Abstract

BACKGROUND
In addition to the oncogenic human papillomavirus (HPV), several cofactors are needed in cervical carcinogenesis, but whether the HPV covariates associated with incident (i) CIN1 are different from those of incident (ii) CIN2 and (iii) CIN3 needs further assessment.
OBJECTIVES
To gain further insights into the true biological differences between CIN1, CIN2 and CIN3, we assessed HPV covariates associated with incident CIN1, CIN2, and CIN3.
STUDY DESIGN AND METHODS
HPV covariates associated with progression to CIN1, CIN2 and CIN3 were analysed in the combined cohort of the NIS (n = 3187) and LAMS study (n = 12,114), using competing-risks regression models (in panel data) for baseline HR-HPV-positive women (n = 1105), who represent a sub-cohort of all 1865 women prospectively followed-up in these two studies.
RESULTS
Altogether, 90 (4.8%), 39 (2.1%) and 14 (1.4%) cases progressed to CIN1, CIN2, and CIN3, respectively. Among these baseline HR-HPV-positive women, the risk profiles of incident CIN1, CIN2 and CIN3 were unique in that completely different HPV covariates were associated with progression to CIN1, CIN2 and CIN3, irrespective which categories (non-progression, CIN1, CIN2, CIN3 or all) were used as competing-risks events in univariate and multivariate models.
CONCLUSIONS
These data confirm our previous analysis based on multinomial regression models implicating that distinct covariates of HR-HPV are associated with progression to CIN1, CIN2 and CIN3. This emphasises true biological differences between the three grades of CIN, which revisits the concept of combining CIN2 with CIN3 or with CIN1 in histological classification or used as a common endpoint, e.g., in HPV vaccine trials.

Authors

Syrjänen K, Shabalova I, Sarian L, Naud P, Longatto-Filho A, Derchain S, Kozachenko V, Zakharchenko S, Roteli-Martins C, Nerovjna R, Kljukina L, Tatti S, Branovskaja M, Branca M, Grunjberga V, Erzen M, Juschenko A, Serpa Hammes L, Podistov J, Costa S, Syrjänen S, NIS Study Research Group, LAMS Study Research Group

Institution

Department of Oncology & Radiotherapy, Turku University Hospital, Turku, Finland. kari.syrjanen@tyks.fi

Source

European journal of gynaecological oncology 33:1 2012 pg 5-14

MeSH

Adolescent
Adult
Aged
Aged, 80 and over
Cervical Intraepithelial Neoplasia
Contraceptives, Oral
Disease Progression
Female
Humans
Middle Aged
Multivariate Analysis
Papillomavirus Infections
Regression Analysis
Risk Factors
Smoking
Uterine Cervical Neoplasms
Vaginal Smears
Young Adult

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22439398