Human papillomavirus and cervical intraepithelial neoplasia grade II-III: a population-based case-control study

• Published in: International journal of cancer Vol. 61; no. 3; p. 312
• Main Authors: Olsen, A O, Gjøen, K, Sauer, T, Orstavik, I, Naess, O, Kierulf, K, Sponland, G, Magnus, P
• Format: Journal Article
• Language: English
• Published: United States 04-05-1995
• Subjects: Adult; Age Factors; Analysis of Variance; Case-Control Studies; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - virology; DNA, Viral - analysis; Female; Humans; Medical History Taking; Menarche; Multivariate Analysis; Norway; Papillomaviridae - isolation & purification; Papillomavirus Infections - pathology; Polymerase Chain Reaction - methods; Random Allocation; Sexual Behavior; Tumor Virus Infections - pathology; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - virology; Vaginal Smears; Norway
• ISSN: 0020-7136
• DOI: 10.1002/ijc.2910610306

The association between certain human papillomaviruses (HPV) and cervical intraepithelial neoplasia (CIN) is well documented, but there is uncertainty about the strength of association and the role of co-factors is unclear. This population-based case-control study in Norwegian women 20-44 years of age included 103 cases with histologically confirmed CIN II-III and 234 age-matched and randomly selected controls. Cytological specimens from the cervix were analyzed using the polymerase chain reaction (PCR). In all, 91% of the cases and 15% of the controls were HPV DNA positive, giving a crude odds ratio (OR) of 67.2 (95% confidence interval: 28.6-157.5). The association between HPV 16 and CIN II-III was even stronger (crude OR = 123.9; 46.7 - 328.5). In logistic regression analysis, additional to HPV, only a high number of sexual partners and a low educational level contributed independently to the risk. The adjusted OR for the association between HPV and CIN II-III was 72.8 (95% CI: 27.6-191.9). The association between HPV and CIN remains very strong even after adjustment for proposed confounding factors. The results therefore support the role of HPV as a causative agent in the development of CIN.