Condylomata acuminata and risk of cancer: an epidemiological study.

OBJECTIVE To determine whether patients with condylomata acuminata have an increased risk of developing cancer. DESIGN Prospective cohort study on patients diagnosed as having condylomata acuminata. The number of malignant tumours in the cohort was compared with national incidences obtained from the Swedish Cancer Registry. SETTING Dermatology department of the Karolinska Hospital, Stockholm, Sweden. SUBJECTS 3260 patients (2549 males and 711 females, median (range) age 23 (1-80) years) seen during 1969-84, with a mean follow up of 7.8 years. MAIN OUTCOME MEASURES Number of malignant tumours observed in the cohort during the study period and expected number from national incidence. RESULTS There were 27 malignancies in the study group. There was no significant increase genital cancer in females compared with the national incidence. Only one patient had invasive cervical cancer (relative risk = 1.8; 95% confidence interval 0 to 10.1). Seventeen women had cervical carcinoma in situ (1.5; 0.9 to 2.5) compared with an expected number of 11.5; this increase was not significant. For males 22 cancers were observed at all sites (1.6; 1.0 to 2.5). The number of genitourinary cancers observed in males was almost three times higher than expected (2.6; 1.2 to 5.0). CONCLUSION The results indicate that the risk of developing cervical carcinoma in situ or invasive cervical cancer after a genital human papillomavirus infection is less than previously thought. The implications of increase in the genitourinary malignancies in males are uncertain.