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Biomedical subjects

G Hallmans

Publications and source records attributed to G Hallmans.

At least 73 records · Page 4Linked to original sources
PubMed1999

Improved fibrinolysis by intense lifestyle intervention. A randomized trial in subjects with impaired glucose tolerance.

OBJECTIVE: To assess the effects of lifestyle intervention on cardiovascular risk factors in general and especially on fibrinolysis. DESIGN: Randomized clinical study. SUBJECTS: A total of 186 subjects with impaired glucose tolerance and obesity. INTERVENTIONS: The intervention programme included a low-fat, high-fibre diet and regular physical exercise. Half of the participants (n = 93) took part in a one-month learning and training session using different behavioural modification techniques and conducted in a full-board wellness centre (intense intervention group). The other half (n = 93) was randomized a one-hour counselling session with a specially trained nurse (usual care group). Follow-up was carried out after 12 months. MAIN OUTCOME MEASURES: Body weight, oxygen consumption, plasminogen activator inhibitor type 1 (PAI-1) activity, tissue plasminogen activator (tPA) antigen, fibrinogen and fasting plasma insulin measured at the start of the programme and at follow-up after 1 year. RESULTS: The intense intervention group had a mean weight decline by 1 year of 5.4 kg compared to 0.5 kg in the usual care group. Oxygen consumption in the intense group increased 10% vs. a 1% decline in the usual care group. In the intense group, PAI-1 activity decreased 31% (-10.1 U mL(-1)), which was significantly more than in the usual care group (12%; -3.0 U mL(-1)). The corresponding reductions in tPA antigen were 14% (-1.65 microg L(-1)) and 6% (-0.69 microg L(-1)). CONCLUSIONS: The present randomized study shows that an intense lifestyle programme has sustained beneficial effects on fibrinolysis.

Adult↗
PubMed1999

Leptin is associated with increased risk of myocardial infarction.

OBJECTIVES AND DESIGN: Leptin is involved in the regulation of bodyweight and metabolism in man and might also be involved in the pathophysiology of the insulin resistance syndrome, which is associated with the development of cardiovascular diseases. We tested whether leptin is a risk factor for acute myocardial infarction (AMI) in a nested case-referent study. SUBJECTS AND METHODS: Sixty-two men with first-ever AMI were identified who, prior to AMI, had participated in population-based health surveys in Northern Sweden. Referents were matched for sex, age, date and type of health survey, and geographical region. Blood pressure, body mass index (BMI) and the presence of smoking, diabetes and hypertension were recorded. Total cholesterol, apolipoprotein A-1 (apo A-1), apolipoprotein B (apo B), plasminogen activator inhibitor (PAI-1), insulin, and leptin were analysed in stored samples. Their influences on first-ever AMI were analysed by conditional logistic regression analysis. RESULTS: Men with first-ever AMI had higher BMI, plasma insulin and leptin, and diastolic blood pressure than the referents. Furthermore, they had lower plasma apo A-1 and were more often smokers. Smoking, high leptin, PAI-1 and cholesterol, and low apo A-1 levels were significant risk factors for first-ever AMI in univariate analysis. High leptin (OR 8.97; 95% CI: 1.73-46.5) and cholesterol (OR 5.18; 95% CI: 1.34-20.0) levels remained significant risk factors for AMI in a multivariate model. High apo A-1 was protective (OR = 0.13; 95% CI: 0.03-0.55). The combination of high leptin and low apo A-1 was associated with a particularly pronounced increased risk for AMI. CONCLUSION: Plasma leptin strongly predicts first-ever AMI. Our data support the hypothesis that leptin is an important link in the development of cardiovascular disease in obesity.

Adult↗
PubMed1999

Interaction between haemochromatosis and transferrin receptor genes in different neoplastic disorders.

A number of genes are involved in iron metabolism, including the transferrin receptor (TFR) and haemochromatosis (HFE) genes. In previous investigations an increased risk for neoplastic disease has been observed in individuals homo- and heterozygous for hereditary haemochromatosis. The HFE wild-type gene product complexes with the transferrin receptor (TF) and two different HFE mutations (Cys282Tyr and His63Asp) have been found to increase the affinity of TFR for TF and increase cellular iron uptake. In a recent study we found no associations for HFE and TFR separately, but an interaction between HFE and TFR genotypes in multiple myeloma. Individuals carrying the HFE Tyr282 allele (homo- and heterozygotes) in combination with homozygosity for the TFR Ser142 allele had an increased risk. In the present study the same association was found in breast and colorectal cancer. The odds ratio for all three neoplasms combined was 2.0 (95% CI 1.0-3.8). The risk for neoplastic disease was further increased (OR 7.7, 95% CI = 1.0-59.9) when the analysis was restricted to HFE Tyr homozygotes and compound heterozygotes in combination with TFR Ser homozygosity. Thus, an interaction between HFE and TFR alleles may increase the risk for different neoplastic disorders.

