Proximity of first sexual intercourse to menarche and risk of high-grade cervical disease.
BACKGROUND
We assessed if risk of developing cervical intraepithelial neoplasia grade 2/3 (CIN2/3) or adenocarcinoma in situ (AIS) is associated with a short interval between menarche and first sexual intercourse (FSI).


METHODS
A total of 1009 Colombian and 1012 Finnish females, aged 16-23, who were enrolled in the phase 3 trials of a quadrivalent human papillomavirus (HPV) 6/11/16/18 vaccine had nonmissing data for age of menarche and FSI. The impact of menarche interval on the odds of developing CIN2-3/AIS was evaluated in placebo recipients who were DNA negative to HPV 6/11/16/18/31/33/35/39/45/51/52/56/58/59 and seronegative to HPV 6/11/16/18 at day 1, and had a normal Pap result at day 1 and month 7, thus approximating sexually naive adolescents (n = 504).


RESULTS
The mean age of menarche and FSI was 12.4 and 16.0 years, respectively. Among the women approximating sexually naive adolescents, 18 developed CIN2-3/AIS. Compared with women who postponed FSI beyond 3 years of menarche, those with FSI within 3 years of menarche had a greater risk of cytologic abnormalities (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.02-2.68; P = .04) and CIN2-3/AIS (OR, 3.56; 95% CI, 1.02-12.47; P = .05).


CONCLUSIONS
A short interval between menarche and FSI was a risk factor for cytologic abnormalities and high-grade cervical disease. These data emphasize the importance of primary prevention through education and vaccination.


BACKGROUND
NCT00092521 and NCT00092534.
Department of Research, Clinical Research Group, School of Medicine and Health Sciences, Rosario University, Bogotá, Colombia. angela.a.ruiz@gmail.com
Ángela María
ÁM
Ruiz
Jaime Enrique
JE
Ruiz
Andrés Velásquez
AV
Gavilanes
Tiina
T
Eriksson
Matti
M
Lehtinen
Gonzalo
G
Pérez
Heather L
HL
Sings
Margaret K
MK
James
Richard M
RM
Haupt
D000230:Adenocarcinoma / Q000453:epidemiology / Q000821:virology; D000293:Adolescent; D000328:Adult; D017326:Clinical Trials, Phase III as Topic; D003075:Coitus; D003105:Colombia / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008572:Menarche; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology*; D018570:Risk Assessment; D012725:Sexual Behavior; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000821:virology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000821:virology