Human papillomavirus and risk factors for cervical adenocarcinoma in the state of Pernambuco, Brazil

Abstract Objectives: to determine the incidence of the main high oncogenic risk types of the human papillomavirus (HPV) ( 16, 18, 31 and 33) and the risk factors for cervical adenocarcinoma. Methods: a case-control study was carried out with 324 women (69 with adenocarcinoma and 260 healthy controls) between 2001 and 2014. Information on risk factors associated with adenocarcinomawere collected and the detection performed on HPVby using Polymerase Chain Reaction (PCR) method. Results: adenocarcinoma was associated with age ≥40 years old (OR=2.95; 95%CI=1.13-7.71), ≤3 years of schooling (OR=2.34; 95%CI=1.02-5.37), presence of HPV (OR=6.75; 95%CI=2.41-18.91),women in menopausal status (OR=4.76; 95%CI:1.70-13.31) black race (OR=6.71; 95%CI= 2.11-21.32) and never had undergone cervical cancer screening (OR=9.92; 95%CI:2.41-40.81). Andamong the HPV types detected, HPV 18 was observed to be strongly associated with adenocarcinoma of the cervix (OR=99.1; 95%CI=12.96-757.78). Conclusions: the factors associated with cervical adenocarcinoma were ≥40 years old, ≤3 years of schooling, black race, menopausal status, never had undergone cervical cancer screening and the presence of HPV.摘要 研究目的：明确人乳头瘤病毒（human papillomavirus, HPV）主要高致癌风险型别（16、18、31及33型）的感染率，以及宫颈腺癌的相关危险因素。方法：本研究为病例对照研究，纳入2001年至2014年间的324名女性受试者，其中宫颈腺癌患者69例，健康对照260名。研究人员收集了与宫颈腺癌相关的危险因素信息，并采用聚合酶链反应（Polymerase Chain Reaction, PCR）法检测HPV感染情况。结果：宫颈腺癌与年龄≥40岁（优势比（odds ratio, OR）=2.95；95%置信区间（confidence interval, CI）=1.13~7.71）、受教育年限≤3年（OR=2.34；95%CI=1.02~5.37）、HPV感染（OR=6.75；95%CI=2.41~18.91）、绝经女性（OR=4.76；95%CI=1.70~13.31）、黑人种族（OR=6.71；95%CI=2.11~21.32）以及从未接受过宫颈癌筛查（OR=9.92；95%CI=2.41~40.81）显著相关。在检出的HPV型别中，HPV18型与宫颈腺癌呈现极强的相关性（OR=99.1；95%CI=12.96~757.78）。结论：与宫颈腺癌相关的危险因素包括年龄≥40岁、受教育年限≤3年、黑人种族、绝经状态、未接受过宫颈癌筛查以及HPV感染。