Serologic markers of Chlamydia trachomatis and other sexually transmitted infections and subsequent ovarian cancer risk: Results from the EPIC cohort

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift


A substantial proportion of epithelial ovarian cancer (EOC) arises in the fallopian tube and other epithelia of the upper genital tract; these epithelia may incur damage and neoplastic transformation after sexually transmitted infections (STI) and pelvic inflammatory disease. We investigated the hypothesis that past STI infection, particularly Chlamydia trachomatis, is associated with higher EOC risk in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 791 cases and 1669 matched controls. Serum antibodies against C. trachomatis, Mycoplasma genitalium, herpes simplex virus type 2 (HSV-2) and human papillomavirus (HPV) 16, 18 and 45 were assessed using multiplex fluorescent bead-based serology. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (CI) comparing women with positive vs. negative serology. A total of 40% of the study population was seropositive to at least one STI. Positive serology to C. trachomatis Pgp3 antibodies was not associated with EOC risk overall, but with higher risk of the mucinous histotype (RR = 2.30 [95% CI = 1.22-4.32]). Positive serology for chlamydia heat shock protein 60 (cHSP60-1) was associated with higher risk of EOC overall (1.36 [1.13-1.64]) and with the serous subtype (1.44 [1.12-1.85]). None of the other evaluated STIs were associated with EOC risk overall; however, HSV-2 was associated with higher risk of endometrioid EOC (2.35 [1.24-4.43]). The findings of our study suggest a potential role of C. trachomatis in the carcinogenesis of serous and mucinous EOC, while HSV-2 might promote the development of endometrioid disease.


  • Annika Idahl
  • Charlotte Le Cornet
  • Sandra González Maldonado
  • Tim Waterboer
  • Noemi Bender
  • Anne Tjønneland
  • Louise Hansen
  • Marie Christine Boutron-Ruault
  • Agnès Fournier
  • Marina Kvaskoff
  • Heiner Boeing
  • Antonia Trichopoulou
  • Elisavet Valanou
  • Eleni Peppa
  • Domenico Palli
  • Claudia Agnoli
  • Amalia Mattiello
  • Rosario Tumino
  • Carlotta Sacerdote
  • N. Charlotte Onland-Moret
  • Inger T. Gram
  • Elisabete Weiderpass
  • Jose R. Quirós
  • Eric J. Duell
  • Maria Jose Sánchez
  • Maria Dolores Chirlaque
  • Aurelio Barricarte
  • Leire Gil
  • Eva Lundin
  • Kay Tee Khaw
  • Aurora Perez-Cornago
  • Marc J. Gunter
  • Laure Dossus
  • Rudolf Kaaks
  • Renée T. Fortner
Enheter & grupper
Externa organisationer
  • Umeå University
  • German Cancer Research Centre
  • INSERM U1018
  • German Institute of Human Nutrition
  • Hellenic Health Foundation, Athens
  • Institute for Cancer Research, Prevention and Clinical Network (ISPRO)
  • Istituto Nazionale dei Tumori
  • University of Naples Federico II
  • Civic and M.P.Arezzo Hospital
  • Citta' della Salute e della Scienza Hospital-University of Turin
  • University Medical Center Utrecht
  • UiT The Arctic University of Norway, Tromsø
  • International Agency for Research on Cancer, World Health Organization
  • Catalan Institute of Oncology
  • University of Granada
  • CIBER Epidemiology and Public Health (CIBERESP)
  • Murcia Regional Health Council
  • University of Murcia
  • Health Research Institute of Navarra (IDISNA)
  • Instituto BIO-Donostia
  • Skåne University Hospital
  • University of Cambridge
  • University of Oxford
  • Danish Cancer Society Research Center
  • Institut Gustave Roussy
  • Consejería de Salud - Gobierno del Principado de Asturias

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Cancer och onkologi


TidskriftInternational Journal of Cancer
StatusE-pub ahead of print - 2020 apr 3
Peer review utfördJa