{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T02:27:48Z","timestamp":1772504868597,"version":"3.50.1"},"reference-count":33,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Catholic University of Korea","award":["ISCTC CMC-2024-3"],"award-info":[{"award-number":["ISCTC CMC-2024-3"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objective: Few studies have examined the direct relationship between cervical cancer and immune-related diseases. Therefore, this study aims to identify the association between cervical cancer and various underlying medical conditions using data from the Korean National Health Insurance System (NHIS). Methods: This retrospective cohort study was conducted using NHIS data from 2006 to 2022. A total of 1,344,628 women aged 19 years and older were included, of whom 68,275 were diagnosed with cervical cancer. Comorbidities were evaluated. The statistical analyses conducted included independent t-tests, chi-square tests, and multivariate logistic regression models to determine relative risks (RRs) and 95% confidence intervals (CIs). Results: The mean age of the patients with cervical cancer was significantly lower than that of the general population group. Body mass index and hypertension prevalence were higher in the cervical cancer group than in the general population group. Significant associations were observed between cervical cancer and respiratory tuberculosis (RR: 1.32, 95% CI: 1.27\u20131.38, p &lt; 0.001), ischemic heart disease (RR: 1.72, 95% CI: 1.69\u20131.76, p &lt; 0.001), chronic rheumatic heart disease (RR: 1.53, 95% CI: 1.44\u20131.64, p &lt; 0.001), chronic viral hepatitis (RR: 1.33, 95% CI: 1.31\u20131.36, p &lt; 0.001), and hematological malignancies (RR: 1.87, 95% CI: 1.67\u20132.09, p &lt; 0.001). Conversely, cerebrovascular disease was associated with a reduced risk of cervical cancer (RR: 0.58, 95% CI: 0.57\u20130.60, p &lt; 0.001). Conclusion: This study highlights the increased risk of cervical cancer in individuals with specific underlying diseases. These findings underscore the need for tailored screening and prevention strategies in high-risk populations.<\/jats:p>","DOI":"10.3390\/jcm14124282","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T09:51:22Z","timestamp":1750067482000},"page":"4282","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ischemic Heart Disease, Hematological Malignancies, and Infectious Diseases as Risk Factors for Cervical Cancer: A Study Based on Korean National Health Insurance Data"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9786-3528","authenticated-orcid":false,"given":"Heekyoung","family":"Song","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Incheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirae","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Incheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0940-0249","authenticated-orcid":false,"given":"Minji","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nowon Eulji Medical Center, Eulji University, Seoul 01830, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong-Wook","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Incheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"385","DOI":"10.4143\/crt.2023.447","article-title":"Community of Population-Based Regional Cancer Registries. Cancer statistics in Korea: Incidence, mortality, survival, and prevalence in 2020","volume":"55","author":"Kang","year":"2023","journal-title":"Cancer Res. Treat."},{"key":"ref_3","first-page":"391","article-title":"Nature of cervical cancer and other HPV\u2014Associated cancers","volume":"14","author":"Georgieva","year":"2009","journal-title":"J. BUON"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1002\/ijc.27828","article-title":"Patterns of persistent genital human papillomavirus infection among women worldwide: A literature review and meta-analysis","volume":"133","author":"Rositch","year":"2013","journal-title":"Int. J. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Choi, Y.J., and Park, J.S. (2016). Clinical significance of human papillomavirus genotyping. J. Gynecol. Oncol., 27.","DOI":"10.3802\/jgo.2016.27.e21"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/j.ygyno.2010.01.024","article-title":"Pathology and epidemiology of HPV infection in females","volume":"117","author":"Stanley","year":"2010","journal-title":"Gynecol. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Looker, K.J., R\u00f6nn, M.M., Brock, P.M., Brisson, M., Drolet, M., Mayaud, P., and Boily, M.C. (2018). Evidence of synergistic relationships between HIV and human papillomavirus (HPV): Systematic reviews and meta-analyses of longitudinal studies of HPV acquisition and clearance by HIV status, and of HIV acquisition by HPV status. J. Int. AIDS Soc., 21.","DOI":"10.1002\/jia2.25110"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Park, S., Park, J.W., Pitot, H.C., and Lambert, P.F. (2016). Loss of dependence on continued expression of the human papillomavirus 16 E7 oncogene in cervical cancers and precancerous lesions arising in fanconi anemia pathway-deficient mice. mBio, 7.","DOI":"10.1128\/mBio.00628-16"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1093\/aje\/kwf180","article-title":"Genital human papillomavirus infection: Incidence and risk factors in a cohort of female university students","volume":"157","author":"Winer","year":"2003","journal-title":"Am. J. Epidemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1002\/ijc.28666","article-title":"Smoking as a major risk factor for cervical cancer and pre-cancer: Results from the EPIC cohort","volume":"135","author":"Roura","year":"2014","journal-title":"Int. J. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1093\/oxfordjournals.jncimonographs.a003481","article-title":"Immunosuppression and co-infection with HIV","volume":"31","author":"Palefsky","year":"2003","journal-title":"J. Natl. Cancer Inst. Monogr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"505","DOI":"10.3322\/caac.21696","article-title":"Cervical cancer prevention and control in women living with human immunodeficiency virus","volume":"71","author":"Castle","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_13","unstructured":"World Health Organization (2025, May 02). Cervical Cancer Elimination Initiative. Available online: https:\/\/www.who.int\/initiatives\/cervical-cancer-elimination-initiative."