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Type specific persistence of high risk human papillomavirus (HPV) as indicator of high grade cervical squamous intraepithelial lesions in young women: population based prospective follow up study
Abstract Objectives: To investigate the role of human papillomavirus (HPV) in the development of cervical neoplasia in women with no previous cervical cytological abnormalities; whether the presence of virus DNA predicts development of squamous intraepithelial lesion; and whether the risk of inciden...
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Published in: | BMJ 2002-09, Vol.325 (7364), p.572-576 |
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creator | Kjaer, Susanne K van den Brule, Adriaan J C Paull, Gerson Svare, Edith I Sherman, Mark E Thomsen, Birthe L Suntum, Mette Bock, Johannes E Poll, Paul A Meijer, Chris J L M |
description | Abstract Objectives: To investigate the role of human papillomavirus (HPV) in the development of cervical neoplasia in women with no previous cervical cytological abnormalities; whether the presence of virus DNA predicts development of squamous intraepithelial lesion; and whether the risk of incident squamous intraepithelial lesions differs with repeated detection of the same HPV type versus repeated detection of different types. Design: Population based prospective cohort study. Setting: General population in Copenhagen, Denmark. Participants: 10 758 women aged 20-29 years followed up for development of cervical cytological abnormalities; 370 incident cases were detected (40 with atypical squamous cells of undetermined significance, 165 with low grade squamous intraepithelial lesions, 165 with high grade squamous intraepithelial lesions). Main outcome measures: Results of cervical smear tests and cervical swabs at enrolment and at the second examination about two years later. Results: Compared with women who were negative for human papillomavirus at enrolment, those with positive results had a significantly increased risk at follow up of having atypical cells (odds ratio 3.2, 95% confidence interval 1.3 to 7.9), low grade lesions (7.5, 4.8 to 11.7), or high grade lesions (25.8,15.3 to 43.6). Similarly, women who were positive for HPV at the second examination had a strongly increased risk of low (34.3,17.6 to 67.0) and high grade lesions (60.7, 25.5 to 144.0). For high grade lesions the risk was strongly increased if the same virus type was present at both examinations (813.0, 168.2 to 3229.2). Conclusions: Infection with human papillomavirus precedes the development of low and high grade squamous intraepithelial lesions. For high grade lesions the risk is greatest in women positive for the same type of HPV on repeated testing. |
doi_str_mv | 10.1136/bmj.325.7364.572 |
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Design: Population based prospective cohort study. Setting: General population in Copenhagen, Denmark. Participants: 10 758 women aged 20-29 years followed up for development of cervical cytological abnormalities; 370 incident cases were detected (40 with atypical squamous cells of undetermined significance, 165 with low grade squamous intraepithelial lesions, 165 with high grade squamous intraepithelial lesions). Main outcome measures: Results of cervical smear tests and cervical swabs at enrolment and at the second examination about two years later. Results: Compared with women who were negative for human papillomavirus at enrolment, those with positive results had a significantly increased risk at follow up of having atypical cells (odds ratio 3.2, 95% confidence interval 1.3 to 7.9), low grade lesions (7.5, 4.8 to 11.7), or high grade lesions (25.8,15.3 to 43.6). Similarly, women who were positive for HPV at the second examination had a strongly increased risk of low (34.3,17.6 to 67.0) and high grade lesions (60.7, 25.5 to 144.0). For high grade lesions the risk was strongly increased if the same virus type was present at both examinations (813.0, 168.2 to 3229.2). Conclusions: Infection with human papillomavirus precedes the development of low and high grade squamous intraepithelial lesions. For high grade lesions the risk is greatest in women positive for the same type of HPV on repeated testing.