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Serologic markers of Chlamydia trachomatis and other sexually transmitted infections and subsequent ovarian cancer risk: Results from the EPIC cohort
Author(s) -
Idahl Annika,
Le Cornet Charlotte,
González Maldonado Sandra,
Waterboer Tim,
Bender Noemi,
Tjønneland Anne,
Hansen Louise,
BoutronRuault MarieChristine,
Fournier Agnès,
Kvaskoff Marina,
Boeing Heiner,
Trichopoulou Antonia,
Valanou Elisavet,
Peppa Eleni,
Palli Domenico,
Agnoli Claudia,
Mattiello Amalia,
Tumino Rosario,
Sacerdote Carlotta,
OnlandMoret N. Charlotte,
Gram Inger T.,
Weiderpass Elisabete,
Quirós Jose R.,
Duell Eric J.,
Sánchez MariaJose,
Chirlaque MariaDolores,
Barricarte Aurelio,
Gil Leire,
Brändstedt Jenny,
Riesbeck Kristian,
Lundin Eva,
Khaw KayTee,
PerezCornago Aurora,
Gunter Marc J.,
Dossus Laure,
Kaaks Rudolf,
Fortner Renée T.
Publication year - 2020
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.32999
Subject(s) - chlamydia trachomatis , mycoplasma genitalium , serology , medicine , population , chlamydia , serous fluid , relative risk , endometrial cancer , ovarian cancer , immunology , gynecology , cancer , antibody , confidence interval , environmental health
A substantial proportion of epithelial ovarian cancer (EOC) arises in the fallopian tube and other epithelia of the upper genital tract; these epithelia may incur damage and neoplastic transformation after sexually transmitted infections (STI) and pelvic inflammatory disease. We investigated the hypothesis that past STI infection, particularly Chlamydia trachomatis , is associated with higher EOC risk in a nested case‐control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 791 cases and 1669 matched controls. Serum antibodies against C. trachomatis , Mycoplasma genitalium , herpes simplex virus type 2 (HSV‐2) and human papillomavirus (HPV) 16, 18 and 45 were assessed using multiplex fluorescent bead‐based serology. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (CI) comparing women with positive vs. negative serology. A total of 40% of the study population was seropositive to at least one STI. Positive serology to C. trachomatis Pgp3 antibodies was not associated with EOC risk overall, but with higher risk of the mucinous histotype (RR = 2.30 [95% CI = 1.22‐4.32]). Positive serology for chlamydia heat shock protein 60 (cHSP60‐1) was associated with higher risk of EOC overall (1.36 [1.13‐1.64]) and with the serous subtype (1.44 [1.12‐1.85]). None of the other evaluated STIs were associated with EOC risk overall; however, HSV‐2 was associated with higher risk of endometrioid EOC (2.35 [1.24‐4.43]). The findings of our study suggest a potential role of C. trachomatis in the carcinogenesis of serous and mucinous EOC, while HSV‐2 might promote the development of endometrioid disease.