Abstract

Abstract Background: Most cervical cancers are directly linked to infection with Human Papillomavirus (HPV), especially oncogenic or high-risk HPVs (HR-HPVs). Studies showed that high levels of several nutritional antioxidants (such as vitamin A, B2, E, and folate) are inversely associated with HR-HPV genital infection among women. These antioxidants are associated with dietary patterns, but associations between dietary patterns and genital HPV infection in women are understudied. To address this gap, this study aims to evaluate associations between healthy eating quality and patterns and genital HPV infection in women. Method: The study included 10,543 women aged 18-59 years from the 14-year (2003-2016) National Health and Nutrition Examination Survey, a US population-based survey. The outcome variable is the HPV infection status (HPV-negative, low-risk [LR] HPV, and HR-HPV), measured based on vaginal swabs. The dietary patterns were evaluated using the Healthy Eating Index (HEI), which measures diet quality based on 13 food components based on key recommendations of the Dietary Guidelines for Americans. A higher HEI score (overall score: range 0-100 or component score: 0-5 or 10) indicates a better diet quality. Associations between the HEI scores and HPV infections were evaluated using the survey weighting multinomial logistic regression adjusting for potential confounding factors. Results: The mean HEI score for US women is 54.5 (standard error=0.4). Women with vaginal HPV infection tended to have a low HEI score (p<0.001). The mean HEI scores for women with HPV-negative, LR-HPV, and HR-HPV are 55.6, 53.1, and 42.2, respectively. However, the association with the overall HEI score became non-statistically significant after adjusting the confounding factors (such as age, smoking, and sexual behavior). The women with the highest intake (score=5 out of 5) of greens and beans and total fruit had a lower risk of HR-HPV (OR=0.70 vs. score=0, p<0.001, and OR=0.57, p<0.01, respectively) adjusted for confounding factors. A high intake of whole grains and dairy can lower the risk of LR-HPV but not HR-HPV. In addition, women with a high score of total protein had a higher risk of HR-HPV (OR=2.1 for score=5 vs. 0-2, p<0.05). Conclusion: This study showed that healthy eating patterns are inversely associated with vaginal HPV infection for US women. These findings can provide valuable insight into developing an intervention to prevent HPV infection from getting established or HPV persistence among the population at higher risk for cervical cancer. Citation Format: Huiyi Lin, Qiufan Fu, Tung-sung Tseng, Krzysztof Reiss, Joseph Su, Martin J. Ronis, Jennifer E. Cameron, Michael E. Hagensee. Impact of healthy eating patterns on HPV infection in women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2261.

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