[Human papilloma virus in the etiology of cervicouterine cancer]. / El virus del papiloma humano en la etiología del cáncer cervicouterino.

The objectives of this study were to confirm the hypothesis that invasive carcinoma of the uterine cervix and the precursors of that condition are most often caused by human papilloma virus (HPV) infections, and to determine whether or not other risk factors are involved in the neoplastic process. For this purpose, four concurrent case-control studies were carried out. Two included cases of invasive cervical cancer and population-based controls. The other two included cases of in situ carcinoma and controls. Research was carried out in nine provinces of Spain and in Cali, Colombia. The identification of cases took place between June 1985 and June 1988. The studies included 436 incident cases of invasive carcinoma and 387 controls, selected at random from the corresponding populations, and 525 cases of in situ carcinoma and 512 controls paired by age, place of recruitment, and date that cytological specimens were taken from the women participating in cytological screening programs. Exposure to HPV was detected through hybridization tests after amplification by polymerase chain reaction (PCR) in exfoliated cervical cells from cases and controls. Exposure to HPV was the principal risk factor in the four studies. For invasive carcinoma, the relative risk and 95% confidence interval were 46.2 (18.5-115.1) in Spain and 15.6 (6.9-34.7) in Colombia. For in situ carcinoma, the figures were 56.9 (24.8-130.6) in Spain and 15.5 (8.2-29.4) in Colombia. This strong association was specific for types 16, 18, 31, 33, and 35 as well as still-unclassified HPV types.(ABSTRACT TRUNCATED AT 250 WORDS)

El virus del papiloma humano en la etiología del cancer cervicouterino / The human papilloma virus in the etiology of cervical cancer

Los objetivos del estudio fueron verificar la hipótesis según la cual el carcinoma invasor del cuello uterino y sus precursores son causados la mayor parte de las veces por infecciones debidas al virus del papiloma humano (VPH), y si otros factores de riesgo intervienen en el proceso neoplásico. Para ello, se realizaron cuatro estudios concurrentes de casos y controles. Dos de ellos incluyeron casos de carcinoma invasor y controles de base poblacional. Los dos restantes incluyeron casos y controles de carcinoma in situ. La investigación se realizó en nueve provincias de España y en Cali, Colombia. La identificación de casos tuvo lugar entre junio de 1985 y junio de 1988. Se incluyeron 436 casos incidentes de carcinoma invasor y 387 controles, seleccionados al azar de las poblaciones correspondientes, y 525 casos de carcinoma in situ y 512 controles apareados por edad, centro de reclutamiento y fecha de toma citológica entre mujeres participantes en programas de tamizaje citológico. La exposición al VPH se detectó mediante pruebas de hibridación tras amplificación por la reacción en cadena de la polimerasa en células cervicales exfoliadas de casos y controles. La exposición al VPH fue el factor de riesgo principal en los cuatro estudios