title: Type specific persistence of high risk human papillomavirus (HPV) as indicator of high grade cervical squamous intraepithelial lesions in young women: population based prospective follow up study.
abstract: OBJECTIVE
  To investigate the role of human papillomavirus (HPV) in the development of cervical neoplasia in women with no previous cervical cytological abnormalities; whether the presence of virus DNA predicts development of squamous intraepithelial lesion; and whether the risk of incident squamous intraepithelial lesions differs with repeated detection of the same HPV type versus repeated detection of different types.
  
  
  METHODS
  Population based prospective cohort study.
  
  
  METHODS
  General population in Copenhagen, Denmark.
  
  
  METHODS
  10 758 women aged 20-29 years followed up for development of cervical cytological abnormalities; 370 incident cases were detected (40 with atypical squamous cells of undetermined significance, 165 with low grade squamous intraepithelial lesions, 165 with high grade squamous intraepithelial lesions).
  
  
  METHODS
  RESULTS of cervical smear tests and cervical swabs at enrollment and at the second examination about two years later.
  
  
  RESULTS
  Compared with women who were negative for human papillomavirus at enrollment, those with positive results had a significantly increased risk at follow up of having atypical cells (odds ratio 3.2, 95% confidence interval 1.3 to 7.9), low grade lesions (7.5, 4.8 to 11.7), or high grade lesions (25.8, 15.3 to 43.6). Similarly, women who were positive for HPV at the second examination had a strongly increased risk of low (34.3, 17.6 to 67.0) and high grade lesions (60.7, 25.5 to 144.0). For high grade lesions the risk was strongly increased if the same virus type was present at both examinations (813.0, 168.2 to 3229.2).
  
  
  CONCLUSIONS
  Infection with human papillomavirus precedes the development of low and high grade squamous intraepithelial lesions. For high grade lesions the risk is greatest in women positive for the same type of HPV on repeated testing.
authors.affiliation: Danish Cancer Society, Institute of Cancer Epidemiology, DK-2100 Copenhagen, Denmark. susanne@cancer.dk
authors.forename: Susanne K
authors.initials: SK
authors.lastname: Kjaer
authors.forename: Adriaan J C
authors.initials: AJ
authors.lastname: van den Brule
authors.forename: Gerson
authors.initials: G
authors.lastname: Paull
authors.forename: Edith I
authors.initials: EI
authors.lastname: Svare
authors.forename: Mark E
authors.initials: ME
authors.lastname: Sherman
authors.forename: Birthe L
authors.initials: BL
authors.lastname: Thomsen
authors.forename: Mette
authors.initials: M
authors.lastname: Suntum
authors.forename: Johannes E
authors.initials: JE
authors.lastname: Bock
authors.forename: Paul A
authors.initials: PA
authors.lastname: Poll
authors.forename: Chris J L M
authors.initials: CJ
authors.lastname: Meijer
mesh_terms: D000328:Adult; D003718:Denmark / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000821:virology*; D014626:Vaginal Smears / Q000379:methods; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000821:virology*