Conisation as a marker of persistent human papilloma virus infection and risk of breast cancer
Menée au Danemark à partir de données portant sur 87 782 femmes ayant subi une conisation pour traiter des lésions cervicales précancéreuses, cette étude évalue l'association entre une infection par le papillomavirus humain et le risque de cancer du sein
Background: Human papillomavirus (HPV) infection may increase breast cancer (BC) risk. Methods: To examine this, we used nationwide medical registries to identify all Danish women who underwent conisation to remove HPV-associated cervical precancerous lesions (n=87 782) from 1978 to 2013. We computed the absolute risk of BC and standardised incidence ratios (SIRs) and 95% confidence intervals (95% CIs) for breast cancer, based on national breast cancer incidence rates. Results: Conisation was associated with slightly increased BC incidence (SIR=1.1, 95% CI=1.0–1.1), and an absolute BC risk of 7.7% (95% CI=7.3–8.1%) in 35.9 years of follow-up. BC risk was elevated throughout follow-up, especially in the first 5 years (<1 year: SIR=1.2, 95% CI=0.92–1.5; 1–5 years: SIR=1.2, 95% CI=1.1–1.3; greater than or equal to5 years: SIR=1.1, 95% CI=1.0–1.1). Women who underwent conisation and had autoimmune disease had elevated BC risk after 5 years of follow-up (SIR=1.4, 95% CI=1.0–1.8). Conclusions: BC risk is slightly elevated in women with persistent HPV infection, possibly due to detection bias.