Serotypes of Chlamydia trachomatis and risk for development of cervical squamous cell carcinoma

JAMA. 2001 Jan 3;285(1):47-51. doi: 10.1001/jama.285.1.47.


Context: Human papillomavirus (HPV) infection has been established as a cause of cervical cancer. Epidemiologic studies suggest that Chlamydia trachomatis infection also confers increased risk for cervical squamous cell carcinoma (SCC). Whether this risk is serotype-specific is unknown.

Objective: To study the association between exposure to different C trachomatis serotypes and subsequent development of cervical SCC.

Design and setting: Longitudinal, nested case-control study within a cohort of 530 000 women who provided samples to serum banks in Finland, Norway, and Sweden. The data files were linked to respective national cancer registries.

Subjects: One hundred twenty-eight women who had developed invasive cervical SCC at least 12 months following serum donation. Each case had 3 matched controls.

Main outcome measure: Risk for the development of cervical SCC by IgG antibodies to 10 different C trachomatis serotypes, adjusted for antibodies to HPV types 16, 18, and 33 and for serum cotinine levels.

Results: Of specific C trachomatis serotypes, serotype G was most strongly associated with SCC (adjusted odds ratio [OR], 6.6; 95% confidence interval [CI], 1. 6-27.0). Other serotypes associated with SCC were I (OR, 3.8; 95% CI, 1.3-11.0) and D (OR, 2.7; 95% CI, 1.3-5.6). Presence of serum IgG antibodies to more than 1 serotype increased the adjusted ORs for SCC (P<.001 for trend).

Conclusions: Chlamydia trachomatis serotype G is most strongly associated with subsequent development of cervical SCC. Increasing numbers of exposures to different C trachomatis serotypes also increases risk. Our results strengthen the evidence that there is a link between past C trachomatis infection and cervical SCC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Bacterial / blood
  • Carcinoma, Squamous Cell / blood
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / microbiology*
  • Carcinoma, Squamous Cell / virology
  • Case-Control Studies
  • Chlamydia Infections / complications
  • Chlamydia trachomatis / classification*
  • Chlamydia trachomatis / genetics
  • Chlamydia trachomatis / immunology
  • Cotinine / blood
  • DNA, Bacterial
  • Female
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Papillomaviridae / isolation & purification
  • Registries
  • Risk Factors
  • Scandinavian and Nordic Countries / epidemiology
  • Serotyping
  • Uterine Cervical Neoplasms / blood
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / microbiology*
  • Uterine Cervical Neoplasms / virology


  • Antibodies, Bacterial
  • DNA, Bacterial
  • Cotinine