Alleles↗
PubMed1999

Sexual behaviour and papillomavirus exposure in cervical intraepithelial neoplasia: a population-based case-control study.

Sexual history is an established risk determinant for cervical neoplasia. It is not clear if human papillomavirus (HPV) exposure entirely explains the sexual behaviour-related risk or if other sexually transmitted agents may act as cofactors for HPV in carcinogenesis. The aim of this study was to elucidate whether HPV exposure or HPV persistence explains the sexual history-related risk of high-grade cervical intraepithelial neoplasia (CIN) using a population-based case-control study of most of the 254 women referred to colposcopy in the Vasterbotten county in Sweden because of an abnormal cervical smear during October 1993 to December 1995 and 320 age-matched women from the general population. The women were interviewed for sexual history and tested for presence of serum antibodies to HPV-16, -18 and -33 as well as for presence of HPV DNA in cervical brush samples. HPV-16, -18 and -33 seropositivity was specific for the corresponding type of HPV DNA, dependent on the lifetime sexual history and associated with a two- to threefold increased risk of CIN 3. There was no sexual history-related risk of CIN among HPV-seropositive women and adjustment for HPV DNA presence explained the sexual history-related risk of CIN. In conclusion, HPV exposure appeared to explain the sexual history-related risk of high-grade CIN.

Adult↗
PubMed1999

Shifting the distribution of risk: results of a community intervention in a Swedish programme for the prevention of cardiovascular disease.

STUDY OBJECTIVE: To examine the impact of a systematic risk factor screening and counselling carried out by family physicians and family nurses within the larger framework of a community intervention programme for the prevention of cardiovascular disease (CVD). DESIGN: Quasi-experimental study comparing trends in an intervention area with those in a reference area. SETTING: A Northern Sweden municipality (5500 inhabitants) constituted the intervention area while the Northern Sweden region (510,000 inhabitants) served as the reference area. PARTICIPANTS: All 30, 40, 50, and 60 year old inhabitants were invited each year from 1985 to 1992. Among 2046 eligible 1893 participated (92.5%), which formed eight independent cross sections. One cross section, 1986, was re-surveyed forming a panel. MAIN RESULTS: In the cross sections, mean total cholesterol was reduced from 7.09 to 6.27 mmol/l for men (p < 0.001) and from 7.13 to 5.89 mmol/l for women (p < 0.001) and mean systolic blood pressure from 132.2 to 123.7 mm Hg for men (p < 0.05) and from 129.2 to 122.0 mm Hg for women (p < 0.001) during the eight years. Body mass index (BMI) increased from 25.6 to 26.2 for men (p < 0.05) and from 25.0 to 25.5 for women (NS). A corresponding reduction in cholesterol and blood pressure (for women) occurred in the panel, while BMI was unchanged. The risk for CVD, using the Framingham equation, was estimated to be reduced overall by 19% (p = 0.0021) when comparing early cross sections (1985/86) with the later cross sections (1990/91). CONCLUSIONS: It was concluded that a long term community based CVD prevention programme that combines population and individual strategies can substantially promote a health shift in CVD risk in a high risk rural population. The individual attention and evaluation provided by the health provider survey seem to accelerate, but not increase the amount of, risk reduction.

Adult↗
PubMed1999

Chlamydia pneumoniae antibodies and high lipoprotein(a) levels do not predict ischemic cerebral infarctions. Results from a nested case-control study in Northern Sweden.

