Consistent condom use increases spontaneous regression in high-risk non-HPV16 but not in HPV16 CIN2-3 lesions, a prospective population-based cohort study

Abstract

BackgroundThe major cause of cervical intraepithelial neoplasia (CIN) is persistent infection with human papillomavirus (HPV). Most CIN grade 2 and 3 lesions are treated with cone excision, although a substantial proportion (6-50%) of CIN2-3 lesions will regresses spontaneously. Predictors for regression of CIN2-3 are desirable in order to reduce this overtreatment.MethodsIn this prospective cohort study, 145 consecutive women with first-time onset CIN2-3 in colposcopy-directed biopsies and standardized biopsy-cone excision interval were included. The genotype of the high-risk human papillomaviruses (=hrHPV) and clinical factors including sexual behaviour, parity, contraception and smoking were assessed. Patients were divided into two groups according to lesions containing HPV16 (hrHPV16+) and high-risk non-HPV16 (hrHPV16-) genotypes.ResultsWomen whose partners consistently used condoms showed a significantly higher regression rate than women using other types of contraception (53% versus 13%, p<0.0001). However, this effect was only seen in hrHPV16- patients (73% regression rate versus 13%, p<0.0001). HrHPV16+ patients had a significantly higher number of sexual partners and more current smokers compared to hrHPV16- patients. The regression rate was not significantly different in CIN2-3 lesions containing HPV16 (hrHPV16+) versus hrHPV16- genotypes.ConclusionsHeterogeneity among hrHPV genotypes excists. HPV-genotype analyses can identify women who significantly increase their chance of regression by consistent condom use.

Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: systematic review and meta-analysis

“…We identified 250 potentially eligible studies; 43 publications met the inclusion criteria (fig 1),6222324252627282930313233343536373839404142434445464748495051525354555657585960616263 but seven were duplicate reports of the same data 27283140505254. Of the 36 eligible studies (total of 3160 women), seven (19%) were randomised trials with suitable data in the non-experimental arm,22253339455762 16 (44%) were prospective cohort studies,6263032343536373841435155566063 and 13 (36%) were retrospective cohort studies23242942444647484953585961 (see supplementary table 2).…”

Condom use in prevention of Human Papillomavirus infections and cervical neoplasia: systematic review of longitudinal studies

“…Eight studies reported in 10 articles met the inclusion criteria. 8–17 For one study, we tabulated the results from the first of three published articles; all three reported the same endpoint with marginally different inclusion criteria. 15…”

“…At baseline, Munk et al. 15–17 asked 162 women with histologically-confirmed CIN2/3 to continue using their usual form of contraception, and to return for colposcopy two months, and again about three to six months after the baseline. Condom use was determined from interviews at baseline and final visits.…”

Lifestyle factors and oncogenic papillomavirus infection in a high-risk male population

“…In addition to HPV16, which is the most common genotype [ 25 ], other genotypes were also involved in both single infection or co-infection with HPV16. The prevalence pattern for specific genotypes in men is still unclear [ 26 ].…”