Low risk of type-specific carcinogenic HPV re-appearance with subsequent cervical intraepithelial neoplasia grade 2/3

被引:26
作者
Cecilia Rodriguez, Ana [1 ]
Schiffman, Mark [2 ]
Herrero, Rolando [3 ]
Hildesheim, Allan [2 ]
Bratti, Concepcion [1 ]
Sherman, Mark E. [2 ]
Solomon, Diane [4 ]
Guillen, Diego [1 ]
Alfaro, Mario [1 ]
Morales, Jorge [1 ]
Hutchinson, Martha [5 ]
Cheung, Li [6 ]
Wacholder, Sholom [2 ]
Burk, Robert D. [7 ]
机构
[1] INCIENSA Fdn, San Jose, Costa Rica
[2] NCI, Div Canc Epidemiol & Genet, NIH, DHHS, Rockville, MD USA
[3] World Hlth Org, Int Agcy Res Canc, Prevent & Implementat Grp, Lyon, France
[4] NCI, Canc Prevent Div, NIH, DHHS, Rockville, MD USA
[5] Womens & Infants Hosp, Providence, RI USA
[6] Informat Management Serv Inc, Silver Spring, MD USA
[7] Albert Einstein Coll Med, Bronx, NY 10467 USA
基金
美国国家卫生研究院;
关键词
HPV infection re-appearance; CIN2+; risk after re-appearance; HPV infection epidemiology; HUMAN-PAPILLOMAVIRUS INFECTION; NATURAL-HISTORY; WOMEN; DURATION; GUANACASTE; INCIDENT; PERSISTENCE; COHORT;
D O I
10.1002/ijc.27418
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Carcinogenic human papillomavirus (HPV) infections are very common after sexual debut and nearly all become undetectable (clear) within a few years. Following clearance, the long-term risks of type-specific HPV re-appearance and subsequent risk of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) are not well defined. In the 7-year, population-based cohort study in Guanacaste, Costa Rica, we studied how often type-specific carcinogenic HPV infections re-appeared after clearance and how often re-appearance led to CIN2+. We considered 1,740 carcinogenic HPV infections detected by MY09/11 PCR among 2,805 women (1891 years old, median 34) who were actively followed at 6- or 12-month intervals. We identified women with one or more type-specific HPV infections that cleared and re-appeared and further defined a subgroup of definite clearance and re-appearance (=2 intervening negative results over a period of =1 year). We determined the absolute risk of CIN2+ among the different groups. p values are two-sided. Only 7.7% (81/1,052) of HPV-infected women had intervening negative results. Very few (3.7%, 39/1,052) had definite clearance and re-appearance, of which 5.1% (2/39) subsequently persisted to a diagnosis of CIN2. There were zero CIN3+ lesions. Extremely few women (2/2,805 of women in our cohort) had a type-specific carcinogenic HPV infection clear, re-appear and lead to CIN2+. If confirmed, this argues against vaccination to avoid re-appearance that leads to precursor lesions and against the need of frequent HPV screening after initial negative results.
引用
收藏
页码:1874 / 1881
页数:8
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