Parity as a cofactor for high-grade cervical disease among women with persistent human papillomavirus infection: a 13-year follow-up

Several environmental factors have been associated with increased risks for cervical cancer. We examined whether reproductive history, contraceptive use, or sexual behaviour increase the risk for cervical intraepithelial neoplasia grade 3 or worse (CIN3+) among women with persistent human papillomav...

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Bibliographic Details
Published in:British journal of cancer 2013-01, Vol.108 (1), p.234-239
Main Authors: JENSEN, K. E, SCHMIEDEL, S, NORRILD, B, FREDERIKSEN, K, IFTNER, T, KJAER, S. K
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Birth control
Cervical cancer
Cervical Intraepithelial Neoplasia - virology
Cohort analysis
Contraception
DNA, Viral - analysis
Epidemiology
Female
Genetic testing
Gynecology
Human papillomavirus
Humans
Infections
Infectious diseases
Intrauterine devices
IUD
Medical research
Medical sciences
Papillomaviridae
Papillomavirus Infections - complications
Parity
Pathology
Personal identification numbers
Sexual Behavior
Tumors
Uterine Cervical Neoplasms - virology
Viral diseases
Womens health
Young Adult
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Summary:Several environmental factors have been associated with increased risks for cervical cancer. We examined whether reproductive history, contraceptive use, or sexual behaviour increase the risk for cervical intraepithelial neoplasia grade 3 or worse (CIN3+) among women with persistent human papillomavirus (HPV) infection. A population-based cohort of women participated in a personal interview and underwent a gynaecological examination at which cervical specimens were obtained for HPV DNA testing. Follow-up information (~13 years) on cervical lesions was obtained from the Danish Pathology Data Bank. Women who had a high-risk HPV infection comprised the overall study population (n=1353). A subgroup of women with persistent high-risk HPV infection (n=312) was identified. Hazard ratios (HRs) for a diagnosis of CIN3+ and the corresponding 95% confidence intervals (CIs) were calculated. Women with persistent HPV infection who had given birth had a significantly increased risk for CIN3+ (HR=1.78; 95% CI: 1.07-2.94). No association was found with pregnancy, use of intrauterine devices, or sexual behaviour. Based on small numbers, women with persistent HPV infection had a decreased risk for CIN3+ with any use of oral contraceptives (HR=0.54; 95% CI: 0.29-1.00). Childbirth increases the risk for subsequent CIN3+ among women with persistent HPV infection.
ISSN:0007-0920
1532-1827
DOI:10.1038/bjc.2012.513