BACKGROUND AND PURPOSE: An association between high lipoprotein(a) [Lp(a)] levels and positive Chlamydia pneumoniae IgG titers in coronary artery disease has been described. The possibility of predicting ischemic stroke by measurements of plasma Lp(a) and C pneumoniae antibodies was investigated. METHODS: This incident case-control study included 101 case subjects (cases) who had suffered ischemic cerebral infarctions and 201 matched control subjects (controls). The study population was nested within the Västerbotten Intervention Program or the WHO MONICA project. Plasma samples were measured for C pneumoniae-specific IgG and IgA antibodies and Lp(a). RESULTS: A significantly higher mean Lp(a) level was found in female cases than in female controls. However, plasma Lp(a) was unable to predict ischemic cerebral infarctions in either women or men. The proportion of individuals with positive C pneumoniae-specific IgG or IgA titers did not differ between cases and controls. Antibody titers were unable to predict a future stroke. The proportion of individuals with a positive C pneumoniae IgG titer in combination with a high Lp(a) level did not differ significantly between cases and controls. CONCLUSIONS: These data suggest that there is no association between baseline plasma Lp(a) levels, presence of C pneumoniae antibodies, and future ischemic cerebral infarctions. Furthermore, no evidence of an interactive effect between high Lp(a) levels and C pneumoniae IgG titers was found. However, selection bias and a recent C pneumoniae epidemic may have influenced the results.

Antibodies, Bacterial↗
PubMed1999

Autoantibodies against oxidatively modified LDL do not constitute a risk factor for stroke: a nested case-control study.

BACKGROUND AND PURPOSE: Autoantibodies against oxidatively modified LDL have been shown to be associated with atherosclerosis. Their possible pathogenic role is not yet fully understood, and earlier published data are inconsistent. In this prospective study, we have investigated the association of these antibodies with future stroke. METHODS: A prospective case-control study in which 44 725 men and women from the World Health Organization Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) project and the Västerbotten Intervention Program (VIP) were enrolled and followed from January 1, 1985, to August 31, 1996. One hundred nineteen cases of stroke (male 75, female 44) were noted and compared with 233 age- and sex-matched controls from the same population. Antibodies against oxidatively modified LDL (copper-oxidized LDL and malonaldehyde [MDA]-LDL) were analyzed by ELISA. RESULTS: There was no difference in the levels or in the prevalence of IgG, IgA, and IgM autoantibodies against copper-oxidized LDL or MDA-LDL between patients and controls. Risk ratios for these antibodies, when adjusted for diabetes mellitus, hypertension, and smoking habits, did not confer a risk of stroke. Serum triglycerides (1.7 versus 1.4 mmol/L, P=0.01), fasting blood sugar, and systolic and diastolic blood pressures were significantly higher in the patient group than in the control group, as was the prevalence of hypertension (51.8% versus 27.4%, P<0.0001) and diabetes mellitus (9.6% versus 0.8%, P<0.001). CONCLUSIONS: Autoantibodies against oxidatively modified LDL do not constitute a risk factor for stroke in an adult population.

Adult↗
PubMed1999

Leptin is a risk marker for first-ever hemorrhagic stroke in a population-based cohort.

BACKGROUND AND PURPOSE: Leptin, important for body weight regulation, may be involved in the pathogenesis of the insulin resistance syndrome, associated with cardiovascular disease. We tested to determine whether leptin is a risk marker for first-ever stroke in a nested case-referent study. METHODS: We identified 113 patients with first-ever stroke (94 with ischemic and 19 with hemorrhagic stroke) who, before the stroke, had participated in population-based health surveys in northern Sweden. Referents were matched for sex, age, date and type of health survey, and geographic region. Blood pressure (BP), body mass index (BMI), and presence of smoking, diabetes, and hypertension were recorded. Total cholesterol, insulin, and leptin were analyzed in stored samples. Risk markers for first-ever stroke were analyzed by conditional logistic regression analysis. RESULTS: Patients with hemorrhagic stroke had higher levels of BMI and systolic and diastolic BPs. Leptin levels were 72% and 59% higher in males and females, respectively, with hemorrhagic stroke versus referents. Patients with ischemic stroke more often had hypertension, diabetes mellitus, and higher fasting glucose and insulin levels. A diagnosis of hypertension and elevated systolic and diastolic BPs were significant risk markers for first-ever hemorrhagic stroke in univariate analysis. High leptin (OR=20.55; 95% CI, 1.12 to 376.7) levels together with hypertension (OR=16.28; 95% CI, 1.49 to 177.3) remained as significant risk markers in a multivariate model. The combination of high leptin and high systolic or diastolic BP were associated with a profoundly increased risk for hemorrhagic stroke (OR=22.11; 95% CI, 1.57 to 310.9). Diabetes, hypertension, and obesity (BMI >/=27), together with high levels of insulin, glucose, systolic and diastolic BP, were significant risk markers for first-ever ischemic stroke in univariate analysis. Hypertension (OR=2.10; 95% CI, 1.14 to 3.86) remained as an independent risk marker in a multivariate model. CONCLUSIONS: Plasma leptin is strongly associated with an increased risk for first-ever hemorrhagic stroke, independent of other risk markers for cardiovascular disease. Leptin may be an important link in the development of cardiovascular disease in obesity.

