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Different risk factor patterns for high‐grade and low‐grade intraepithelial lesions on the cervix among HPV‐positive and HPV‐negative young women

Different risk factor patterns for high‐grade and low‐grade intraepithelial lesions on the cervix... Risk factors for cervical intraepithelial neoplasia have most often been studied in high‐grade lesions. Furthermore, in a high proportion of the studies, human papillomavirus (HPV), the most significant risk determinant of cervical neoplasia, was not taken into account when evaluating other risk factors. To compare risk factors for ASCUS (atypical cells of undetermined significance), LSIL (low‐grade squamous intraepithelial lesion) and HSIL (high‐grade squamous intraepithelial lesion), we conducted a case‐control study among 20 to 29 year‐old women participating in a prospective cohort study in Copenhagen. It included 131 women with ASCUS, 120 women with LSIL, 79 women with HSIL and 1,000 randomly chosen, cytologically normal, control women. All participants had a personal interview and a gynecological examination including a Pap smear and cervical swabs for HPV DNA detection using general primer‐mediated polymerase chain reaction. The most significant risk determinant of all 3 disease categories was the presence of genital HPV DNA. The risk factor pattern was nearly identical for ASCUS and LSIL, but differed significantly from that for HSIL. Stratified analysis by HPV‐status showed that, apart from, respectively, smoking and parity among HPV‐positive women, and smoking and number of sex partners among HPV‐negative women, no additional risk factors were observed for ASCUS and LSIL. In contrast, among HPV‐negative women with HSIL, long‐term use of oral contraceptives was the most important risk factor. However, our result should be taken with great caution as it is based on very small numbers, and as it is unknown whether the HPV‐negative lesions constitute a true entity. Among HPV‐positive women, the risk of HSIL was associated with e.g., years of sex life without barrier contraceptive use, early age at first genital warts and smoking. Whether the risk factors that are applicable only to HSIL represent factors related to progression remains unknown. Int. J. Cancer 76:613–619, 1998.© 1998 Wiley‐Liss, Inc. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Cancer Wiley

Different risk factor patterns for high‐grade and low‐grade intraepithelial lesions on the cervix among HPV‐positive and HPV‐negative young women

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References (28)

Publisher
Wiley
Copyright
Copyright © 1998 Wiley Subscription Services
ISSN
0020-7136
eISSN
1097-0215
DOI
10.1002/(SICI)1097-0215(19980529)76:5<613::AID-IJC1>3.0.CO;2-T
Publisher site
See Article on Publisher Site

Abstract

Risk factors for cervical intraepithelial neoplasia have most often been studied in high‐grade lesions. Furthermore, in a high proportion of the studies, human papillomavirus (HPV), the most significant risk determinant of cervical neoplasia, was not taken into account when evaluating other risk factors. To compare risk factors for ASCUS (atypical cells of undetermined significance), LSIL (low‐grade squamous intraepithelial lesion) and HSIL (high‐grade squamous intraepithelial lesion), we conducted a case‐control study among 20 to 29 year‐old women participating in a prospective cohort study in Copenhagen. It included 131 women with ASCUS, 120 women with LSIL, 79 women with HSIL and 1,000 randomly chosen, cytologically normal, control women. All participants had a personal interview and a gynecological examination including a Pap smear and cervical swabs for HPV DNA detection using general primer‐mediated polymerase chain reaction. The most significant risk determinant of all 3 disease categories was the presence of genital HPV DNA. The risk factor pattern was nearly identical for ASCUS and LSIL, but differed significantly from that for HSIL. Stratified analysis by HPV‐status showed that, apart from, respectively, smoking and parity among HPV‐positive women, and smoking and number of sex partners among HPV‐negative women, no additional risk factors were observed for ASCUS and LSIL. In contrast, among HPV‐negative women with HSIL, long‐term use of oral contraceptives was the most important risk factor. However, our result should be taken with great caution as it is based on very small numbers, and as it is unknown whether the HPV‐negative lesions constitute a true entity. Among HPV‐positive women, the risk of HSIL was associated with e.g., years of sex life without barrier contraceptive use, early age at first genital warts and smoking. Whether the risk factors that are applicable only to HSIL represent factors related to progression remains unknown. Int. J. Cancer 76:613–619, 1998.© 1998 Wiley‐Liss, Inc.

Journal

International Journal of CancerWiley

Published: Jan 29, 1998

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