title: The natural history of human papillomavirus infection and cervical intraepithelial neoplasia among young women in the Guanacaste cohort shortly after initiation of sexual life.
abstract: 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.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Rockville, Maryland 20859, USA. rodrigac@mail.nih.gov
authors.forename: Ana Cecilia
authors.initials: AC
authors.lastname: Rodriguez
authors.forename: Robert
authors.initials: R
authors.lastname: Burk
authors.forename: Rolando
authors.initials: R
authors.lastname: Herrero
authors.forename: Allan
authors.initials: A
authors.lastname: Hildesheim
authors.forename: Concepcion
authors.initials: C
authors.lastname: Bratti
authors.forename: Mark E
authors.initials: ME
authors.lastname: Sherman
authors.forename: Diane
authors.initials: D
authors.lastname: Solomon
authors.forename: Diego
authors.initials: D
authors.lastname: Guillen
authors.forename: Mario
authors.initials: M
authors.lastname: Alfaro
authors.forename: Raphael
authors.initials: R
authors.lastname: Viscidi
authors.forename: Jorge
authors.initials: J
authors.lastname: Morales
authors.forename: Martha
authors.initials: M
authors.lastname: Hutchinson
authors.forename: Sholom
authors.initials: S
authors.lastname: Wacholder
authors.forename: Mark
authors.initials: M
authors.lastname: Schiffman
mesh_terms: 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
chemical_list: D004279:DNA, Viral