Adult↗
PubMed1999

Low levels of serum vitamins A and E in blood and subsequent risk for cervical cancer: interaction with HPV seropositivity.

Nutritional factors have been associated with risk of cervical cancer, but it is unclear whether the associations are of etiological significance or secondary to human papillomavirus (HPV) exposure. A delineation of this question requires a prospective study with invasive cancer as the end point. We conducted a nested case-control study in Finland and Sweden within a joint cohort of 405,000 women followed up for, on average, 4 years. Blood samples from 38 prospective cases of invasive cervical cancer diagnosed between 1985 and 1994 and 116 controls matched for age, country, and sample storage time were available for the study. Levels of retinol or unoxidized alpha-tocopherol in the blood were not risk factors for cervical cancer. However, joint-effect analysis of low levels of retinol disclosed statistically significant (p = 0.023) synergistic (more than multiplicative) interaction with HPV (HPV16, HPV18, or HPV33) seropositivity (observed relative risk = 2.6, 95% confidence interval = 0.7-8.8, expected relative risk = 0.3). Retinol might act as an effect modifier of the HPV-associated risk for cervical cancer; exposed women may require adequate levels for immunologic surveillance of HPV.

Adult↗
PubMed1999

Screening for impaired glucose tolerance. Results from a population-based study in 21,057 individuals.

OBJECTIVE: To study the distribution of fasting plasma glucose and impaired glucose tolerance (IGT) in a large general population and explore their possible implications for large-scale screening. The study focuses especially on the relation to age, obesity, and heredity background of diabetes. RESEARCH DESIGN AND METHODS: A total of 21,057 men and women aged 30-60 years were used for this cross-sectional study. Individuals with known diabetes and individuals with a fasting plasma glucose > or = 7 mmol/l were excluded. A physical examination, including blood sampling and an oral glucose tolerance test, was conducted. RESULTS: The relative risk for IGT increased more than fourfold among obese subjects compared with normal-weight subjects, yet only 25% of IGT subjects were obese. Similarly, IGT subjects more frequently reported having first-degree relatives with diabetes than did subjects with normal glucose tolerance. Nonetheless, > 70% of IGT subjects reported no heredity background of diabetes. Subjects with IGT showed higher mean values of BMI, blood pressure, and triglycerides. Only 13% of the men and 19% of the women having impaired fasting glucose (IFG) fulfilled the criteria of IGT. CONCLUSIONS: The present study shows that a high-risk screening strategy for IGT targeted solely toward subjects with obesity and/or heredity background of diabetes will fail to detect the majority of subjects with IGT in the general population. The new concept of IFG may not replace the concept of IGT as a risk marker for worsening to diabetes.

Adult↗
PubMed1998

High plasminogen activator inhibitor and tissue plasminogen activator levels in plasma precede a first acute myocardial infarction in both men and women: evidence for the fibrinolytic system as an independent primary risk factor.

BACKGROUND: In patients with established ischemic heart disease, prospective cohort studies have indicated that plasminogen activator inhibitor (PAI-1), the inhibitor of the fibrinolytic system, may predict cardiovascular events. So far, there have been no primary prospective studies of PAI-1. METHODS AND RESULTS: The aim of the present study was to test whether plasma levels of PAI-1, tissue-type plasminogen activator (tPA), von Willebrand factor (vWF), and thrombomodulin (TM) could predict the occurrence of a first acute myocardial infarction (AMI) in a population with high prevalence of coronary heart disease by use of a prospective nested case-control design. Mass concentrations of PAI-1 and tPA were significantly higher for the 78 subjects who developed a first AMI compared with the 156 references matched for age, sex, and sampling time; for tPA, this increase was independent of smoking habits, body mass index, hypertension, diabetes, cholesterol, and apolipoprotein A-I. The ratio of quartile 4 to 1 for tPA was 5.9 for a patient to develop a first AMI. The association between tPA and AMI was seen in both men and women. Increased levels of vWF were associated with AMI in a univariate analysis. High levels of TM were associated with AMI in women but not in men. CONCLUSIONS: The plasma levels of PAI-1, tPA, and vWF are associated with subsequent development of a first AMI; for PAI-1 and tPA, this relation was found in both men and women. For tPA but not for PAI-1 and vWF, this association is independent of established risk factors.

