title: Human T-cell lymphotropic virus type I and severe neoplasia of the cervix in Jamaica.
abstract: Human T-cell lymphotropic virus type I (HTLV-I) was associated with carcinoma of the cervix in Japan in a recent study that compared hospital cases with healthy population-based controls. To test this relationship in women more alike for cervical neoplasia risk factors (including sexual behavior and human papilloma virus; HPV), we enrolled consecutive patients from a colposcopy clinic in Kingston, Jamaica (an HTLV-I endemic area). Patients underwent Pap smear, colposcopy, biopsy and cervical swab for detection of HPV by polymerase chain reaction. Cases were defined as women with CIN-3 or invasive cancer (CIN-3/CA). Controls included all patients with either CIN-I or koilocytotic atypia, atypical squamous cells of undetermined significance or benign cervical pathology (all but one had at least inflammatory changes). Patients with CIN-2 were excluded to minimize risk of case-control misclassification. Cases were much more likely to be HTLV-I seropositive than controls. Although mean age differed significantly between cases (mean age = 39 years) and controls (mean age = 33 years), control for age did not explain the relation of CIN-3/CA with HTLV-I. Among HPV DNA positive subjects the age-adjusted association was not diminished but lost statistical significance. HTLV-I seroprevalence may be independently associated with progression to severe neoplasia of the cervix.
authors.affiliation: Viral and Environmental Epidemiology Branches, National Cancer Institute, Bethesda, MD, USA.
authors.forename: H D
authors.initials: HD
authors.lastname: Strickler
authors.forename: C
authors.initials: C
authors.lastname: Rattray
authors.forename: C
authors.initials: C
authors.lastname: Escoffery
authors.forename: A
authors.initials: A
authors.lastname: Manns
authors.forename: M H
authors.initials: MH
authors.lastname: Schiffman
authors.forename: C
authors.initials: C
authors.lastname: Brown
authors.forename: B
authors.initials: B
authors.lastname: Cranston
authors.forename: B
authors.initials: B
authors.lastname: Hanchard
authors.forename: J M
authors.initials: JM
authors.lastname: Palefsky
authors.forename: W A
authors.initials: WA
authors.lastname: Blattner
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000821:virology; D015497:HIV-1; D015481:HTLV-I Antibodies / Q000032:analysis; D015490:HTLV-I Infections / Q000453:epidemiology / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000235:genetics; D006801:Humans; D007563:Jamaica / Q000453:epidemiology; D027383:Papillomaviridae; D015995:Prevalence; D012307:Risk Factors; D002577:Uterine Cervical Diseases / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology / Q000821:virology*
chemical_list: D004279:DNA, Viral; D015481:HTLV-I Antibodies