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Reproductive Factors, Oral Contraceptive Use, and Human Papillomavirus Infection: Pooled Analysis of the IARC HPV Prevalence Surveys

¹ International Agency for Research on Cancer, Lyon, France; ² Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, San José, Costa Rica; ³ VU University Medical Center, Amsterdam, the Netherlands; ⁴ College of Medicine, University of Ibadan, Ibadan, Nigeria; ⁵ National Cancer Institute, Hanoi, Vietnam; ⁶ Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; ⁷ Instituto de Oncología Angel H. Roffo, Universidad de Buenos Aires, Buenos Aires, Argentina; ⁸ Instituto Nacional de Cancerología, Bogota, Colombia; ⁹ Servei d'Epidemiologia i Registre del Cancer Institut Català d'Oncologia, L'Hospitalet del Llobregat, Barcelona, Spain; ¹⁰ Research Institute, National Cancer Centre, Goyang, Korea; ¹¹ Research Division, National Cancer Institute, Bangkok, Thailand; ¹² Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico; ¹³ Unit of Cancer Epidemiology, CPO Piemonte, ASO S. Giovanni Battista, Turin, Italy; ¹⁴ Christian Fellowship Community Health Centre, Ambilikai, Dindigul District, Tamil Nadu, India; and ¹⁵ Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Beijing, China

Requests for reprints: Salvatore Vaccarella, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France. Phone: 33-47273-8097; Fax: 33-47273-8345. E-mail: vaccarella{at}iarc.fr

High parity, early age at first full-term pregnancy (FTP), and long-term oral contraceptive (OC) use increase cervical cancer risk, but it is unclear whether these variables are also associated with increased risk of acquisition and persistence of human papillomavirus (HPV) infection, the main cause of cervical cancer. Information on reproductive and menstrual characteristics and OC use were collected from 14 areas worldwide, among population-based, age-stratified random samples of women aged 15 years or older. HPV testing was done using PCR-based enzyme immunoassay. Unconditional logistic regression was used to estimate the odds ratios (OR) of being HPV-positive according to reproductive and menstrual factors and corresponding 95% confidence intervals (CI). When more than two groups were compared, floating CIs (FCI) were estimated. A total of 15,145 women (mean age, 40.9 years) were analyzed. Women with 5 FTPs (OR, 0.90; 95% FCI, 0.76-1.06) showed a similar risk of being HPV-positive compared with women with only one FTP (OR, 1.00; 95% FCI, 0.86-1.16). However, nulliparous women showed an OR of 1.40 (95% CI, 1.16-1.69) compared with parous women. Early age at first FTP was not significantly related to HPV positivity. HPV positivity was similar for women who reported 10 years of use of OCs (OR, 1.16; 95% FCI, 0.85-1.58) and never users of OCs (OR, 1.00; 95% FCI, 0.90-1.12). Our study suggests, therefore, that high parity, early age at first FTP, and long-term OC use are not associated with HPV prevalence, but rather these factors might be involved in the transition from HPV infection to neoplastic cervical lesions. (Cancer Epidemiol Biomarkers Prev 2006;15(11):2148–53)

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