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TitleCo-factors of high-risk human papillomavirus infections display unique profiles in incident CIN1, CIN2 and CIN3
Author(s)Syrjänen, K.
Shabalova, I.
Naud, P.
Derchain, S.
Sarian, L.
Kozachenko, V.
Zakharchenko, S.
Roteli-Martins, C.
Nerovjna, R.
Longatto, Adhemar
Kljukina, L.
Tatti, S.
Branovskaja, M.
Branca, M.
Grunjberga, V.
Erzen, M.
Juschenko, A.
Hammes, L. Serpa
Costa, S.
Podistov, J.
Syrjänen, S.
LAMS Study Research Groups
Aged, 80 and over
Cervical Intraepithelial Neoplasia
Latin America
Middle Aged
Papillomavirus Infections
Risk Factors
Young Adult
Multinomial regression
Prospective follow-up
NIS Cohort
LAMS Study
Issue dateMay-2011
PublisherSAGE Publications
JournalInternational Journal of STD & AIDS
CitationSyrjänen, K., Shabalova, I., Naud, P., Derchain, S., et. al. (2011). Co-factors of high-risk human papillomavirus infections display unique profiles in incident CIN1, CIN2 and CIN3. International journal of STD & AIDS, 22(5), 263-272
Abstract(s)In addition to oncogenic 'high-risk' human papillomaviruses (HR-HPV), several co-factors are needed in cervical carcinogenesis, but it is poorly understood whether these HPV co-factors associated with incident cervical intraepithelial neoplasia (CIN) grade 1 are different from those required for progression to CIN2 and CIN3. To gain further insights into the true biological differences between CIN1, CIN2 and CIN3, we assessed HPV co-factors increasing the risk of incident CIN1, CIN2 and CIN3. Data from the New Independent States of the Former Soviet Union (NIS) Cohort (n = 3187) and the Latin American Screening (LAMS) Study (n = 12,114) were combined, and co-factors associated with progression to CIN1, CIN2 and CIN3 were analysed using multinomial logistic regression models with all covariates recorded at baseline. HR-HPV-positive women (n = 1105) represented a subcohort of all 1865 women prospectively followed up in both studies. Altogether, 90 (4.8%), 39 (2.1%) and 14 (1.4%) cases progressed to CIN1, CIN2 and CIN3, respectively. Baseline HR-HPV was the single most powerful predictor of incident CIN1, CIN2 and CIN3. When controlled for residual HPV confounding by analysing HR-HPV-positive women only, the risk profiles of incident CIN1, CIN2 and CIN3 were unique. Completely different HPV co-factors were associated with progression to CIN1, CIN2 and CIN3 in univariate and multivariate analyses, irrespective of whether non-progression, CIN1 or CIN2 was used as the reference outcome. HPV co-factors associated with progression to CIN1, CIN2 and CIN3 display unique profiles, implicating genuine biological differences between the three CIN grades, which prompts us to re-visit the concept of combining CIN2 with CIN3 or CIN1.
Publisher version
AccessRestricted access (Author)
Appears in Collections:ICVS - Artigos em revistas internacionais / Papers in international journals

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