HPV and cofactors for invasive cervical cancer in Morocco: a multicentre case-control study

BMC Cancer. 2017 Jun 20;17(1):435. doi: 10.1186/s12885-017-3425-z.

Abstract

Background: Limited national information is available in Morocco on the prevalence and distribution of HPV-sub-types of cervical cancer and the role of other risk factors. The aim was to determine the frequency of HPV-sub-types of cervical cancer in Morocco and investigate risk factors for this disease.

Methods: Between November 2009 and April 2012 a multicentre case-control study was carried out. A total of 144 cases of cervical cancer and 288 age-matched controls were included. Odds-ratios and corresponding confidence-intervals were computed by conditional logistic regression models.

Results: Current HPV infection was detected in 92.5% of cases and 13.9% of controls. HPV16 was the most common type for both cases and controls. Very strong associations between HPV-sub-types and cervical cancer were observed: total-HPV (OR = 39), HPV16 (OR = 49), HPV18 (OR = 31), and multiple infections (OR = 13). Education, high parity, sexual intercourse during menstruation, history of sexually transmitted infections, and husband's multiple sexual partners were also significantly associated with cervical cancer in the multivariate analysis.

Conclusions: Our results could be used to establish a primary prevention program and to prioritize limited screening to women who have specific characteristics that may put them at an increased risk of cervical cancer.

Keywords: Case-control study; Cervical cancer; Determinants; Hpv; Morocco.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / epidemiology*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / virology
  • Case-Control Studies
  • DNA, Viral / isolation & purification
  • Female
  • Human papillomavirus 16 / isolation & purification
  • Human papillomavirus 16 / pathogenicity
  • Humans
  • Middle Aged
  • Morocco / epidemiology
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / pathology
  • Papillomavirus Infections / virology
  • Risk Factors
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / pathology
  • Sexually Transmitted Diseases / virology
  • Uterine Cervical Neoplasms / epidemiology*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / virology

Substances

  • DNA, Viral