title: Consistent condom use increases spontaneous regression in high-risk non-HPV16 but not in HPV16 CIN2-3 lesions, a prospective population-based cohort study.
abstract: BACKGROUND
  The major cause of cervical intraepithelial neoplasia (CIN) is persistent infection with human papillomavirus (HPV). Most CIN grade 2 and 3 lesions are treated with cone excision, although a substantial proportion (6-50%) of CIN2-3 lesions will regresses spontaneously. Predictors for regression of CIN2-3 are desirable in order to reduce this overtreatment.
  
  
  METHODS
  In this prospective cohort study, 145 consecutive women with first-time onset CIN2-3 in colposcopy-directed biopsies and standardized biopsy-cone excision interval were included. The genotype of the high-risk human papillomaviruses (=hrHPV) and clinical factors including sexual behaviour, parity, contraception and smoking were assessed. Patients were divided into two groups according to lesions containing HPV16 (hrHPV16+) and high-risk non-HPV16 (hrHPV16-) genotypes.
  
  
  RESULTS
  Women whose partners consistently used condoms showed a significantly higher regression rate than women using other types of contraception (53% versus 13%, p<0.0001). However, this effect was only seen in hrHPV16- patients (73% regression rate versus 13%, p<0.0001). HrHPV16+ patients had a significantly higher number of sexual partners and more current smokers compared to hrHPV16- patients. The regression rate was not significantly different in CIN2-3 lesions containing HPV16 (hrHPV16+) versus hrHPV16- genotypes.
  
  
  CONCLUSIONS
  Heterogeneity among hrHPV genotypes excists. HPV-genotype analyses can identify women who significantly increase their chance of regression by consistent condom use.
authors.affiliation: Department of Pathology, Stavanger University Hospital, Box 8100, 4068, Stavanger, Norway. jpabaak47@yahoo.com.
authors.forename: Ane Cecilie
authors.initials: AC
authors.lastname: Munk
authors.forename: Irene Tveiterås
authors.initials: IT
authors.lastname: Ovestad
authors.forename: Einar
authors.initials: E
authors.lastname: Gudlaugsson
authors.forename: Kjell
authors.initials: K
authors.lastname: Løvslett
authors.forename: Bent
authors.initials: B
authors.lastname: Fiane
authors.forename: Bianca
authors.initials: B
authors.lastname: van Diermen-Hidle
authors.forename: Arnold-Jan
authors.initials: AJ
authors.lastname: Kruse
authors.forename: Ivar
authors.initials: I
authors.lastname: Skaland
authors.forename: Emiel Am
authors.initials: EA
authors.lastname: Janssen
authors.forename: Jan Pa
authors.initials: JP
authors.lastname: Baak