{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:13Z","timestamp":1787017033540,"version":"build-2736575974"},"reference-count":22,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T00:00:00Z","timestamp":1695168000000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Science and Technology Department of Sichuan Province","award":["2021YFS0156"],"award-info":[{"award-number":["2021YFS0156"]}]},{"name":"The Science and Technology Department of Sichuan Province","award":["2022YFS0066"],"award-info":[{"award-number":["2022YFS0066"]}]},{"name":"Sichuan Medical and Health CarePromotion Institute","award":["KY2022QN0270"],"award-info":[{"award-number":["KY2022QN0270"]}]},{"DOI":"10.13039\/501100013365","name":"West China Hospital, Sichuan University","doi-asserted-by":"crossref","award":["ZYJC21027"],"award-info":[{"award-number":["ZYJC21027"]}],"id":[{"id":"10.13039\/501100013365","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Youth Science Foundation of China","doi-asserted-by":"crossref","award":["82002868"],"award-info":[{"award-number":["82002868"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Youth Science Foundation of China","doi-asserted-by":"crossref","award":["82272777"],"award-info":[{"award-number":["82272777"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,8,30]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To systematically assess the associations between various immune-mediated diseases (IMDs) and human papillomavirus (HPV)-associated diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>UK Biobank.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 500\u2009371 subjects aged 40\u201369 years were eligible for the analysis, after excluding those with prevalent HPV-associated diseases at baseline and those who had withdrawn their informed consent or lacked information on sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Eighty IMDs (involving allergic\/atopic diseases, autoimmune diseases, immunodeficiency diseases, etc) were identified in the UK Biobank.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The main outcome was the incidence of HPV-associated diseases (including warts and malignancies of the cervix, oropharynx, anus, penis, vulva and vagina). Cox proportional hazards model was used to estimate HRs and 95% CIs with particular adjustment for sexual behaviours. We also conducted subgroup analyses based on benign and malignant status, and anatomical sites of HPV-associated diseases, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During a median of 12.0 years of follow-up, 2244 cases out of 500\u2009371 subjects developed HPV-associated diseases. Overall, participants with IMDs had a higher risk of HPV-associated diseases than their controls after adjustment for sexual behaviours and other potential confounders (female: HR=1.90, 95%\u2009CI=1.66 to 2.17, p\n                      <jats:italic>&lt;<\/jats:italic>\n                      0.001; male: HR=1.66, 95%\u2009CI=1.41 to 1.97, p\n                      <jats:italic>&lt;<\/jats:italic>\n                      0.001). Additionally, eight individual IMDs in women (eg, asthma: HR=1.76, 95%\u2009CI=1.47 to 2.11, p\n                      <jats:italic>&lt;<\/jats:italic>\n                      0.001) and three in men (eg, chronic nephritic syndrome: HR=6.05, 95%\u2009CI=3.32 to 11.04, p\n                      <jats:italic>&lt;<\/jats:italic>\n                      0.001) were associated with increased risk of HPV-associated diseases. Subgroup analyses revealed significant IMD differences between benign and malignant subgroups as well as between oropharyngeal and anogenital subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large retrospective cohort study, IMDs were significantly associated with an elevated risk of HPV-associated diseases. Besides, gender-specific and region-specific associations were also observed between individual IMDs and HPV-associated diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-072249","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T01:47:16Z","timestamp":1695174436000},"page":"e072249","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Associations between immune-mediated diseases (IMDs) and the risk of HPV-associated diseases: a UK Biobank cohort analysis"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7143-7398","authenticated-orcid":false,"given":"Lan","family":"Feng","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head & Neck Surgery, Sichuan University West China Hospital, Chengdu, 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