</description><edition>International edition</edition><identifier>ISSN: 0959-8138</identifier><identifier>ISSN: 0959-8146</identifier><identifier>EISSN: 1468-5833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.325.7364.572</identifier><identifier>PMID: 12228133</identifier><identifier>CODEN: BMJOAE</identifier><language>eng</language><publisher>London: British Medical Journal Publishing Group</publisher><subject>Adult ; Age ; Biological and medical sciences ; Cervical cancer ; Cervical Intraepithelial Neoplasia - epidemiology ; Cervical Intraepithelial Neoplasia - virology ; Data collection ; Denmark - epidemiology ; Epidemiologic Methods ; Female ; Female genital diseases ; Follow up studies ; Gynecological examination ; Gynecology. Andrology. Obstetrics ; Human papillomavirus ; Humans ; Infections ; Lesions ; Medical sciences ; Neoplasia ; Papillomavirus Infections - complications ; Papillomavirus Infections - epidemiology ; Pathology ; Patient assessment ; Polls ; Population ; Population characteristics ; Sexually transmitted diseases ; STD ; Studies ; Tumors ; Uterine Cervical Neoplasms - epidemiology ; Uterine Cervical Neoplasms - virology ; Vaginal Smears - methods ; Womens health ; Womens studies ; Young adults</subject><ispartof>BMJ, 2002-09, Vol.325 (7364), p.572-576</ispartof><rights>2002 BMJ Publishing Group Ltd.</rights><rights>Copyright 2002 BMJ</rights><rights>2002 INIST-CNRS</rights><rights>Copyright: 2002 (c) 2002 BMJ Publishing Group Ltd.</rights><rights>Copyright BMJ Publishing Group Sep 14, 2002</rights><rights>Copyright © 2002, BMJ 2002</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b603t-6baf6e6c20df564661c4931af810007f428e4e206237383d213ff3d55a78e7e43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmj.com/content/325/7364/572.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://bmj.com/content/325/7364/572.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>112,113,230,314,780,784,885,3194,27924,27925,30999,58238,58471,77594,77595</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13883677$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12228133$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kjaer, Susanne K</creatorcontrib><creatorcontrib>van den Brule, Adriaan J C</creatorcontrib><creatorcontrib>Paull, Gerson</creatorcontrib><creatorcontrib>Svare, Edith I</creatorcontrib><creatorcontrib>Sherman, Mark E</creatorcontrib><creatorcontrib>Thomsen, Birthe L</creatorcontrib><creatorcontrib>Suntum, Mette</creatorcontrib><creatorcontrib>Bock, Johannes E</creatorcontrib><creatorcontrib>Poll, Paul A</creatorcontrib><creatorcontrib>Meijer, Chris J L M</creatorcontrib><title>Type specific persistence of high risk human papillomavirus (HPV) as indicator of high grade cervical squamous intraepithelial lesions in young women: population based prospective follow up study</title><title>BMJ</title><addtitle>BMJ</addtitle><description>Abstract Objectives: To investigate the role of human papillomavirus (HPV) in the development of cervical neoplasia in women with no previous cervical cytological abnormalities; whether the presence of virus DNA predicts development of squamous intraepithelial lesion; and whether the risk of incident squamous intraepithelial lesions differs with repeated detection of the same HPV type versus repeated detection of different types. Design: Population based prospective cohort study. Setting: General population in Copenhagen, Denmark. Participants: 10 758 women aged 20-29 years followed up for development of cervical cytological abnormalities; 370 incident cases were detected (40 with atypical squamous cells of undetermined significance, 165 with low grade squamous intraepithelial lesions, 165 with high grade squamous intraepithelial lesions). Main outcome measures: Results of cervical smear tests and cervical swabs at enrolment and at the second examination about two years later. Results: Compared with women who were negative for human papillomavirus at enrolment, those with positive results had a significantly increased risk at follow up of having atypical cells (odds ratio 3.2, 95% confidence interval 1.3 to 7.9), low grade lesions (7.5, 4.8 to 11.7), or high grade lesions (25.8,15.3 to 43.6). Similarly, women who were positive for HPV at the second examination had a strongly increased risk of low (34.3,17.6 to 67.0) and high grade lesions (60.7, 25.5 to 144.0). For high grade lesions the risk was strongly increased if the same virus type was present at both examinations (813.0, 168.2 to 3229.2). Conclusions: Infection with human papillomavirus precedes the development of low and high grade squamous intraepithelial lesions. For high grade lesions the risk is greatest in women positive for the same type of HPV on repeated testing.