Human papillomavirus and long-term oral contraceptive use increase the risk of adenocarcinoma in situ of the cervix

We examined United States Surveillance, Epidemiology, and End Results incid ence data and conducted a population-based case-control study to examine th e role of human papillomavirus (HPV) and oral contraceptive (OC) use in the etiology of adenocarcinoma in situ of the cervix (ACIS), One hundred and f ifty women diagnosed with ACIS and 651 randomly selected control women comp leted in-person interviews. The presence of HPV DNA in archival ACIS specim ens was determined by E6 and L1 consensus PCR, Serum samples from case and control subjects were collected at interview, and antibodies to HPV-16 L1 a nd HPV-18 L1 were detected by virus-like particle capture assays. The overa ll prevalence of HPV DNA was 86,6%, with 39.0% positive for HPV-16 DNA, 52. 4% positive for HPV-18 DNA, and 13.4% positive for more than one HPV type. The age-adjusted relative risk of ACIS associated with HPV-IS seropositivit y was 3.3 (95% confidence interval 2,2-4,9), No increased risk was associat ed with antibodies to HPV-16 LI, Among women born after 1945, the relative risk increased with duration of OC use, with the highest risk for 12 or mor e years of use (odds ratio, 5.5; 95% confidence interval, 2.1-14.6) relativ e to nonusers. The detection of HPV DNA in 86.6% of ACIS and the strong ass ociation of ACIS with HPV-18 LI seropositivity underscore the importance of HPV, particularly HPV-18.