Risk of cervical dysplasia among human papillomavirus-infected women in Korea

A multicenter prospective study

Yoon Park, Tae Jin Kim, Chang Sun Hwang, Chi Heum Cho, Dae Hoon Jeong, Seok Ju Seong, Jae Kwan Lee, Sooyoung Hur, Mee Kyung Kee, Jaehyun Seong, Moran Ki

Research output: Contribution to journalArticle

Abstract

Objective: Human papillomavirus (HPV) infection is the most important risk factor for cervical cancer, which progresses from precursor lesions with no symptom if left untreated. We compared the risk of cervical dysplasia among HPV-positive Korean women based on HPV types and infection patterns. Methods: We observed participants of a 5-year multicenter prospective cohort study, comprising HPV-positive women with either atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion of the cervix at their enrollment. Follow-ups, comprising cytology and HPV DNA testing results, were included in the final analysis. Incidence was calculated for each infection pattern (persistent infection, incidental infection, and clearance). To investigate cervical dysplasia risk, we used Cox proportional hazard models adjusted for variables that were significantly different among infection patterns. From April 2010 to September 2017, 71 of 1,027 subjects developed cervical dysplasia more severe than high-grade squamous intraepithelial lesion of the cervix. Results: Of these 71 subjects, persistent infection, incidental infection, and clearance were noted in 30, 39, and 2 individuals, respectively. Based on changes in DNA results during follow-up, cumulative incidence was 27.2%, 10.4%, and 0.5% for persistent infection, incidental infection, and clearance, respectively. Compared to clearance, the adjusted hazard ratios for cervical dysplasia were 51.6 and 24.1 for persistent and incidental infections, respectively (p<0.001). Conclusion: Individuals persistently infected with the same HPV types during the follow-up period had the highest risk of severe cervical dysplasia. Hence, it is necessary to monitor HPV types and infection patterns to prevent severe cervical precancerous lesions.

Original languageEnglish
Article numbere50
JournalJournal of gynecologic oncology
Volume30
Issue number3
DOIs
Publication statusPublished - 2019 May 1

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Uterine Cervical Dysplasia
Korea
Multicenter Studies
Prospective Studies
Infection
Papillomavirus Infections
DNA
Incidence
Proportional Hazards Models
Uterine Cervical Neoplasms
Cell Biology
Cohort Studies

Keywords

  • Cohort studies
  • Papillomavirus infections
  • Republic of korea
  • Uterine cervical cancer
  • Uterine cervical dysplasia

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

Cite this

Risk of cervical dysplasia among human papillomavirus-infected women in Korea : A multicenter prospective study. / Park, Yoon; Kim, Tae Jin; Hwang, Chang Sun; Cho, Chi Heum; Jeong, Dae Hoon; Seong, Seok Ju; Lee, Jae Kwan; Hur, Sooyoung; Kee, Mee Kyung; Seong, Jaehyun; Ki, Moran.

In: Journal of gynecologic oncology, Vol. 30, No. 3, e50, 01.05.2019.

Research output: Contribution to journalArticle

Park, Y, Kim, TJ, Hwang, CS, Cho, CH, Jeong, DH, Seong, SJ, Lee, JK, Hur, S, Kee, MK, Seong, J & Ki, M 2019, 'Risk of cervical dysplasia among human papillomavirus-infected women in Korea: A multicenter prospective study', Journal of gynecologic oncology, vol. 30, no. 3, e50. https://doi.org/10.3802/jgo.2019.30.e50
Park, Yoon ; Kim, Tae Jin ; Hwang, Chang Sun ; Cho, Chi Heum ; Jeong, Dae Hoon ; Seong, Seok Ju ; Lee, Jae Kwan ; Hur, Sooyoung ; Kee, Mee Kyung ; Seong, Jaehyun ; Ki, Moran. / Risk of cervical dysplasia among human papillomavirus-infected women in Korea : A multicenter prospective study. In: Journal of gynecologic oncology. 2019 ; Vol. 30, No. 3.
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abstract = "Objective: Human papillomavirus (HPV) infection is the most important risk factor for cervical cancer, which progresses from precursor lesions with no symptom if left untreated. We compared the risk of cervical dysplasia among HPV-positive Korean women based on HPV types and infection patterns. Methods: We observed participants of a 5-year multicenter prospective cohort study, comprising HPV-positive women with either atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion of the cervix at their enrollment. Follow-ups, comprising cytology and HPV DNA testing results, were included in the final analysis. Incidence was calculated for each infection pattern (persistent infection, incidental infection, and clearance). To investigate cervical dysplasia risk, we used Cox proportional hazard models adjusted for variables that were significantly different among infection patterns. From April 2010 to September 2017, 71 of 1,027 subjects developed cervical dysplasia more severe than high-grade squamous intraepithelial lesion of the cervix. Results: Of these 71 subjects, persistent infection, incidental infection, and clearance were noted in 30, 39, and 2 individuals, respectively. Based on changes in DNA results during follow-up, cumulative incidence was 27.2{\%}, 10.4{\%}, and 0.5{\%} for persistent infection, incidental infection, and clearance, respectively. Compared to clearance, the adjusted hazard ratios for cervical dysplasia were 51.6 and 24.1 for persistent and incidental infections, respectively (p<0.001). Conclusion: Individuals persistently infected with the same HPV types during the follow-up period had the highest risk of severe cervical dysplasia. Hence, it is necessary to monitor HPV types and infection patterns to prevent severe cervical precancerous lesions.",
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T2 - A multicenter prospective study

