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Environmental co-factors in HPV carcinogenesis
Xavier Castellsagué1, F Xavier Bosch, Nubia Muñoz
1Servei d'Epidemiologia I Registre del Càncer, Institut Català d'Oncologia, Gran Vias/n km 2,7 08907 L'Hospitalet de Llobregat, Barcelona, Spain. xcastellsague@ico.scs.es
Virus Research
|November 26, 2002
Summary
Certain factors increase cervical cancer risk in women with human papillomavirus (HPV) infection. High parity, long-term oral contraceptive use, smoking, and other sexually transmitted infections are key co-factors.
Area of Science:
- Oncology
- Epidemiology
- Infectious Diseases
Background:
- Oncogenic human papillomavirus (HPV) infection is necessary but not sufficient for cervical cancer (CC) development.
- Environmental co-factors are hypothesized to influence the progression from HPV infection to cervical malignancy.
Purpose of the Study:
- To review epidemiological evidence on environmental co-factors in HPV carcinogenesis.
- To identify factors associated with progression from HPV infection to high-grade intraepithelial lesions (HSIL) and CC.
Main Methods:
- Review of epidemiological studies focusing on HPV-DNA positive women.
- Assessment of co-factors including parity, oral contraceptive (OC) use, smoking, other sexually transmitted diseases (STDs), and diet.
Main Results:
- High parity, long-term OC use, smoking, and co-infection with other STDs are consistently identified as co-factors.
- These factors increase the risk of progression from HPV infection to HSIL and invasive CC.
- Limited evidence suggests a role for dietary factors.
Conclusions:
- Multiparous women, smokers, and those on long-term OC use may require closer cytological and HPV surveillance.
- Further research is needed to fully elucidate the role of these and other co-factors in HPV carcinogenesis.