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Chen, G.L., Guo, L., Yang, S., and Ji, D.M. (2021). Cancer risk in tuberculosis patients in a high endemic area. BMC Cancer, 21.","DOI":"10.1186\/s12885-021-08391-6"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s13027-017-0143-8","article-title":"Non-pulmonary cancer risk following tuberculosis: A nationwide retrospective cohort study in Lithuania","volume":"12","author":"Everatt","year":"2017","journal-title":"Infect. Agent Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.ejogrb.2011.07.020","article-title":"Mycobacterium bovis BCG and purified protein derivative-induced reduction in the CD80 expression and the antigen up-take function of dendritic cells from patients with cervical cancer","volume":"159","author":"Manickam","year":"2011","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Min, Y., Wei, X., Xia, X., Wei, Z., Li, R., Jin, J., Liu, Z., Hu, X., and Peng, X. (2023). Hepatitis B virus infection: An insight into the clinical connection and molecular interaction between hepatitis B virus and host extrahepatic cancer risk. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1141956"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"An, J., Kim, J.W., Shim, J.H., Han, S., Yu, C.S., Choe, J., Lee, D., Kim, K.M., Lim, Y.S., and Chung, Y.H. (2018). Chronic hepatitis B infection and non-hepatocellular cancers: A hospital registry-based, case-control study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0193232"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.canep.2018.05.012","article-title":"HBV infection and extra-hepatic cancers in adolescents and 20s: A retrospective study in China","volume":"55","author":"Lu","year":"2018","journal-title":"Cancer Epidemiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s13027-022-00466-8","article-title":"Hepatitis B or C viral infection and the risk of cervical cancer","volume":"17","author":"Luo","year":"2022","journal-title":"Infect. Agent Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.ijgo.2013.04.012","article-title":"HIV or human papillomavirus co-infection among Brazilian individuals infected with hepatitis B and\/or hepatitis C","volume":"122","author":"Eleuterio","year":"2013","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1093\/eurheartj\/ehae020","article-title":"Human papillomavirus infection and cardiovascular mortality: A cohort study","volume":"45","author":"Cheong","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.ygyno.2007.08.095","article-title":"Interaction between inflammation and angiogenesis during different stages of cervical carcinogenesis","volume":"108","author":"Mazibrada","year":"2008","journal-title":"Gynecol. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s00705-004-0420-x","article-title":"The E5 protein of the human papillomavirus type 16 modulates composition and dynamics of membrane lipids in keratinocytes","volume":"150","author":"Bravo","year":"2005","journal-title":"Arch. Virol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1007\/s00432-019-02855-w","article-title":"Cancer risk in stroke survivors followed for up to 10 years in general practices in Germany","volume":"145","author":"Jacob","year":"2019","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Kim, M., Jung, W., Kim, S.Y., Park, J.H., and Shin, D.W. (2023). The Korea National Disability Registration System. Epidemiol. Health, 45.","DOI":"10.4178\/epih.e2023053"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Robledo-Resina, I.d.M., Romero-Morales, C., Mart\u00edn-Casas, P., Villafa\u00f1e, J.H., and Abu\u00edn-Porras, V. (2024). Relationship between Female Sexual Dysfunction and Trunk Stability Post-Stroke: A Cross-Sectional Study. Medicina, 60.","DOI":"10.3390\/medicina60020324"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1016\/S0140-6736(11)61171-9","article-title":"Rheumatic heart disease","volume":"379","author":"Marijon","year":"2012","journal-title":"Lancet"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1038\/bmt.2015.63","article-title":"Secondary solid cancer screening following hematopoietic cell transplantation","volume":"50","author":"Inamoto","year":"2015","journal-title":"Bone Marrow Transplant."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.bbmt.2008.07.005","article-title":"Increased risk of cervical dysplasia in long-term survivors of allogeneic stem cell transplantation\u2014Implications for screening and HPV vaccination","volume":"14","author":"Savani","year":"2008","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_31","first-page":"327","article-title":"HIV and cancer: An overview of AIDS-defining and non-AIDS-defining cancers in patients with HIV","volume":"23","author":"McNally","year":"2019","journal-title":"Clin. J. Oncol. Nurs."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"5227","DOI":"10.1038\/s41467-019-13089-2","article-title":"HPV infection and the genital cytokine milieu in women at high risk of HIV acquisition","volume":"10","author":"Liebenberg","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1056\/NEJMoa1917338","article-title":"HPV Vaccination and the Risk of Invasive Cervical Cancer","volume":"383","author":"Lei","year":"2020","journal-title":"N. Engl. J. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/12\/4282\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:52:56Z","timestamp":1760032376000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/12\/4282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,16]]},"references-count":33,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jcm14124282"],"URL":"https:\/\/doi.org\/10.3390\/jcm14124282","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,16]]}}}