Cervical ectopy and the transformation zone measured by computerized planimetry in adolescents

Jacobson, Denise L.; Peralta, Lígia; Farmer, Mychelle; Graham, Neil M.H.; Zenilman, Jonathan M.

doi:10.1016/s0020-7292(99)00037-5

Cited by 30 publications

(25 citation statements)

References 13 publications

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“…Duration of oral contraceptive use had no apparent influence on the prevalence of C trachomatis infection-as reported also by Munk et al 12 and Jacobson et al 30 The lack of association between parity and C trachomatis infection observed by us is in line with the study by Munk et al 12 but it contrasts with the study by Bagshaw et al…”

Section: Discussionsupporting

confidence: 88%

Prevalence and determinants of Chlamydia trachomatis infections in women from Bogota, Colombia

Molano

2003

Sexually Transmitted Infections

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Objectives: Chlamydia trachomatis infection in the cervix and uterus has been hypothesised to be a cofactor for cervical cancer. We performed a cross sectional study in Bogota, Colombia, where cervical cancer rates are high, to determine the prevalence and determinants of C trachomatis infection, and in particular its association with human papillomavirus (HPV). Methods: 1829 low income sexually active women were interviewed and tested for C trachomatis, using an endogenous plasmid PCR-EIA, and for 37 HPV types, using a general primer GP5+/6+ mediated PCR-EIA. Results: The overall prevalence of C trachomatis was 5.0%, and it did not differ substantially between women with normal (5.0%) and those with abnormal (5.2%) cervical cytology. Women infected with any HPV type (15.1%) had a slightly increased risk of being simultaneously infected with C trachomatis (adjusted OR 1.3, 95% CI: 0.8 to 2.4). This association was stronger when multiple HPV infections (adjusted OR 2.5, 95% CI: 1.1 to 5.9) were present. No other lifestyle or reproductive characteristics were clearly associated with risk of C trachomatis infection. Conclusions: HPV infected women, particularly women with multiple HPV infections, are at increased risk of being infected with C trachomatis.

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Section: Discussionsupporting

confidence: 88%

Prevalence and determinants of Chlamydia trachomatis infections in women from Bogota, Colombia

Molano

2003

Sexually Transmitted Infections

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“…This finding is biologically plausible, given that the life cycle of HPV is dependent on host cell replication and differentiation, which are characteristic of squamous metaplasia occurring in the cervical transformation zone; basal cells, the target cells for HPV infection, are most accessible in the transformation zone which, in young women, increases in size with time from menarche, independent of sexual and other reproductive factors. 7,8 Our findings contradict studies that suggest that a short interval between menarche and first intercourse increases the risk of HPV infection. 1,2 In these studies, women were first sampled some years after first intercourse; as the authors concede, there is no evidence that infection was acquired during the hypothesized period of increased vulnerability.…”

Section: Discussioncontrasting

confidence: 84%

Proximity of first intercourse to menarche and the risk of human papillomavirus infection: A longitudinal study

Collins

Mazloomzadeh

Winter

et al. 2004

Intl Journal of Cancer

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Cross-sectional studies have suggested that compared with women who delay the start of their sexual career, those who first have intercourse soon after menarche are more susceptible to cervical human papillomavirus (HPV) infection and thus have a greater risk of cervical neoplasia. We describe, using longitudinal observations, how the risk of infection with HPV varies with the interval between menarche and first intercourse in 474 women aged 15-19 recruited within 12 months of first intercourse and before the acquisition of a second sexual partner. One hundred forty-five women became HPV-positive; the cumulative risk of HPV infection 3 years after first intercourse was 45.0% (95% CI ‫؍‬ 37.9 -51.2). In univariate analyses, the hazards ratio (HR) of HPV infection increased significantly with age at first intercourse (HR ‫؍‬ Key words: sexual behavior; longitudinal study; human papillomavirus; partner age; interval between menarche and first intercourse Cross-sectional studies have suggested that compared with women who delay the start of their sexual career, those who first have intercourse soon after menarche are more susceptible to cervical human papillomavirus (HPV) infection and thus have a greater risk of cervical neoplasia. 1,2 However, these studies are limited in so far as outcomes are first defined some years after the first sexual experience and therefore the first exposure, when it is not possible to distinguish the effects of early, late and cumulative exposures to HPV. The longer the interval between first intercourse and first sampling, the more likely it is that a woman will have acquired and then cleared at least one HPV infection before first sampling, or possibly have established a latent infection, following which HPV may be only transiently detectable in cervical samples. 3 Clearly, the occurrence of outcomes of interest in the interval immediately following the onset of sexual activity, and those factors that bear on it, can only be described when observations are made during this interval. In order to measure the susceptibility of the adolescent cervix to HPV infection, we describe, using longitudinal data, the risks associated with the proximity of first intercourse to menarche during the first sexual relationship in women who were first sampled within 12 months of the start of their sexual career. Material and methodsBetween 1988 and 1992, 2,011 women aged 15 to 19 were recruited from a family planning clinic for a longitudinal study of the natural history of early cervical neoplasia. 4 At recruitment, a detailed social and sexual history and 2 cervical samples were taken, 1 for immediate cytologic assessment and the other for virologic examination after all clinical follow-up had ended. Women were asked to reattend at intervals of 6 months, when sexual histories were updated and further samples taken. Follow-up ended on 31 August 1997. The study protocol had ethical committee approval and informed oral consent was obtained from all women.The study population for this analysis is a subset ...

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“…Some authors have assessed the visual demarcation between endocervical columnar cells and the rest of the cervix, with this area defined as ectopy. Others have used computerized images, as in the current study, although in some studies no correlation between hormonal contraception and ectopy was found [4].…”

mentioning

confidence: 66%

“…A number of factors have been suggested as potentially affecting cervical maturation, including trauma, hormonal status, douching, age of coitarche, and number of sexual partners [4,5]. Other factors-such as noncoital sexual activities, the use of condoms, vaginal spermicides, or progestinonly contraceptives, could potentially play a role; however such factors have either not been a focus of investigation, or the published studies have not been sufficiently large to answer the questions.…”

mentioning

confidence: 99%

Behavioral Correlates of Biologic Maturity of the Cervix in Adolescents

Hillard

2009

Journal of Adolescent Health

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Cervical ectopy and the transformation zone measured by computerized planimetry in adolescents

Abstract: Computerized planimetry provides standardized measurements. Douching and sexual activity may decrease ectopy through increased squamous metaplasia. Hormonal contraceptives were not associated with ectopy in adolescents. However, long-term progestin use may decrease T zone size.

Cited by 30 publications

References 13 publications

Prevalence and determinants of Chlamydia trachomatis infections in women from Bogota, Colombia

Prevalence and determinants of Chlamydia trachomatis infections in women from Bogota, Colombia

Proximity of first intercourse to menarche and the risk of human papillomavirus infection: A longitudinal study

Behavioral Correlates of Biologic Maturity of the Cervix in Adolescents

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