Risk for anogenital cancer and other cancer among women hospitalized with gonorrhea


Address for correspondence: Christoffer Johansen, M.D., Ph.D.
Danish Cancer Society, Institute of Cancer Epidemiology
Strandboulevarden 49
DK-2100 Copenhagen Ø
e-mail: christof@cancer.dk


Background. We investigated the relationship between infections with Neisseria gonorrhoeae and anogenital and other cancers.

Methods. Nationwide and population based register linkage study utilizing prospectively notified information. The observed numbers of cancers among the women were compared with those expected on the basis of national incidence rates.

Results. In a cohort of 4440 women hospitalized for gonorrhea we observed a total of 227 cases of cervical intraepithelial neoplasia grade III (CIN III), with 103 expected (standardized incidence ratio (SIR), 2.2; 95% confidence interval (CI), 1.9–2.5). No significantly increased risk for other anogenital cancers or cancer at other sites was seen.

Conclusions. These results support the view that the observed association between gonorrheal infection and subsequent cervical preneoplasia is due mainly to surveillance bias. However, our results also indicate that women hospitalized with a N. gonorrhoeae infection will benefit from the compliance with the regular Pap smear screening programs.