Human papillomavirus and the incidence of nonmelanoma and melanoma skin cancer using cervical conization as a surrogate marker: a nationwide population-based Danish cohort study

Ann Epidemiol. 2015 Apr;25(4):293-296.e2. doi: 10.1016/j.annepidem.2014.12.001. Epub 2014 Dec 12.


Purpose: Human papillomavirus' (HPV's) role in skin cancer is controversial. To examine whether an individual is prone to develop a chronic oncogenic infection, we conducted a nationwide population-based cohort study of the risk of skin cancer after another HPV-related neoplasia-that is, cervical high-grade dysplasia or carcinoma-using cervical conization as a surrogate marker.

Methods: Using Danish registries, we identified all women who underwent conization from 1978 to 2011 (n = 87,164) and followed them until first-time skin cancer diagnosis, death, emigration, or 31 December 2011, whichever came first. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM) according to national incidence rates.

Results: The 1-year absolute risks were 0.0012%, 0.045%, and 0.029% for SCC, BCC, and MM, respectively. Conization was clearly associated with increased incidence of SCC (SIR = 1.37; 95% CI: 1.13-1.65), but not MM (SIR = 1.00; 95% CI: 0.91-1.11). BCC risk was slightly increased (SIR = 1.08; 95% CI: 1.02-1.13).

Conclusions: The association between conization and cutaneous SCC provides evidence for conization as a marker of underlying general susceptibility to oncogenic HPV.

Keywords: Cohort studies; Conization; Papillomaviridae; Skin neoplasms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers
  • Carcinoma, Basal Cell / etiology
  • Carcinoma, Basal Cell / virology
  • Cervix Uteri / pathology*
  • Cervix Uteri / virology
  • Cohort Studies
  • Conization
  • Denmark / epidemiology
  • Female
  • Humans
  • Incidence
  • Melanoma / etiology*
  • Melanoma / virology
  • Middle Aged
  • Neoplasms, Squamous Cell / etiology
  • Neoplasms, Squamous Cell / virology
  • Papillomavirus Infections / complications*
  • Risk Factors
  • Skin Neoplasms / etiology*
  • Skin Neoplasms / virology
  • Uterine Cervical Dysplasia / epidemiology*
  • Uterine Cervical Dysplasia / virology


  • Biomarkers