title: Specific human papillomavirus types and other factors on the risk of cervical intraepithelial neoplasia: a case-control study in Korea.
abstract: OBJECTIVE
  Cervical neoplasia is attributed to a persistent human papillomavirus (HPV) infection. We performed a hospital-based, case-control study to evaluate the associations of HPV genotypes and other cofactors with cervical intraepithelial neoplasia (CIN).
  
  
  METHODS
  A total of 158 women were enrolled after we received their informed consent, and the control group (the non-CIN group; n = 80) was selected from women at St Paul's Health Promotion Center. The CIN group (n = 78) was enrolled from the outpatient clinics at Kangnam St Mary's Hospital. Cervical intraepithelial neoplasia was confirmed with colposcopic-guided biopsy or loop electrosurgical excision procedure-conization. A structured questionnaire, Papanicolaou test, and HPV testing were completed. We compared each risk factor using chi2 tests and simple logistic regression analysis between the CIN and non-CIN groups. Finally, odds ratios (ORs) were calculated again by multiple logistic regression analysis.
  
  
  RESULTS
  The most frequent HPV types in CIN were HPV-16, HPV-58, HPV-31/-33, and HPV-35/-56. The OR of the A9 group (HPV-16, HPV-31, HPV-33, HPV-35, HPV-52, HPV-58) was 22.7 (95% confidence interval [CI], 8.3-62.5), that of the A6 group (HPV-53, HPV-56, HPV-66) was 2.9 (95% CI, 1.1-7.5), and that of the A7 group (HPV-18, HPV-39, HPV-45, HPV-59, HPV-68) was 1.5. Sexual debut before 20 years old had significantly higher OR than did a sexual debut after 30 years (OR, 32.9; 95% CI, 2.8-364.7). The OR for CIN in single women versus married women was 6.2 (95% CI, 2.5-15.2). Compared with parous women (parity >3), nonparous women had a higher OR (95% CI, 1.4-16.7). On the multiple logistic regression analysis including the sexual debut age, the marital status, parity, cytology, and the HPV groups, the A9 group had a significant OR for CIN (6.1; 95% CI, 1.6-23.6).
  
  
  CONCLUSIONS
  The risk of CIN was higher for women infected with the HPV-A9 group after multiple logistic regression analysis. The other clinical risk factors were not significant factors of CIN.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea.
authors.forename: Chan Joo
authors.initials: CJ
authors.lastname: Kim
authors.forename: Young Suk
authors.initials: YS
authors.lastname: Lee
authors.forename: Hyun Sung
authors.initials: HS
authors.lastname: Kwack
authors.forename: Won Sik
authors.initials: WS
authors.lastname: Yoon
authors.forename: Tae Chul
authors.initials: TC
authors.lastname: Park
authors.forename: Jong-Sup
authors.initials: JS
authors.lastname: Park
mesh_terms: D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000145:classification* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D018570:Risk Assessment; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*