title: Age at menarche is not an independent risk factor for high-risk human papillomavirus infections and cervical intraepithelial neoplasia.
abstract: Data are controversial as to the role of menarche age as a risk factor of high-risk human papillomavirus (HR-HPV) infections. The objective of this study was to analyse the risk estimates for age at menarche as determinant of cervical intraepithelial neoplasia (CIN) and HR-HPV infections. A cohort of 3187 women were stratified into three groups according to their age at menarche: (i) women <13 years of age; (ii) those between 13 and 14 years and (iii) women >15 years of age. These groups were analysed for predictors of (a) HR-HPV, (b) high-grade CIN and (c) outcome of HR-HPV and cytological abnormalities during prospective follow-up. All the three groups had identical prevalence of HR-HPV, Papanicolaou smear abnormalities and CIN grades. In contrast to menarche age itself, the time from menarche to the first intercourse (TMI), to the first pregnancy (TMP) and to the first delivery (TMD) were all significant (P = 0.0001) predictors of HR-HPV (but not CIN2) in univariate analysis, but lost their significance in a multivariate model. Outcome of cervical disease and HR-HPV infection was unrelated to menarche age, the latter and the three intervals being not predictors of CIN2 in a multivariate model. In conclusion, age at menarche and the intervals between menarche and (i) onset of sexual activity, (ii) first pregnancy and iii) first delivery, are not independent predictors of HR-HPV infections and CIN2 in multivariate analysis.
authors.affiliation: Department of Oncology and Radiotherapy, Turku University Hospital, Savitehtaankatu 1, Turku FIN-20521, Finland. kari.syrjanen@tyks.fi
authors.forename: Kari
authors.initials: K
authors.lastname: Syrjänen
authors.forename: Irena
authors.initials: I
authors.lastname: Shabalova
authors.forename: Nicolay
authors.initials: N
authors.lastname: Petrovichev
authors.forename: Vladimir
authors.initials: V
authors.lastname: Kozachenko
authors.forename: Tatjana
authors.initials: T
authors.lastname: Zakharova
authors.forename: Julia
authors.initials: J
authors.lastname: Pajanidi
authors.forename: Jurij
authors.initials: J
authors.lastname: Podistov
authors.forename: Galina
authors.initials: G
authors.lastname: Chemeris
authors.forename: Larisa
authors.initials: L
authors.lastname: Sozaeva
authors.forename: Elena
authors.initials: E
authors.lastname: Lipova
authors.forename: Irena
authors.initials: I
authors.lastname: Tsidaeva
authors.forename: Olga
authors.initials: O
authors.lastname: Ivanchenko
authors.forename: Alla
authors.initials: A
authors.lastname: Pshepurko
authors.forename: Sergej
authors.initials: S
authors.lastname: Zakharenko
authors.forename: Raisa
authors.initials: R
authors.lastname: Nerovjna
authors.forename: Ludmila
authors.initials: L
authors.lastname: Kljukina
authors.forename: Oksana
authors.initials: O
authors.lastname: Erokhina
authors.forename: Marina
authors.initials: M
authors.lastname: Branovskaja
authors.forename: Maritta
authors.initials: M
authors.lastname: Nikitina
authors.forename: Valerija
authors.initials: V
authors.lastname: Grunberga
authors.forename: Alexandr
authors.initials: A
authors.lastname: Grunberg
authors.forename: Anna
authors.initials: A
authors.lastname: Juschenko
authors.forename: Rosa
authors.initials: R
authors.lastname: Santopietro
authors.forename: Marcella
authors.initials: M
authors.lastname: Cintorino
authors.forename: Piero
authors.initials: P
authors.lastname: Tosi
authors.forename: Stina
authors.initials: S
authors.lastname: Syrjänen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008572:Menarche; D008875:Middle Aged; D015999:Multivariate Analysis; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000145:classification / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology*; D011247:Pregnancy / Q000706:statistics & numerical data; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D013997:Time Factors; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology