The natural history of human papillomavirus infection and cervical intraepithelial neoplasia among young women in the Guanacaste cohort shortly after initiation of sexual life.
OBJECTIVE
Cross-sectional analyses of our 10,000-woman, population-based Guanacaste cohort suggest a lag of > or =10 years between the peak of human papillomavirus (HPV) infection and the later peak of cervical intraepithelial neoplasia grade 3 (CIN 3). We wanted to explore early HPV natural history and CIN 3 prospectively.


METHODS
As part of the Guanacaste cohort, we followed 206 initially virginal women aged 18 to 26 semiannually for a median of 3.6 years after initiation of sexual life.


RESULTS
A total of 53.4% of women tested positive during the study for > or =1 HPV type. Very few infections persisted for >1 to 2 years. Three women had histologically confirmed CIN 3, of which 2 showed persistent HPV 16. The other had serologic evidence of HPV 31.


CONCLUSIONS
HPV infection occurs frequently and clears rapidly in most young women initiating sexual intercourse. Persistent HPV 16 can cause early CIN 3. The peak age for CIN 3 will decline with the increased screening intensity and sensitivity typical of longitudinal studies.
Rodriguez
Ana Cecilia
AC
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Rockville, Maryland 20859, USA. rodrigac@mail.nih.gov
Burk
Robert
R
Herrero
Rolando
R
Hildesheim
Allan
A
Bratti
Concepcion
C
Sherman
Mark E
ME
Solomon
Diane
D
Guillen
Diego
D
Alfaro
Mario
M
Viscidi
Raphael
R
Morales
Jorge
J
Hutchinson
Martha
M
Wacholder
Sholom
S
Schiffman
Mark
M
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003364:Costa Rica / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D009819:Office Visits / Q000706:statistics & numerical data; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D010808:Physical Examination / Q000706:statistics & numerical data; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012725:Sexual Behavior; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control
D004279:DNA, Viral