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

• 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: 692/308/409; 692/699/255/2514; 692/699/67/1517/1371; Adolescent; Adult; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Birth control; Cancer Research; Cervical cancer; Cervical Intraepithelial Neoplasia - virology; Cohort analysis; Contraception; DNA, Viral - analysis; Drug Resistance; Epidemiology; Female; Genetic testing; Gynecology; Human papillomavirus; Humans; Infections; Infectious diseases; Intrauterine devices; IUD; Medical research; Medical sciences; Molecular Medicine; Oncology; Papillomaviridae; Papillomavirus Infections - complications; Parity; Pathology; Personal identification numbers; Sexual Behavior; Tumors; Uterine Cervical Neoplasms - virology; Viral diseases; Womens health; Young Adult
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2012.513

Background: 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. Methods: 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. Results: 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). Conclusion: Childbirth increases the risk for subsequent CIN3+ among women with persistent HPV infection.