Human Papillomavirus Infection and Incidence of Squamous Cell and Basal Cell Carcinomas of the Skin

• Published in: JNCI : Journal of the National Cancer Institute Vol. 98; no. 6; pp. 389 - 395
• Main Authors: Karagas, Margaret R., Nelson, Heather H., Sehr, Peter, Waterboer, Tim, Stukel, Therese A., Andrew, Angeline, Green, Adele C., Bouwes Bavinck, Jan Nico, Perry, Ann, Spencer, Steven, Rees, Judy R., Mott, Leila A., Pawlita, Michael
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 15-03-2006; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Biological and medical sciences; Carcinoma, Basal Cell - virology; Carcinoma, Squamous Cell - virology; Case-Control Studies; Dermatology; Female; Human papillomavirus; Humans; Incidence; Logistic Models; Male; Medical sciences; Middle Aged; Odds Ratio; Oncology; Papillomaviridae; Papillomavirus Infections - complications; Papillomavirus Infections - virology; Risk Factors; Sexually transmitted diseases; Skin cancer; Skin Neoplasms - virology; STD; Surveys and Questionnaires; Tumors; Tumors of the skin and soft tissue. Premalignant lesions; United States - epidemiology; Viruses; United States; North America; America; New Hampshire; Human; Skin disease; Basal cell carcinoma; Papovaviridae; Malignant tumor; Case control study; Epidemiology; Incidence; Infection; Papillomavirus; Virus; Human papillomavirus; Skin squamous cell carcinoma; Cancerology; Viral disease; Public health
• ISSN: 0027-8874; 1460-2105
• DOI: 10.1093/jnci/djj092

Background: Although infection with human papillomaviruses (HPVs) is a major risk factor for several epithelial cancers, an etiologic relationship between HPV and keratinocyte cancers, such as squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs), remains unclear. Methods: In a population-based case–control study of 252 SCC case patients, 525 BCC case patients, and 461 control subjects, we used multiplex serology to detect antibodies in plasma samples against 16 HPV types from phylogenetic genera alpha, beta, and mu. Multiplex serology is a new method that is based on fluorescent bead technology and allows simultaneous detection of antibodies against up to 100 different in situ affinity-purified recombinant HPV proteins. Data on sun sensitivity, outdoor exposure, and other risk factors for keratinocyte cancers were collected through personal interviews. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated via unconditional logistic regression models. Results: Overall, we detected HPV antibodies more frequently in SCC patients than in control subjects (OR = 1.6, 95% CI = 1.2 to 2.3), but we found no difference in HPV seropositivity between BCC case patients and control subjects (OR = 0.8, 95% CI = 0.6 to 1.1). Among HPV types, seropositivity to HPV types in genus beta (OR = 1.5, 95% CI = 1.0 to 2.1), particularly HPV 5 (OR = 1.8, 95% CI = 1.0 to 3.1), was associated with SCC risk. Individuals with tumors on chronically sun exposed sites were more likely to be seropositive for beta HPV types than individuals with SCC at other anatomic sites. The highest SCC risk was associated with positivity for multiple HPV types and, among individuals seropositive for HPV beta, a tendency to sunburn; however, the associations had limited statistical precision. Conclusions: Our findings support a role for HPV types from the genus beta in the pathogenesis of SCC.