Adult↗
PubMed1998

Inhibitory effects of soy and rye diets on the development of Dunning R3327 prostate adenocarcinoma in rats.

METHODS: Dunning R3327 PAP prostate tumors were transplanted in 125 rats, the rats were divided into five groups, and tumor development was examined for 24 weeks during treatment with diets containing 33% of soy flour (SD), rye bran (RB), heat-treated rye bran (HRB), or rye endosperm (RE). RESULTS: In the SD, RB, and HRB groups, significantly fewer palpable tumors and lower tumor volume were detected 14 and 16 weeks after transplantation when compared with the control, fiber-free dietary (FF) group. The body weight was lower 16 weeks after tumor transplantation in the RB and HRB groups when compared with the control group (P < 0.05). Rats in the RB and the HRB groups had a significant lower energy intake than the FF group during the first metabolic observation period, 3-6 weeks after tumor transplantation (P < 0.05), whereas the energy intake was the same in all groups during the second metabolic observation period, 13-16 weeks after tumor transplantation. However, when the tumor volume was adjusted for the body weight of the animals, there were still significant lower tumor volumes in the SD, RB, and HRB groups compared with the FF group (P < 0.05). A significant increase in daily urinary excretion of the isoflavonoids, daidzein, O-desmethylangolensin, equol, and Genistein, was observed in the rats fed SD, and of the ligands enterolactone and enterodiol in the rats fed RB and HRB during both metabolic periods. There were no differences in testosterone levels between the groups. CONCLUSIONS: The present study shows that SD inhibits implanted prostate cancer growth. Although RB and HRB had a protective effect, further studies are needed to exclude the possibility that a low energy intake played a role in this respect. The results suggest that phytoestrogens (isoflavonoids and ligands), may be responsible for the delayed prostate tumor growth.

Adenocarcinoma↗
PubMed1998

Intense nonpharmacological intervention in subjects with multiple cardiovascular risk factors: decreased fasting insulin levels but only a minor effect on plasma plasminogen activator inhibitor activity.

Increased plasma levels of insulin and the fibrinolytic inhibitor, plasminogen activator inhibitor type 1 (PAI-1), are two new cardiovascular risk factors. The extent to which these two risk factors can be affected by nonpharmacological intervention modalities has not been convincingly proven in subjects at high risk for cardiovascular disease. This study assesses the effects on fasting plasma insulin and plasma PAI-1 activity of an intervention program including a low-fat, high-fiber diet and regular daily physical exercise. The intervention was implemented by a 1-month learning and training session in a full-boarding wellness center and included a follow-up evaluation after 12 months. The study was conducted on 108 subjects (31 men and 77 women) referred for multiple risk factor treatment. After 1 month of intense intervention, the physical condition improved significantly, and this effect was maintained during the year. The body mass index (BMI), fasting plasma insulin, and plasma lipids were significantly decreased. In women, PAI-1 activity was significantly reduced. At follow-up study in both sexes, the BMI and fasting insulin were still significantly decreased. In women, PAI-1 activity reverted to the preintervention level. In subjects with multiple risk factors, ie, the insulin resistance syndrome, the plasma insulin level can be reduced by an intense nonpharmacological program. Also, at least in women, plasma PAI-1 activity can be modestly modified. However, the magnitude of the decrease in PAI-1 activity was probably too small to reverse the hypofibrinolytic state characteristic of these subjects.

Adolescent↗
PubMed1998

Perceived health modifies the effect of biomedical risk factors in the prediction of acute myocardial infarction. An incident case-control study from northern Sweden.

OBJECTIVES: To assess the importance of biomedical risk factors, social factors and self-reported health in the prediction of the first event of acute myocardial infarction (AMI) in an apparently healthy middle-aged population. DESIGN: An incident case-control study. SETTING: The study was nested within the Västerbotten Intervention Program and the Northern Sweden MONICA cohorts. SUBJECTS: The study consists of 78 AMI cases with two randomly selected controls per case from the same study cohorts. RESULTS: Significant odds ratios were found for history of diabetes, daily smoking, cholesterol, body-mass index, hypertension, lower education and perceived ill health. In multivariate logistic regression smoking, hypertension and cholesterol of > or =7.8 mmol L(-1) remained significant. An interaction was observed between number of biomedical risk factors and perceived health. CONCLUSIONS: Smoking, hypertension and hypercholesterolaemia explain a major share of incident AMI events in a Swedish middle-aged population. The study further illustrates that perceived ill health negatively modifies the impact of these risk factors.

