title: Abnormal Papanicolaou smear. A population-based study of risk factors in Greenlandic and Danish women.
abstract: Possible risk factors for abnormal Papanicolaou smear were investigated in a population-based cross-sectional study. From Nuuk (Greenland) and Nykøbing Falster (Denmark), random samples of 800 women aged 20-39 years were drawn. Totals of 586 and 661 women were included in Greenland and Denmark, respectively. All women went through a personal interview, and had a gynecologic examination including a PAP smear and cervical swab for HPV analysis. A blood sample was taken for analysis of HSV type specific antibodies. Multiple sexual partners was the most important risk factor for abnormal cervical cytology (OR = 4.2). An infectious etiology was also indirectly supported by a relatively protective effect of barrier contraceptive methods (OR = 0.6). The simultaneous finding of HPV 16/18 as a significant risk factor (OR = 2.4) cannot be taken uncritically as support for a causal effect of this HPV type, since such a relationship between cytological changes of the cervix and HPV infection could also emerge if the positive PAP smear was not just a measure of intra-epithelial neoplasia but also an expression of the infection itself on the cervix.
authors.affiliation: Danish Cancer Society, Institute of Cancer Epidemiology, Copenhagen.
authors.forename: S K
authors.initials: SK
authors.lastname: Kjaer
authors.forename: P
authors.initials: P
authors.lastname: Poll
authors.forename: H
authors.initials: H
authors.lastname: Jensen
authors.forename: G
authors.initials: G
authors.lastname: Engholm
authors.forename: B J
authors.initials: BJ
authors.lastname: Haugaard
authors.forename: C
authors.initials: C
authors.lastname: Teisen
authors.forename: R B
authors.initials: RB
authors.lastname: Christensen
authors.forename: K A
authors.initials: KA
authors.lastname: Möller
authors.forename: B F
authors.initials: BF
authors.lastname: Vestergaard
authors.forename: E M
authors.initials: EM
authors.lastname: de Villiers
mesh_terms: D000328:Adult; D003268:Contraception Behavior; D003430:Cross-Sectional Studies; D003718:Denmark; D005260:Female; D006116:Greenland; D006558:Herpes Genitalis / Q000150:complications; D006801:Humans; D065006:Papanicolaou Test; D027383:Papillomaviridae; D012307:Risk Factors; D012725:Sexual Behavior; D012907:Smoking; D014412:Tumor Virus Infections / Q000150:complications; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000209:etiology*; D014626:Vaginal Smears