, but the reduction was significantly greater for squamous cell carcinoma than for adenocarcinoma (RR = 0.46 (0.42-0.50) and 0.68 (0.56-0.82), respectively; case-case comparison, p = 0.002). A positive test for cervical high-risk HPV-DNA was a strong risk factor for each histological type, with 74% of squamous cell carcinomas and 78% of adenocarcinomas testing positive for HPV types 16 or 18. Squamous cell and adenocarcinoma of the cervix share most risk factors, with the exception of smoking.

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  • Authors

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    Source

    International journal of cancer 120:4 2007 Feb 15 pg 885-91

    MeSH

    Adenocarcinoma
    Adult
    Carcinoma, Squamous Cell
    Case-Control Studies
    Cohort Studies
    Female
    Humans
    Incidence
    International Cooperation
    Middle Aged
    Risk Factors
    Uterine Cervical Neoplasms

    Pub Type(s)

    Comparative Study
    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17131323

    Citation

    Berrington de González, Amy, et al. "Comparison of Risk Factors for Invasive Squamous Cell Carcinoma and Adenocarcinoma of the Cervix: Collaborative Reanalysis of Individual Data On 8,097 Women With Squamous Cell Carcinoma and 1,374 Women With Adenocarcinoma From 12 Epidemiological Studies." International Journal of Cancer, vol. 120, no. 4, 2007, pp. 885-91.
    Berrington de González A, Green J, International Collaboration of Epidemiological Studies of Cervical Cancer. Comparison of risk factors for invasive squamous cell carcinoma and adenocarcinoma of the cervix: collaborative reanalysis of individual data on 8,097 women with squamous cell carcinoma and 1,374 women with adenocarcinoma from 12 epidemiological studies. Int J Cancer. 2007;120(4):885-91.
    Berrington de González, A., & Green, J. (2007). Comparison of risk factors for invasive squamous cell carcinoma and adenocarcinoma of the cervix: collaborative reanalysis of individual data on 8,097 women with squamous cell carcinoma and 1,374 women with adenocarcinoma from 12 epidemiological studies. International Journal of Cancer, 120(4), pp. 885-91.
    Berrington de González A, Green J, International Collaboration of Epidemiological Studies of Cervical Cancer. Comparison of Risk Factors for Invasive Squamous Cell Carcinoma and Adenocarcinoma of the Cervix: Collaborative Reanalysis of Individual Data On 8,097 Women With Squamous Cell Carcinoma and 1,374 Women With Adenocarcinoma From 12 Epidemiological Studies. Int J Cancer. 2007 Feb 15;120(4):885-91. PubMed PMID: 17131323.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Comparison of risk factors for invasive squamous cell carcinoma and adenocarcinoma of the cervix: collaborative reanalysis of individual data on 8,097 women with squamous cell carcinoma and 1,374 women with adenocarcinoma from 12 epidemiological studies. AU - Berrington de González,Amy, AU - Green,Jane, AU - ,, PY - 2006/11/30/pubmed PY - 2007/5/15/medline PY - 2006/11/30/entrez SP - 885 EP - 91 JF - International journal of cancer JO - Int. J. Cancer VL - 120 IS - 4 N2 - Squamous cell carcinomas account for about 80% of cancers of the uterine cervix, and the majority of the remainder are adenocarcinomas. There is limited evidence on the extent to which these histological types share a common etiology. The International Collaboration of Epidemiological Studies of Cervical Cancer has brought together and combined individual data on 8,097 women with invasive squamous cell carcinoma, 1,374 women with invasive adenocarcinoma and 26,445 women without cervical cancer (controls) from 12 epidemiological studies. Compared to controls, the relative risk of each histological type of invasive cervical cancer was increased with increasing number of sexual partners, younger age at first intercourse, increasing parity, younger age at first full-term pregnancy and increasing duration of oral contraceptive use. Current smoking was associated with a significantly increased risk of squamous cell carcinoma (RR = 1.50, 95% CI: 1.35-1.66) but not of adenocarcinoma (RR = 0.86 (0.70-1.05)), and the difference between the two histological types was statistically significant (case-case comparison p < 0.001). A history of screening (assessed as having had at least one previous nondiagnostic cervical smear) was associated with a reduced risk of both histological types, but the reduction was significantly greater for squamous cell carcinoma than for adenocarcinoma (RR = 0.46 (0.42-0.50) and 0.68 (0.56-0.82), respectively; case-case comparison, p = 0.002). A positive test for cervical high-risk HPV-DNA was a strong risk factor for each histological type, with 74% of squamous cell carcinomas and 78% of adenocarcinomas testing positive for HPV types 16 or 18. Squamous cell and adenocarcinoma of the cervix share most risk factors, with the exception of smoking. SN - 0020-7136 UR - https://www.unboundmedicine.com/medline/citation/17131323/full_citation L2 - https://doi.org/10.1002/ijc.22357 DB - PRIME DP - Unbound Medicine ER -