Case-Control Studies↗
PubMed1998

Lipoprotein(a) and cholesterol levels act synergistically and apolipoprotein A-I is protective for the incidence of primary acute myocardial infarction in middle-aged males. An incident case-control study from Sweden.

OBJECTIVE: To further establish the importance of total plasma apolipoprotein A-I and lipoprotein(a) in the prediction of primary acute myocardial infarction (AMI) in men. DESIGN: An incident case-control study. SETTING: The study was nested within the Västerbotten Intervention Program (VIP) and the Northern Sweden MONICA cohorts. SUBJECTS: A total of 62 male AMI cases and 124 matched controls, randomly selected from the study cohorts. RESULTS: In multivariate logistic regression, significant odds ratios (OR) were found for Lp(a) above 200 mg L-1, apo A-I below the mean value (1136 mg L-1) and total cholesterol (TC) above 7.8 mmol L-1. TC interacted significantly with Lp(a); for Lp(a) above 200 mg L-1 and TC below 6.5 mmol L-1, OR = 5.6; for Lp(a) above 200 mg L-1 and TC above 6.5 mmol L-1, OR = 12.6. To evaluate the potential effect of reducing high levels of Lp(a) or TC on the incidence of AMI in males, the attributable risk percentage (ARP) was calculated when interaction between the two variables was present. ARP is 31% for Lp(a) and 21% for TC, implying that 31% of the cases are due to high Lp(a) and 21% of the cases are due to high TC levels. CONCLUSIONS: In the Swedish male population, total apo A-I in plasma is a protective factor and a plasma Lp(a) level above 200 mg L-1 is a risk factor for AMI in males. A TC level above 6.5 mmol L-1 increased the risk of AMI if the Lp(a) level was above 200 mg L-1, suggesting Lp(a) to be useful in identifying high risk individuals needed to be treated.

Apolipoprotein A-I↗
PubMed1997

Prospective seroepidemiologic study of human papillomavirus infection as a risk factor for invasive cervical cancer.

BACKGROUND: Major risk factors for invasive cervical cancer include infection with human papillomavirus (HPV), infection with other sexually transmitted pathogens (e.g., Chlamydia trachomatis), and smoking. Since exposures to these risk factors can be related, the contribution of any single factor to cervical carcinogenesis has been difficult to assess. We conducted a prospective study to define the role of HPV infection in cervical carcinogenesis, with invasive cancer as an end point. METHODS: A nested case-control study within a joint cohort of 700,000 Nordic subjects was performed. The 182 women who developed invasive cervical cancer during a mean follow-up of 5 years were matched with 538 control women on the basis of age and time of enrollment. Serum samples taken at enrollment were analyzed for evidence of tobacco use (i.e., cotinine levels); for antibodies against HPV types 16, 18, and 33; and for antibodies against C. trachomatis. Relative risks (RRs) were estimated by use of conditional logistic regression. RESULTS: Presence of antibodies against HPV in serum (seropositivity) was associated with an increased risk of cervical cancer, and adjustment for smoking and for C. trachomatis seropositivity did not affect this finding (RR = 2.4; 95% confidence interval [CI] = 1.6-3.7). HPV16 seropositivity was associated primarily with an increased risk of squamous cell carcinoma (RR = 3.2; 95% CI = 1.7-6.2). In contrast, risk associated with HPV18 seropositivity tended to be higher for cervical adenocarcinoma (RR = 3.4; 95% CI = 0.8-14.9). In populations with a low prevalence of antibodies against C. trachomatis, the HPV16-associated risk of cervical cancer was very high (RR = 11.8; 95% CI = 3.7-37.0); in contrast, in populations with a high prevalence of antibodies against C. trachomatis, no excess risk was found. CONCLUSION: Past infection with HPV16 increases the risk of invasive cervical squamous cell carcinoma, most clearly seen in populations with a low prevalence of sexually transmitted diseases.

Adenocarcinoma↗