Cervical Dysplasia - Indicators

Cervical Dysplasia - Type specific persistence of high-risk human papillomavirus (HPV) as indicator of high-grade cervical squamous intraepithelial lesions in young women: population based prospective follow up study.

Cervical Dysplasia - Kjaer SK, van den Brule AJ, Paull G, Svare EI, Sherman ME, Thomsen BL, Suntum M, Bock JE, Poll PA, Meijer CJ.

Danish Cancer Society, Institute of Cancer Epidemiology, DK-2100 Copenhagen, Denmark. OBJECTIVES: To investigate the role of human papillomavirus (HPV) in the development of cervical neoplasia in women with no previous cervical cytological abnormalities; whether the presence of virus DNA predicts development of squamous intraepithelial lesion; and whether the risk of incident squamous intraepithelial lesions differs with repeated detection of the same HPV type versus repeated detection of different types.

DESIGN: Population based prospective cohort study.

SETTING: General population in Copenhagen, Denmark.

PARTICIPANTS: 10 758 women aged 20-29 years followed up for development of cervical cytological abnormalities; 370 incident cases were detected (40 with atypical squamous cells of undetermined significance, 165 with low grade squamous intraepithelial lesions, 165 with high grade squamous intraepithelial lesions).

MAIN OUTCOME MEASURES: Results of cervical smear tests and cervical swabs at enrollment and at the second examination about two years later. Results: Compared with women who were negative for human papillomavirus at enrollment, those with positive results had a significantly increased risk at follow up of having atypical cells (odds ratio 3.2, 95% confidence interval 1.3 to 7.9), low grade lesions (7.5, 4.8 to 11.7), or high grade lesions (25.8, 15.3 to 43.6). Similarly, women who were positive for HPV at the second examination had a strongly increased risk of low (34.3, 17.6 to 67.0) and high-grade lesions (60.7, 25.5 to 144.0). For high-grade lesions the risk was strongly increased if the same virus type was present at both examinations (813.0, 168.2 to 3229.2).

CONCLUSIONS: Infection with human papillomavirus precedes the development of low and high-grade squamous intraepithelial lesions. For high-grade lesions the risk is greatest in women positive for the same type of HPV on repeated testing.
Resource: PubMed - indexed for MEDLINE

Cervical Dysplasia - Behavior of mild cervical dysplasia during long-term follow-up

Cervical Dysplasia - Nasiell K, Roger V, Nasiell M.

555 women with cervical cytologically diagnosed mild cervical dysplasia were followed by cytology without major treatment. Biopsies were performed in 14% resulting in no significant influence on the outcome of the studied material. Regression to normal occurred in 62% (follow-up, 39 months), progression to severe dysplasia/carcinoma in situ/invasive carcinoma in 16% (invasive carcinoma: 2 patients), and persistence of dysplasia in 22%. Life table analysis calculated the risk of progression of mild dysplasia to be 250-800/100,000 women/year. A comparison with the incidence of carcinoma in situ, 4 of 100,000 women/year, illustrates the yearly risk for a woman with mild dysplasia as 560 times greater than for a woman without cervical dysplasia to develop severe dysplasia/carcinoma in situ/invasive carcinoma.
Resource: PubMed - indexed for MEDLINE