子宮頸がんにおけるパリティとヒトパピローマウイルスの役割:IARCの多中心的症例対照研究
Nubia Muñoz1, Silvia Franceschi, Cristina Bosetti
1Unit of Field and Intervention Studies, International Agency for Research on Cancer, 150 Cours Albert Thomas, F-69372, Cédex 08, Lyon, France. munoz@iarc.fr
Lancet (London, England)
|April 12, 2002
まとめ
高精度または多くの妊娠は,ヒトパピローマウイルス (HPV) 感染の女性において,状細胞性子宮頸がんのリスクを大幅に増加させます. この発見は,最近,子宮頸がん率の減少を説明するのに役立つかもしれない.
科学分野:
- 婦人科 婦人科について
- 腫瘍学 腫瘍学
- エピデミオロジー エピデミオロジー
背景:
- 高いパリティは,歴史的に,子宮頸がんのリスクの増加と関連しています.
- 以前の研究では,ヒトパピローマウイルス (HPV) の重要な役割について十分に説明できませんでした.
- この研究は,子宮頸がんへのHPVの進行に影響を与える生殖要因に焦点を当てています.
研究 の 目的:
- 高パリティと子宮頸がんリスクの関連性を,特にHPV陽性女性で調査する.
- 状細胞性子宮頸がんの発症における生殖歴の役割を明らかにする.
- パリティがアデノカルシノーマまたはアデノスクワムスカルシノーマのリスクを影響するかどうかを評価する.
主な方法:
- 侵襲性子宮頸がん (ICC) に関する8件のケース・コントロール研究と,イン・シトゥ癌 (ISC) に関する2件のケース・コントロール研究を総合分析した.
- 1465件のICC,211件のISC,124件のアデノカルシノマ/アデノスクワムスICC症例,および255件のHPV陽性対照を含む.
- 無条件マルチロジスティック回帰を使用して,混乱要因を調整して,プールされたオッズ比率を計算しました.
主要な成果:
- 完全妊娠の数と状細胞子宮頸がんのリスクとの間には直接的な関連性が見られた.
- 7回またはそれ以上の満期妊娠をした女性は,無妊娠女性と比較して,オッズ比率が3.8 (95%CI 2.7-5.5) であった.
- パリティとアデノカルシノーマまたはアデノスクワムスカルシノーマのリスクとの間に有意な関連性は観察されなかった.
結論:
- 高いパリティは,HPV陽性女性における状細胞性子宮頸がんの重要な危険因子である.
- 観察された関連は,子宮頸がん発生における生殖歴とHPVの相互作用を強調しています.
- 平均パリティの潜在的低下は,世界的に観察された子宮頸がん発生率の減少に寄与する可能性がある.
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