TY - JOUR
T1 - Risk of cervical dysplasia among human papillomavirus-infected women in Korea
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
N1 - Funding Information:
This study was supported by a grant for the Chronic Infectious Disease Cohort Study (Korea HPV Cohort Study) from the Korea Centers for Disease Control and Prevention (2016-E51002-02) and a research grant from the National Cancer Center of Korea (NCC-1710141).
Publisher Copyright:
© 2019. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.
PY - 2019/5
Y1 - 2019/5
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.
KW - Cohort studies
KW - Papillomavirus infections
KW - Republic of korea
KW - Uterine cervical cancer
KW - Uterine cervical dysplasia
UR - http://www.scopus.com/inward/record.url?scp=85063257757&partnerID=8YFLogxK
U2 - 10.3802/jgo.2019.30.e50
DO - 10.3802/jgo.2019.30.e50
M3 - Article
C2 - 30887765
AN - SCOPUS:85063257757
VL - 30
JO - Journal of Gynecologic Oncology
JF - Journal of Gynecologic Oncology
SN - 2005-0380
IS - 3
M1 - e50
ER -