A Population-Based Study of Squamous Cell Vaginal Cancer: HPV and Cofactors

doi:10.1006/gyno.2001.6502

Gynecologic Oncology

Volume 84, Issue 2, February 2002, Pages 263-270

https://doi.org/10.1006/gyno.2001.6502 Get rights and content

Abstract

Background. Little is known about the etiology of in situ or invasive squamous cell cancer of the vagina. It is thought that some vaginal cancers may have the same etiology as cervical cancer. It is also not known whether in situ and invasive vaginal cancer share the same etiologic factors. We conducted a study to evaluate risk factors for in situ and invasive vaginal cancer and their potential relationship to prior exposure to human papillomaviruses (HPV).

Methods. A population-based case–control study included 156 women with squamous cell in situ or invasive vaginal cancer diagnosed between January 1981 and June 1998 and 2041 control women identified through random-digit dialing in western Washington state. Cases and controls were interviewed in person and provided blood samples; archival tumor tissue was retrieved for cases. Blood samples were tested for antibodies to HPV, and tumor tissue was tested for HPV DNA.

Results. Women with vaginal cancer were more likely to have five or more lifetime sexual partners (OR = 3.1, 95% CI 1.9 to 4.9), to have an early age at first intercourse (<17 years OR = 2.0, 95% CI 1.2 to 3.5), and to be current smokers at diagnosis (OR = 2.1, 95% CI 1.4 to 3.1) than control women. Approximately 30% of all cases had been treated for a prior anogenital tumor, most often of the cervix. Prior hysterectomy was a risk factor only among women who had no history of prior anogenital cancer (OR = 3.9 95% CI 2.5 to 6.1). Antibodies to HPV16 L1 were strongly related to risk of vaginal cancer (OR = 4.3, 95% CI 3.0 to 6.2). We detected HPV DNA in tumor blocks from over 80% of the patients with in situ and 60% of the patients with invasive cancers.

Conclusions. In situ and invasive vaginal neoplasia have many of the same risk factors as cervical cancer, including a strong relationship to HPV infection. Women who have been treated for a prior anogenital cancer, particularly of the cervix, have a high relative risk, although low absolute risk, of being diagnosed with vaginal cancer.

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^☆: Supported by National Cancer Institute Grant 3 PO1 CA 42792 and by the Cancer Surveillance System of the Fred Hutchinson Cancer Research Center, which is funded by Contract NO1-CN-05230 from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute with additional support from the Fred Hutchinson Cancer Research Center.

²: To whom correspondence and reprint requests should be addressed at Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North (MP 381), Seattle, WA 98109-1024. Fax: 206-667-5948. E-mail: [email protected].

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Regular ArticleA Population-Based Study of Squamous Cell Vaginal Cancer: HPV and Cofactors☆

Abstract

Gynecol Oncol

J Virol Methods

Gynecol Oncol

Gynecol Oncol

Cigarette smoking and the risk of anogenital cancer

Am J Epidemiol

Sampling methods for random digit dialing

J Am Stat Assoc

Comparison of HPV 16, 18 and 6 capsid antibody responses following incident infection

J Infect Dis

Use of the polymerase chain reaction for detection of genital human papillomavirus

Cancer Cells

Telomerase activation in cervical cancer

Am J Pathol

Humoral immune response to human papillomavirus infection

Clin Dermatol

Sexual, reproductive, and other risk factors for adenocarcinoma of the cervix: results from a population-based case–control study (California, United States)

Cancer Causes Control

A case–control study of women with adenocarcinoma in situ of the cervix

Cancer Epidemiol Biomarkers Prev

Tobacco smoking impairs the local immunosurveillance in the uterine cervix

Gynecol Obstet Invest

Cervical cotinine and macrophage–Langerhans cell density in the normal human uterine cervix

J Gynecol Obstet Invest

Numerical and functional alterations in circulatory lymphocytes in cigarette smokers

Clin Exp Immunol

Regular Article
A Population-Based Study of Squamous Cell Vaginal Cancer: HPV and Cofactors☆