1. ¹Department of Pathology, The Norwegian Radium Hospital, 0310 Oslo, Norway
2. ²Department of Gynecologic Oncology, The Norwegian Radium Hospital, 0310 Oslo, Norway
3. ³Division of Epidemiology, Norwegian Institute of Public Health, 0403 Oslo, Norway
4. ⁴Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, 00170 Helsinki, Finland
5. ⁵Cancer Registry of Norway, Institute of Population-based Cancer Research, 0310 Oslo, Norway
6. ⁶Department of Oto-rhino-laryngology, The National Hospital, 0027 Oslo, Norway
7. ⁷Janus Committee, Norwegian Cancer Society, 0369 Oslo, Norway
8. ⁸National Public Health Institute, 00300 Helsinki and Oulu, Finland
9. ⁹Department of Medical Microbiology, Lund University, MAS University Hospital, S-20502 Malmö, Sweden

Correspondence: T Bjørge, Department of Pathology, The Norwegian Radium Hospital, N-0310 Oslo, Norway. E-mail: tone.bjorge@oslo.online.no

Received 14 February 2002; Revised 27 March 2002; Accepted 10 April 2002.

Abstract

Human papillomavirus has emerged as the leading infectious cause of cervical and other anogenital cancers. We have studied the relation between human papillomavirus infection and the subsequent risk of anal and perianal skin cancer. A case–cohort study within two large Nordic serum banks to which about 760 000 individuals had donated serum samples was performed. Subjects who developed anal and perianal skin cancer during follow up (median time of 10 years) were identified by registry linkage with the nationwide cancer registries in Finland and Norway. Twenty-eight cases and 1500 controls were analysed for the presence of IgG antibodies to HPV 16, 18, 33 or 73, and odds ratios of developing anal and perianal skin cancer were calculated. There was an increased risk of developing anal and perianal skin cancer among subjects seropositive for HPV 16 (OR=3.0; 95%CI=1.1–8.2) and HPV 18 (OR=4.4; 95%CI=1.1–17). The highest risks were seen for HPV 16 seropositive patients above the age of 45 years at serum sampling and for patients with a lag time of less than 10 years. This study provides prospective epidemiological evidence of an association between infection with HPV 16 and 18 and anal and perianal skin cancer.