Obstet Gynecol Sci.  2018 Nov;61(6):662-668. 10.5468/ogs.2018.61.6.662.

Risk factors for cytological progression in HPV 16 infected women with ASC-US or LSIL: The Korean HPV cohort

Affiliations
  • 1Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University, Seoul, Korea. kimonc111@naver.com
  • 2Division of Viral Disease Research Center for Infectious Disease Research, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea.
  • 3Department of Obstetrics and Gynecology, Keimyung University Dongsan Medical Center, Daegu, Korea.
  • 4Department of Pathology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
  • 5Human Resource Biobank, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
  • 6Laboratory of R&D for Genomics, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University, Seoul, Korea.
  • 7Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 8Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
  • 9Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, The Catholic University, Seoul, Korea. jspark@catholic.ac.kr

Abstract


OBJECTIVE
This study was to identify the risk factors for cytological progression in women with atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL).
METHODS
We analyzed data from women infected with the human papillomavirus (HPV) who participated in the Korean HPV cohort study. The cohort recruited women aged 20-60 years with abnormal cervical cytology (ASC-US or LSIL) from April 2010. All women were followed-up at every 6-month intervals with cervical cytology and HPV DNA testing.
RESULTS
Of the 1,158 women included, 654 (56.5%) and 504 (43.5%) women showed ASC-US and LSIL, respectively. At the time of enrollment, 143 women tested positive for HPV 16 (85 single and 58 multiple infections). Cervical cytology performed in the HPV 16-positive women showed progression in 27%, no change in 23%, and regression in 50% of the women at the six-month follow-up. The progression rate associated with HPV 16 infection was higher than that with infection caused by other HPV types (relative risk [RR], 1.75; 95% confidence interval [CI], 1.08-2.84; P=0.028). The cytological progression rate in women with persistent HPV 16 infection was higher than that in women with incidental or cleared infections (P < 0.001). Logistic regression analysis showed a significant relationship between cigarette smoking and cytological progression (RR, 4.15; 95% CI, 1.01-17.00).
CONCLUSION
The cytological progression rate in HPV 16-positive women with ASC-US or LSIL is higher than that in women infected with other HPV types. Additionally, cigarette smoking may play a role in cytological progression.

Keyword

Papillomaviridae; Smoking; Epidemiology

MeSH Terms

Atypical Squamous Cells of the Cervix*
Cohort Studies*
Epidemiology
Female
Follow-Up Studies
Human papillomavirus 16*
Human Papillomavirus DNA Tests
Humans
Logistic Models
Papillomaviridae
Risk Factors*
Smoking
Squamous Intraepithelial Lesions of the Cervix
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