HPV infection and breast cancer risk: insights from a nationwide population study in Taiwan

Abstract

BackgroundThe prevalence of cancer, specifically breast cancer, has raised globally. The etiology of breast cancer has been attributed to age, genetic mutations, reproductive history, hormone therapy, lifestyle factors, and viral infections. The human papillomavirus (HPV) has been one of the most widespread sexually transmitted infection in the United States. The role of HPV in breast oncogenesis was hypothesized before, yet the association remained unclear.MethodsIn this study, we employed a nationwide population study using centralized patient data managed by the Ministry of Health and Welfare in Taiwan and the Taiwan Cancer Registry database. The breast cancer incidence rates of the 467,454 HPV patients were compared to twice as many non-HPV patients with matching sex and age. Cumulative breast cancer incidence rates were presented by a Kaplan-Meier curve, and the relative risk of breast cancer for HPV and non-HPV patients were calculated using Cox-regression model.ResultsOur results indicated a crude hazard ratio (HR) and an adjusted hazard ratio (aHR) of 2.336 and 2.271, respectively, when comparing the risk of breast cancer in the HPV and non-HPV group. The risk of breast cancer was comparable or higher than those of head and neck cancer (aHR=1.595) and cervical cancer (aHR=2.225), which both were found to have causal relationships with HPV. The Kaplan-Meier curve further illustrated a higher cumulative risk across 84 months for HPV patients (p<.0001). Besides HPV, age (p<.0001), insurance providers (p<.001), and comorbidities such as abnormal liver function (aHR=1.191, p=.0069) and hyperlipidemia (aHR=1.218, p=.0002) were found to be correlated with higher risks of breast cancer.ConclusionA correlation between HPV and breast cancer can be inferred using national health databases. More molecular studies are required to understand the mechanism of the virus-induced oncogenesis of the breast.

Human Papilloma Virus Infection in Iranian Women with Breast Cancer: A Systematic Review

“…The potential mechanisms by which HPV may contribute to the development of BC are not yet fully understood. It is hypothesized that HPV infection may activate oncogenic pathways, induce immune dysfunction, or directly integrate viral DNA into the host genome, leading to BC development (33)(34)(35). However, more research is needed to clarify the underlying mechanisms and establish a definitive link between HPV and BC.…”

“…However, other studies have failed to find a consistent association between HPV and BC (32). The potential mechanisms of HPV-mediated cancer development have not yet been proven, but it is hypothesized that HPV infection may cause BC through activation of oncogenic pathways, immune dysregulation, or direct integration of viral DNA into the host genome (33)(34)(35). In addition, HPV infection may interact with other risk factors, such as hormonal imbalance or genetic predisposition, to increase the risk of BC (36,37).…”

High rate of high-risk human papillomavirus among benign and breast cancer patients in Ethiopia

“…The presence of HPV in malignant breast tumors has been reported, indicating a potential role of HPV in the early stage of breast cancer and breast carcinogenesis [7][8][9][10][11]. The existence of a causal link between HPV infection and breast cancer is still subject to debate; while some research revealed a higher risk consistent with a possible role of HPV in the development of breast cancer [5,8,10,[12][13][14][15][16][17][18], other studies found no such association [19][20][21][22][23][24]. Data, however, is limited in Ethiopia.…”

Synergistic Effect of Human Papillomavirus and Environmental Factors on Skin Squamous Cell Carcinoma, Basal Cell Carcinoma, and Melanoma: Insights from a Taiwanese Cohort

“…While HPV is primarily linked to these mucosal cancers, its association with skin cancers is less direct but increasingly studied [ 2 , 3 ]. HPV infections are generally asymptomatic, with warts being the most common clinical manifestation on the skin [ 4 , 5 ]. Although 90% of HPV infections will clear up on their own within two years, the risk of developing cancer increases with prolonged latency and frequent infections [ 5 ].…”