Human papillomavirus and the incidence of nonmelanoma and melanoma skin cancer using cervical conization as a surrogate marker: a nationwide population-based Danish cohort study

• Published in: Annals of epidemiology 2015-04, Vol.25 (4), p.293-296.e2
• Main Authors: Schmidt, Sigrun Alba Johannesdottir, MD, Hamilton-Dutoit, Stephen J., FRCPath, Farkas, Dóra Körmendiné, MSc, Steiniche, Torben, MD, DMSc, Sørensen, Henrik Toft, MD, PhD, DMSci
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biomarkers; Carcinoma, Basal Cell - etiology; Carcinoma, Basal Cell - virology; Cervix Uteri - pathology; Cervix Uteri - virology; Cohort Studies; Conization; Denmark - epidemiology; Female; Humans; Incidence; Internal Medicine; Melanoma - etiology; Melanoma - virology; Middle Aged; Neoplasms, Squamous Cell - etiology; Neoplasms, Squamous Cell - virology; Papillomaviridae; Papillomavirus Infections - complications; Risk Factors; Skin neoplasms; Skin Neoplasms - etiology; Skin Neoplasms - virology; Uterine Cervical Dysplasia - epidemiology; Uterine Cervical Dysplasia - virology
• ISSN: 1047-2797; 1873-2585
• DOI: 10.1016/j.annepidem.2014.12.001

Abstract Purpose Human papillomavirus' (HPV's) role in skin cancer is controversial. To examine whether an individual is prone to develop a chronic oncogenic infection, we conducted a nationwide population-based cohort study of the risk of skin cancer after another HPV-related neoplasia—that is, cervical high-grade dysplasia or carcinoma—using cervical conization as a surrogate marker. Methods Using Danish registries, we identified all women who underwent conization from 1978 to 2011 ( n  = 87,164) and followed them until first-time skin cancer diagnosis, death, emigration, or 31 December 2011, whichever came first. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM) according to national incidence rates. Results The 1-year absolute risks were 0.0012%, 0.045%, and 0.029% for SCC, BCC, and MM, respectively. Conization was clearly associated with increased incidence of SCC (SIR = 1.37; 95% CI: 1.13–1.65), but not MM (SIR = 1.00; 95% CI: 0.91–1.11). BCC risk was slightly increased (SIR = 1.08; 95% CI: 1.02–1.13). Conclusions The association between conization and cutaneous SCC provides evidence for conization as a marker of underlying general susceptibility to oncogenic HPV.