Serotypes of Chlamydia trachomatis and Risk for Development of Cervical Squamous Cell Carcinoma

Abstract

Human papillomavirus (HPV) infection is the leading cause of cervical neoplasia.^1-3 Additional risk factors include other sexually transmitted infections (STIs) and smoking. The evidence linking oncogenic HPV types and cervical carcinoma is very strong and consistent. Human papillomavirus DNA–based cohort studies^4,5 have confirmed the seroepidemiologic findings^6,7 that past HPV infection predisposes women to developing cervical carcinoma. Longitudinal seroepidemiologic studies have also provided evidence that Chlamydia trachomatis infection is an independent risk factor for the development of invasive cervical squamous cell carcinoma (SCC).^6-8 Cervical chlamydial infection can persist for long periods of time.⁹ Similarly, elevated antichlamydial antibody titers persist for several years.¹⁰ Microimmunofluorescence (MIF) testing is still the gold standard for chlamydia serology, and researchers also can use MIF for serotyping.^11,12 We found a link between the presence of serum antibodies to C trachomatis and the subsequent development of cervical SCC.⁸ This study was conducted to determine whether this association is serotype-specific.