title: Risk factors for cervical intraepithelial neoplasm in Alaska Native women: a pilot study.
abstract: Although rates for invasive cervical cancer have declined over the past twenty years among Alaska Native women, they continue to show high rates of pre-invasive cervical lesions (cervical intraepithelial neoplasia, or CIN). We investigated risk factors for CIN II/III among Alaska Native women in a pilot case-control study. Cases (n = 26) included women with biopsy-proven CIN II/III, while controls (n = 52) had normal cervical epithelium. The strongest risks associated with CIN II/III were HPV infection of any type (Crude Odds Ratio [OR] 8.4, 95% Confidence Interval [CI]: 2.9-29.4), HPV 16 infection (OR 40.8, 95% CI: 9.4-176.4), and a family history of cervical dysplasia (OR 3.9, 95% CI: 1.3-11.3). We also found that use of depot-medroxy progesterone acetate was associated with CIN (OR 3.0, 95% CI: 1.1-8.5). A larger investigation would be necessary to allow adequate evaluation of these, and other, risk factors for CIN among Alaska Native women.
authors.affiliation: Health Care Financing Administration, Seattle, Washington, USA. rmaclehose@hcfa.gov
authors.forename: R F
authors.initials: RF
authors.lastname: MacLehose
authors.forename: A
authors.initials: A
authors.lastname: Harpster
authors.forename: A P
authors.initials: AP
authors.lastname: Lanier
authors.forename: M A
authors.initials: MA
authors.lastname: Schiff
authors.forename: K
authors.initials: K
authors.lastname: Koehler
authors.forename: N
authors.initials: N
authors.lastname: Murphy
authors.forename: T M
authors.initials: TM
authors.lastname: Becker
mesh_terms: D000328:Adult; D000413:Alaska / Q000453:epidemiology; D016022:Case-Control Studies; D003271:Contraceptive Agents, Female; D005260:Female; D006801:Humans; D007198:Indians, North American; D004930:Inuit; D017258:Medroxyprogesterone Acetate; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000453:epidemiology; D010865:Pilot Projects; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000208:ethnology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000208:ethnology
chemical_list: D003271:Contraceptive Agents, Female; D017258:Medroxyprogesterone Acetate