</description><subject>Adult</subject><subject>Age</subject><subject>Biological and medical sciences</subject><subject>Cervical cancer</subject><subject>Cervical Intraepithelial Neoplasia - epidemiology</subject><subject>Cervical Intraepithelial Neoplasia - virology</subject><subject>Data collection</subject><subject>Denmark - epidemiology</subject><subject>Epidemiologic Methods</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>Follow up studies</subject><subject>Gynecological examination</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Human papillomavirus</subject><subject>Humans</subject><subject>Infections</subject><subject>Lesions</subject><subject>Medical sciences</subject><subject>Neoplasia</subject><subject>Papillomavirus Infections - complications</subject><subject>Papillomavirus Infections - epidemiology</subject><subject>Pathology</subject><subject>Patient assessment</subject><subject>Polls</subject><subject>Population</subject><subject>Population characteristics</subject><subject>Sexually transmitted diseases</subject><subject>STD</subject><subject>Studies</subject><subject>Tumors</subject><subject>Uterine Cervical Neoplasms - epidemiology</subject><subject>Uterine Cervical Neoplasms - virology</subject><subject>Vaginal Smears - methods</subject><subject>Womens health</subject><subject>Womens studies</subject><subject>Young adults</subject><issn>0959-8138</issn><issn>0959-8146</issn><issn>1468-5833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNqFkt2L00AUxYMobln33RdlcFEUSZ2PzEcFH6Roqyy6D-sKvgzT5KadbpLJziRd-_f5jzmhpauC7FNgzu_c3Hs4SfKY4DEhTLxZ1Osxo3wsmcjGXNJ7yYhkQqVcMXY_GeEJn6SKMHWUnISwxhhTJtVE8IfJEaGURomNkl8X2xZQaCG3pc1RCz7Y0EGTA3IlWtnlCnkbrtCqr02DWtPaqnK12VjfB_Ryfn75CpmAbFPY3HTOH0xLbwpAOfhNFCoUrntTu34gO2-gtd0KKhuFCoJ1zfCOtq5vlujG1dC8Ra1r-8p0UUMLE6BArXfDlp3dACpdXOIG9S0KXV9sHyUPSlMFONl_j5NvHz9cTOfp2dfZp-n7s3QhMOtSsTClAJFTXJRcZEKQPJswYkpFYjiyzKiCDCgWMSemWEEJK0tWcG6kAgkZO07e7ea2_aKGIofhlkq33tbGb7UzVv-tNHall26jCc04J9H_Yu_37rqH0OnahhyqyjQQs9GSYpXR-Ou7QKKkoJMMR_DZP-Da9b6JIWiKM4wVI8Pap_-DiJRSECbFMArvqDwGHTyUh7sI1kPfdOybjn3TQ9907Fu0PP0zj1vDvl0ReL4HTIgtKL1pchtuOaYUE1JG7smOW4fYoYNOecYpo8OcdKcP1fx50I2_0kIyyfWXy6n-fD6f4e8_pJ5F_vWOH1a-84zfyC4IRg</recordid><startdate>20020914</startdate><enddate>20020914</enddate><creator>Kjaer, Susanne K</creator><creator>van den Brule, Adriaan J C</creator><creator>Paull, Gerson</creator><creator>Svare, Edith I</creator><creator>Sherman, Mark E</creator><creator>Thomsen, Birthe L</creator><creator>Suntum, Mette</creator><creator>Bock, Johannes E</creator><creator>Poll, Paul A</creator><creator>Meijer, Chris J L M</creator><general>British Medical Journal Publishing Group</general><general>British Medical Association</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><general>BMJ</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7QJ</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20020914</creationdate><title>Type specific persistence of high risk human papillomavirus (HPV) as indicator of high grade cervical squamous intraepithelial lesions in young women: population based prospective follow up study</title><author>Kjaer, Susanne K ; van den Brule, Adriaan J C ; Paull, Gerson ; Svare, Edith I ; Sherman, Mark E ; Thomsen, Birthe L ; Suntum, Mette ; Bock, Johannes E ; Poll, Paul A ; Meijer, Chris J L M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b603t-6baf6e6c20df564661c4931af810007f428e4e206237383d213ff3d55a78e7e43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Age</topic><topic>Biological and medical sciences</topic><topic>Cervical cancer</topic><topic>Cervical Intraepithelial Neoplasia - epidemiology</topic><topic>Cervical Intraepithelial Neoplasia - virology</topic><topic>Data collection</topic><topic>Denmark - epidemiology</topic><topic>Epidemiologic Methods</topic><topic>Female</topic><topic>Female genital diseases</topic><topic>Follow up studies</topic><topic>Gynecological examination</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Human papillomavirus</topic><topic>Humans</topic><topic>Infections</topic><topic>Lesions</topic><topic>Medical sciences</topic><topic>Neoplasia</topic><topic>Papillomavirus Infections - complications</topic><topic>Papillomavirus Infections - epidemiology</topic><topic>Pathology</topic><topic>Patient assessment</topic><topic>Polls</topic><topic>Population</topic><topic>Population characteristics</topic><topic>Sexually transmitted diseases</topic><topic>STD</topic><topic>Studies</topic><topic>Tumors</topic><topic>Uterine Cervical Neoplasms - epidemiology</topic><topic>Uterine Cervical Neoplasms - virology</topic><topic>Vaginal Smears - methods</topic><topic>Womens health</topic><topic>Womens