title: Cofactors in human papillomavirus infection and cervical carcinogenesis.
abstract: OBJECTIVE
  This study aimed to identify the effect of various risk factors as the promoters of HPV infection, and to identify which HPV-positive women may have an increased risk of developing cervical cancer.
  
  
  METHODS
  Smear preparations were examined and classified according to the Bethesda system. HPV-DNA detection and genotyping was carried out using polymerase chain reaction combined with reverse hybridization line-probe assays. Age, smoking habit, age at first sexual intercourse, number of sexual partners, number of term births, contraceptive method, progesterone therapy, history of sexually transmitted diseases, history or existence of warts and existence of cervical infection were recorded.
  
  
  RESULTS
  642 women (96 women with abnormal cervical cytology and 546 women with normal cytology) provided cervical samples. Smoking habit, number of sexual partners, number of term births, history of sexually transmitted diseases, history or existence of warts and existence of cervical infection were identified as the promoters of HPV infection. History of sexually transmitted diseases, history or existence of warts and existence of cervical infection were identified as cofactors affecting progression from HPV infection to cervical cancer. Neither of contraceptive methods studied was related to HPV infection or coexistence with malign transformation to cervical cancer.
  
  
  CONCLUSIONS
  Information gathered from this study could be used to prioritize limited screening and treatment services to woman who have specific characteristics that may put them at an increased risk of HPV infection. Additionally, by identifying which women have a higher risk of cervical cancer; it may be possible to reduce the number of unnecessary colposcopies.
authors.affiliation: Department of Obstetrics and Gynecology Clinic III, Izmir Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Yetimalar
authors.forename: Burcu
authors.initials: B
authors.lastname: Kasap
authors.forename: Kulal
authors.initials: K
authors.lastname: Cukurova
authors.forename: Askin
authors.initials: A
authors.lastname: Yildiz
authors.forename: Adnan
authors.initials: A
authors.lastname: Keklik
authors.forename: Ferit
authors.initials: F
authors.lastname: Soylu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000453:epidemiology* / Q000821:virology*; D002471:Cell Transformation, Neoplastic / Q000378:metabolism*; D003267:Contraception / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology*; D010298:Parity; D015995:Prevalence; D012307:Risk Factors; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000821:virology; D012907:Smoking / Q000453:epidemiology; D002577:Uterine Cervical Diseases / Q000453:epidemiology / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000821:virology*; D014860:Warts / Q000453:epidemiology / Q000821:virology; D055815:Young Adult