Cited by 590Cervical Cancer and HPV ResearchReproductive tract infections researchWomen's cancer prevention and management

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Persistent Human Papillomavirus Infection as a Predictor of Cervical Intraepithelial Neoplasia

Schlecht, Nicolas F.·2001·JAMA

DOI 10.1001/jama.286.24.3106

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Abstract

Context Human papillomavirus (HPV) infection is believed to be the central cause of cervical cancer, although most of the epidemiological evidence has come from retrospective, case-control studies, which do not provide information on the dynamics of cumulative or persistent exposure to HPV infection. Objective To assess the risks of cervical neoplasia related to prior persistent HPV infections. Design and setting Longitudinal study of the natural history of HPV infection and cervical neoplasia in women residing in the city of São Paulo, Brazil, which was conducted between November 1993 and March 1997 and involved repeated measurements of HPV and lesions with follow-up until June 2000. Participants A total of 1611 women with no cytological lesions at enrollment and HPV test results available from the first 2 visits. Main outcome measure Cervical specimens taken for Papanicolaou cytology and HPV testing every 4 months in the first year and twice yearly thereafter. Incident cervical cancer precursor lesions ascertained by expert review of all cytology smears. Results The incidence rate of squamous intraepithelial lesions (SILs) was 0.73 per 1000 women-months (95% confidence interval [CI], 0.5-0.9) among women free of HPV at the 2 initial visits and 8.68 (95% CI, 2.3-15.1) among women with HPV type 16 or 18 infections persisting over both visits. Relative to those negative for HPV oncogenic types at both initial visits, the relative risk (RR) of incident SIL was 10.19 (95% CI, 5.…

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Authors: Schlecht, N. F.
Affiliations: McGill University (CA)
Corresponding author: Schlecht, Nicolas F.
ORCID: Schlecht, Nicolas F.
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 2001-12-26
Volume: 286
Issue: 24
Pages: 3106
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.286.24.3106
OpenAlex: W2161489192
Cited by: 590
References: 22
Citations by year: 2026: 6 · 2025: 5 · 2024: 15 · 2023: 12 · 2022: 10 · 2021: 10 · 2020: 15 · 2019: 16 · 2018: 12 · 2017: 13 · 2016: 21 · 2015: 28 · 2014: 28 · 2013: 18 · 2012: 27
FWCI: 20.86
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Public Health Service (MA13647)
National Cancer Institute (CA70269, R01CA070269)
Topics: Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
Keywords: human papillomavirus, persistent HPV infection, cervical intraepithelial neoplasia, squamous intraepithelial lesions, HPV 16/18, cervical precancerous lesions, natural history of HPV infection, high-risk HPV genotypes, cervical cancer risk
MeSH terms: Adult, Uterine Cervical Dysplasia, Uterine Cervical Neoplasms, DNA, Viral, Female, Humans, Longitudinal Studies, Middle Aged, Risk Factors, Tumor Virus Infections, Vaginal Smears, Multivariate Analysis, Papillomaviridae, Papillomavirus Infections, Papanicolaou Test

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Persistent Human Papillomavirus Infection as a Predictor of Cervical Intraepithelial Neoplasia

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