Update on micronutrients and cervical dysplasia.
This manuscript reviews the current state of knowledge of cervical carcinogenesis and present recent results and introduces ongoing studies on the relationships among micronutrients and natural history of high-risk human papillomaviruses (HR-HPVs) and cervical intraepithelial neoplasia (CIN). Numerous studies have attempted to determine associations between micronutrients and risk of CIN and cervical cancer. Studies that were conducted before a reliable test for assessing HPV infections was available may have resulted in misclassification because of differences in assay sensitivity, which could have led to residual confounding. Another limitation in previous studies may be related to methodologic limitations such as the proper choice of controls for case-control studies. Since cervical cancer does not develop in the absence of HR-HPV infections, only controls exposed to HR-HPV should be included in studies that investigate cofactors for CIN or cervical cancer. Also, the recruitment of subjects for these studies had been based on screening programs that used different approaches such as cytology, colposcopic impression, or biopsy to identify pre-neoplastic cervical lesions. Recent studies have demonstrated that some of these approaches could lead to substantial underdetection and misclassification of preneoplastic lesions of the cervix. Recent studies that addressed these issues have demonstrated that folate is an important micronutrient in cervical cancer prevention via its influence on HR-HPV and the development of CIN. Carefully designed ongoing studies are expected to generate data on whether folate-related biomarkers could be used to identify subjects who are at risk of developing cervical cancer and whether folate supplementation will be beneficial in preventing cervical cancer in women exposed to HR-HPV.
Department of Nutrition Sciences, Division of Nutritional Biochemistry and Genomics, University of Alabama at Birmingham, Birmingham, AL 35294, USA. piyathic@uab.edu
Chandrika J
CJ
Piyathilake
D005260:Female; D006801:Humans; D018977:Micronutrients / Q000494:pharmacology*; D030361:Papillomavirus Infections / Q000517:prevention & control; D014481:United States; D002578:Uterine Cervical Dysplasia / Q000178:diet therapy / Q000208:ethnology / Q000517:prevention & control*
D018977:Micronutrients