A prospective study showing long-term infection with human papillomavirus 16 before the development of cervical carcinoma in Situ
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A prospective study showing long-term infection with human papillomavirus 16 before the development of cervical carcinoma in Situ. / Ylitalo, Nathalie; Josefsson, Agnetha; Melbye, Mads; Sorensen, Per; Frisch, Morten; Andersen, Per Kragh; Sparen, Pär; Gustafsson, Margit; Magnusson, Patrik; Ponten, Jan; Gyllensten, Ulf; Adami, Hans Olov.
I: Cancer Research, Bind 60, Nr. 21, 01.11.2000, s. 6027-6032.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - A prospective study showing long-term infection with human papillomavirus 16 before the development of cervical carcinoma in Situ
AU - Ylitalo, Nathalie
AU - Josefsson, Agnetha
AU - Melbye, Mads
AU - Sorensen, Per
AU - Frisch, Morten
AU - Andersen, Per Kragh
AU - Sparen, Pär
AU - Gustafsson, Margit
AU - Magnusson, Patrik
AU - Ponten, Jan
AU - Gyllensten, Ulf
AU - Adami, Hans Olov
PY - 2000/11/1
Y1 - 2000/11/1
N2 - Human papillomavirus 16 (HPV16) is a predominant cause of cervical neoplasia. However, no population-based study with long-term follow-up has clarified the temporal relationship between HPV16 infection and occurrence of carcinoma in situ, or the importance of recurrent or persistent infection. This nested case-control study was carried out in a population-based cohort of women participating in cytological screening whose initial smear, taken in 1969-1995, was normal. During up to 26 years of follow-up, carcinoma in situ was diagnosed in 484 eligible women. Archival smears from these women were compared with smears from 619 individually matched controls. After DNA extraction, a highly sensitive PCR system was used to detect HPV16. Among case women, the prevalence of HPV16 positivity was 56% at the time of diagnosis. The relative risk of cervical carcinoma in situ increased from 3.6 (95% confidence interval, 1.2-11.0) 13 years before diagnosis to 11.1 (95% confidence interval, 5.5-22.2) 1 year before diagnosis. Having a positive smear at entry to the cohort increased risk >5-fold, whereas having persistent infection with HPV in two subsequent smears increased risk 30-fold. We estimated that among HPV16-positive women, the median incubation period from infection to carcinoma in situ was 7-12 years. We conclude that evidence of persistent and/or recurrent infection is associated with a drastically higher risk of cervical carcinoma in situ than occasional infection with HPV16.
AB - Human papillomavirus 16 (HPV16) is a predominant cause of cervical neoplasia. However, no population-based study with long-term follow-up has clarified the temporal relationship between HPV16 infection and occurrence of carcinoma in situ, or the importance of recurrent or persistent infection. This nested case-control study was carried out in a population-based cohort of women participating in cytological screening whose initial smear, taken in 1969-1995, was normal. During up to 26 years of follow-up, carcinoma in situ was diagnosed in 484 eligible women. Archival smears from these women were compared with smears from 619 individually matched controls. After DNA extraction, a highly sensitive PCR system was used to detect HPV16. Among case women, the prevalence of HPV16 positivity was 56% at the time of diagnosis. The relative risk of cervical carcinoma in situ increased from 3.6 (95% confidence interval, 1.2-11.0) 13 years before diagnosis to 11.1 (95% confidence interval, 5.5-22.2) 1 year before diagnosis. Having a positive smear at entry to the cohort increased risk >5-fold, whereas having persistent infection with HPV in two subsequent smears increased risk 30-fold. We estimated that among HPV16-positive women, the median incubation period from infection to carcinoma in situ was 7-12 years. We conclude that evidence of persistent and/or recurrent infection is associated with a drastically higher risk of cervical carcinoma in situ than occasional infection with HPV16.
UR - http://www.scopus.com/inward/record.url?scp=0034326836&partnerID=8YFLogxK
M3 - Journal article
C2 - 11085523
AN - SCOPUS:0034326836
VL - 60
SP - 6027
EP - 6032
JO - Cancer Research
JF - Cancer Research
SN - 0008-5472
IS - 21
ER -
ID: 259465102