1. Drug addiction is not an independent risk factor for oncogenic human papillomavirus infections or high-grade cervical intraepithelial neoplasia: case-control study nested within the Latin American Screening study cohort
- Author
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Sophie Françoise Mauricette Derchain, F C Arlindo, Kari Syrjänen, M Y S Maeda, Silvano Costa, Jean Carlos de Matos, Luis Otávio Sarian, Silvio Tatti, Mojca Eržen, Paulo Naud, Adhemar Longatto-Filho, Margherita Branca, Joana Froes Bragança, Stina Syrjänen, Renata Clementino Gontijo, Luciano Serpa Hammes, Cecilia Roteli-Martins, Attila T. Lorincz, Gerson Botacini das Dores, and Universidade do Minho
- Subjects
Sexually transmitted disease ,Case-control setting ,Medicina Básica [Ciências Médicas] ,Cohort Studies ,0302 clinical medicine ,Pharmacology (medical) ,030212 general & internal medicine ,CIN ,Cervical cancer ,Smoking ,Middle Aged ,female genital diseases and pregnancy complications ,3. Good health ,Substance abuse ,Infectious Diseases ,030220 oncology & carcinogenesis ,Ciências Médicas::Medicina Básica ,Cohort ,Female ,Papanicolaou Test ,Cohort study ,Adult ,medicine.medical_specialty ,Adolescent ,Substance-Related Disorders ,Addiction ,Dermatology ,Cervical intraepithelial neoplasia ,Drug abuse ,03 medical and health sciences ,Internal medicine ,Conditional logistic regression ,medicine ,Humans ,HR-HPV ,Cervical Intraepithelial Neoplasia ,Risk factor ,Aged ,Vaginal Smears ,Gynecology ,Science & Technology ,business.industry ,Papillomavirus Infections ,Public Health, Environmental and Occupational Health ,Uterine Cervical Dysplasia ,medicine.disease ,Risk factors ,Case-Control Studies ,High Grade Cervical Intraepithelial Neoplasia ,business - Abstract
Drug abuse (addiction) has been listed among the risk factors for human papillomavirus (HPV) infections, but no case-control studies exist to rule out sexual behaviour and other potential confounders. The aim of this study is to evaluate the role of drug addiction as an independent predictor of HR-HPV infections and (cervical intraepithelial neoplasia) CIN2+ in an age-matched case-control (1:4) study nested within the prospective Latin American Screening (LAMS) study cohort. All 109 women in the LAMS cohort (n=12,114) reporting drug abuse/addiction were matched with four controls (n = 436) of non-abusers strictly by age. Conditional logistic regression analysis was used to estimate the co-variates of drug abuse, and the whole series (n=545) was analysed for predictors of HR-HPV and CIN2+ using univariate and multivariate regression models. Oncogenic HPV infections were significantly (P=0.019) more prevalent among abusers (37.7%) than in controls (21.9%), but there was no difference in high-grade squamous intraepithelial lesions (P=0.180) or CIN2+ lesions (P=0.201). In multivariate conditional logistic regression, number of lifetime sexual partners (P=0.0001), ever smokers (P=0.0001), non-use of OCs (P=0.013), ever having sexually transmitted diseases (STD) (P=0.041) and no previous Pap smear (P=0.027) were independent co-variates of drug addiction. Drug abuse was not an independent risk factor of high-risk (HR)-HPV infection, which was significantly predicted by (1) age below 30 years (P=0.045), (2) more than five lifetime sexual partners (P=0.046) and (3) being current smoker (P=0.0001). In multivariate model, only HR-HPV infection was an independent risk factor of CIN2+ (P=0.031), with adjusted OR=11.33 (95% CI 1.25-102.50). These data indicate that drug addiction is not an independent risk factor of either HR-HPV infections or CIN2+, but the increased prevalence of HR-HPV infections is explained by the high-risk sexual behaviour and smoking habits of these women., European Commission (LAMS denotes Latin American Screening study funded by European Commission), INCO-DEV Programme (Contract No. ICA4-CT-2001-10013). The generous contribution of DIGENE Inc. (USA) donating the HCII tests at our disposal is gratefully acknowledged
- Published
- 2008