The causal link between human papillomavirus and invasive cervical cancer: A population‐based case‐control study in colombia and spain

TLDR

The study aimed to assess the association between HPV and invasive cervical cancer through a population‑based case‑control design in Colombia and Spain. The study enrolled 436 cervical‑cancer cases and 387 controls, collected demographic and sexual behavior data via interview, and tested cervical swabs for HPV DNA using ViraPap, Southern hybridization, and PCR assays. HPV DNA, particularly types 16, 18, 31, 33, and 35, was strongly associated with invasive cervical cancer, with adjusted odds ratios ranging from 6.8 to 28.8 across assays, indicating a likely causal link.

Abstract

To evaluate the association between human papillomavirus (HPV) and cervical cancer, we performed a population-based case-control study in Columbia and Spain, the former country having an incidence rate of cervical cancer about 8 times higher than the latter. It included 436 cases of histologically confirmed invasive cervical cancer and 387 randomly selected population controls. Information on demographic variables, sexual behaviour and other risk factors was obtained by interview. HPV-DNA was measured in cervical-swab specimens with 3 hybridization assays: ViraPap, Southern hybridization (SH) and polymerase chain reaction (PCR). The presence of HPV-DNA and detection of types 16, 18, 31, 33 and 35 were strongly associated with cervical cancer in each country regardless of the assay used. For both countries combined the adjusted odds ratios and 95% confidence intervals were: ViraPap OR = 25.9 (10.0-66.7); SH OR = 6.8 (3.4-13.4); and PCR OR = 28.8 (15.7-52.6). HPV-16 was the most common type detected in both cases and controls. Our results indicate that there is a very strong association between HPV 16, 18, 31, 33 and 35 and invasive cervical cancer and that this association is probably causal.