AU - Park, Yoon

AU - Kim, Tae Jin

AU - Hwang, Chang Sun

AU - Cho, Chi Heum

AU - Jeong, Dae Hoon

AU - Seong, Seok Ju

AU - Lee, Jae Kwan

AU - Hur, Sooyoung

AU - Kee, Mee Kyung

AU - Seong, Jaehyun

AU - Ki, Moran

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Objective: Human papillomavirus (HPV) infection is the most important risk factor for cervical cancer, which progresses from precursor lesions with no symptom if left untreated. We compared the risk of cervical dysplasia among HPV-positive Korean women based on HPV types and infection patterns. Methods: We observed participants of a 5-year multicenter prospective cohort study, comprising HPV-positive women with either atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion of the cervix at their enrollment. Follow-ups, comprising cytology and HPV DNA testing results, were included in the final analysis. Incidence was calculated for each infection pattern (persistent infection, incidental infection, and clearance). To investigate cervical dysplasia risk, we used Cox proportional hazard models adjusted for variables that were significantly different among infection patterns. From April 2010 to September 2017, 71 of 1,027 subjects developed cervical dysplasia more severe than high-grade squamous intraepithelial lesion of the cervix. Results: Of these 71 subjects, persistent infection, incidental infection, and clearance were noted in 30, 39, and 2 individuals, respectively. Based on changes in DNA results during follow-up, cumulative incidence was 27.2%, 10.4%, and 0.5% for persistent infection, incidental infection, and clearance, respectively. Compared to clearance, the adjusted hazard ratios for cervical dysplasia were 51.6 and 24.1 for persistent and incidental infections, respectively (p<0.001). Conclusion: Individuals persistently infected with the same HPV types during the follow-up period had the highest risk of severe cervical dysplasia. Hence, it is necessary to monitor HPV types and infection patterns to prevent severe cervical precancerous lesions.

AB - Objective: Human papillomavirus (HPV) infection is the most important risk factor for cervical cancer, which progresses from precursor lesions with no symptom if left untreated. We compared the risk of cervical dysplasia among HPV-positive Korean women based on HPV types and infection patterns. Methods: We observed participants of a 5-year multicenter prospective cohort study, comprising HPV-positive women with either atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion of the cervix at their enrollment. Follow-ups, comprising cytology and HPV DNA testing results, were included in the final analysis. Incidence was calculated for each infection pattern (persistent infection, incidental infection, and clearance). To investigate cervical dysplasia risk, we used Cox proportional hazard models adjusted for variables that were significantly different among infection patterns. From April 2010 to September 2017, 71 of 1,027 subjects developed cervical dysplasia more severe than high-grade squamous intraepithelial lesion of the cervix. Results: Of these 71 subjects, persistent infection, incidental infection, and clearance were noted in 30, 39, and 2 individuals, respectively. Based on changes in DNA results during follow-up, cumulative incidence was 27.2%, 10.4%, and 0.5% for persistent infection, incidental infection, and clearance, respectively. Compared to clearance, the adjusted hazard ratios for cervical dysplasia were 51.6 and 24.1 for persistent and incidental infections, respectively (p<0.001). Conclusion: Individuals persistently infected with the same HPV types during the follow-up period had the highest risk of severe cervical dysplasia. Hence, it is necessary to monitor HPV types and infection patterns to prevent severe cervical precancerous lesions.

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KW - Republic of korea

KW - Uterine cervical cancer

KW - Uterine cervical dysplasia

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