studies</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kjaer, Susanne K</creatorcontrib><creatorcontrib>van den Brule, Adriaan J C</creatorcontrib><creatorcontrib>Paull, Gerson</creatorcontrib><creatorcontrib>Svare, Edith I</creatorcontrib><creatorcontrib>Sherman, Mark E</creatorcontrib><creatorcontrib>Thomsen, Birthe L</creatorcontrib><creatorcontrib>Suntum, Mette</creatorcontrib><creatorcontrib>Bock, Johannes E</creatorcontrib><creatorcontrib>Poll, Paul A</creatorcontrib><creatorcontrib>Meijer, Chris J L M</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Science Database (ProQuest)</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kjaer, Susanne K</au><au>van den Brule, Adriaan J C</au><au>Paull, Gerson</au><au>Svare, Edith I</au><au>Sherman, Mark E</au><au>Thomsen, Birthe L</au><au>Suntum, Mette</au><au>Bock, Johannes E</au><au>Poll, Paul A</au><au>Meijer, Chris J L M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Type specific persistence of high risk human papillomavirus (HPV) as indicator of high grade cervical squamous intraepithelial lesions in young women: population based prospective follow up study</atitle><jtitle>BMJ</jtitle><addtitle>BMJ</addtitle><date>2002-09-14</date><risdate>2002</risdate><volume>325</volume><issue>7364</issue><spage>572</spage><epage>576</epage><pages>572-576</pages><issn>0959-8138</issn><issn>0959-8146</issn><eissn>1468-5833</eissn><eissn>1756-1833</eissn><coden>BMJOAE</coden><abstract>Abstract Objectives: To investigate the role of human papillomavirus (HPV) in the development of cervical neoplasia in women with no previous cervical cytological abnormalities; whether the presence of virus DNA predicts development of squamous intraepithelial lesion; and whether the risk of incident squamous intraepithelial lesions differs with repeated detection of the same HPV type versus repeated detection of different types. Design: Population based prospective cohort study. Setting: General population in Copenhagen, Denmark. Participants: 10 758 women aged 20-29 years followed up for development of cervical cytological abnormalities; 370 incident cases were detected (40 with atypical squamous cells of undetermined significance, 165 with low grade squamous intraepithelial lesions, 165 with high grade squamous intraepithelial lesions). Main outcome measures: Results of cervical smear tests and cervical swabs at enrolment and at the second examination about two years later. Results: Compared with women who were negative for human papillomavirus at enrolment, those with positive results had a significantly increased risk at follow up of having atypical cells (odds ratio 3.2, 95% confidence interval 1.3 to 7.9), low grade lesions (7.5, 4.8 to 11.7), or high grade lesions (25.8,15.3 to 43.6). Similarly, women who were positive for HPV at the second examination had a strongly increased risk of low (34.3,17.6 to 67.0) and high grade lesions (60.7, 25.5 to 144.0). For high grade lesions the risk was strongly increased if the same virus type was present at both examinations (813.0, 168.2 to 3229.2). Conclusions: Infection with human papillomavirus precedes the development of low and high grade squamous intraepithelial lesions. For high grade lesions the risk is greatest in women positive for the same type of HPV on repeated testing.</abstract><cop>London</cop><pub>British Medical Journal Publishing Group</pub><pmid>12228133</pmid><doi>10.1136/bmj.325.7364.572</doi><tpages>5</tpages><edition>International edition</edition><oa>free_for_read</oa></addata></record> |
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subjects | Adult Age Biological and medical sciences Cervical cancer Cervical Intraepithelial Neoplasia - epidemiology Cervical Intraepithelial Neoplasia - virology Data collection Denmark - epidemiology Epidemiologic Methods Female Female genital diseases Follow up studies Gynecological examination Gynecology. Andrology. Obstetrics Human papillomavirus Humans Infections Lesions Medical sciences Neoplasia Papillomavirus Infections - complications Papillomavirus Infections - epidemiology Pathology Patient assessment Polls Population Population characteristics Sexually transmitted diseases STD Studies Tumors Uterine Cervical Neoplasms - epidemiology Uterine Cervical Neoplasms - virology Vaginal Smears - methods Womens health Womens studies Young adults |
title | Type specific persistence of high risk human papillomavirus (HPV) as indicator of high grade cervical squamous intraepithelial lesions in young women: population based prospective follow up study |
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