title: Human papillomavirus and cervical intraepithelial neoplasia grade II-III: a population-based case-control study.
abstract: The association between certain human papillomaviruses (HPV) and cervical intraepithelial neoplasia (CIN) is well documented, but there is uncertainty about the strength of association and the role of co-factors is unclear. This population-based case-control study in Norwegian women 20-44 years of age included 103 cases with histologically confirmed CIN II-III and 234 age-matched and randomly selected controls. Cytological specimens from the cervix were analyzed using the polymerase chain reaction (PCR). In all, 91% of the cases and 15% of the controls were HPV DNA positive, giving a crude odds ratio (OR) of 67.2 (95% confidence interval: 28.6-157.5). The association between HPV 16 and CIN II-III was even stronger (crude OR = 123.9; 46.7 - 328.5). In logistic regression analysis, additional to HPV, only a high number of sexual partners and a low educational level contributed independently to the risk. The adjusted OR for the association between HPV and CIN II-III was 72.8 (95% CI: 27.6-191.9). The association between HPV and CIN remains very strong even after adjustment for proposed confounding factors. The results therefore support the role of HPV as a causative agent in the development of CIN.
authors.affiliation: Department of Epidemiology, National Institute of Public Health, Oslo, Norway.
authors.forename: A O
authors.initials: AO
authors.lastname: Olsen
authors.forename: K
authors.initials: K
authors.lastname: Gjøen
authors.forename: T
authors.initials: T
authors.lastname: Sauer
authors.forename: I
authors.initials: I
authors.lastname: Orstavik
authors.forename: O
authors.initials: O
authors.lastname: Naess
authors.forename: K
authors.initials: K
authors.lastname: Kierulf
authors.forename: G
authors.initials: G
authors.lastname: Sponland
authors.forename: P
authors.initials: P
authors.lastname: Magnus
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D016022:Case-Control Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008487:Medical History Taking; D008572:Menarche; D015999:Multivariate Analysis; D009664:Norway; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000473:pathology; D016133:Polymerase Chain Reaction / Q000379:methods; D011897:Random Allocation; D012725:Sexual Behavior; D014412:Tumor Virus Infections / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000821:virology*
chemical_list: D004279:DNA, Viral