HPV 16 Dna in Normal and Malignant Cervical Epithelium: Implications for the Aetiology and Behaviour of Cervical Neoplasia

Meanwell, CliveA.; Blackledge, George; Cox, M. F.; Nj, Maitland

doi:10.1016/s0140-6736(87)90353-9

Cited by 181 publications

(69 citation statements)

References 26 publications

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“…In some papers which do, the subjects come from a limited number of clinics or hospitals, but it is still not clear whether any further selection has taken place (Cox et al, 1986;Lorincz et al, 1986;Macnab et al, 1986;Meanwell et al, 1987;Schneider et al, 1987;Scholl et al, 1985;Wagner et al, 1984;Wickenden et al, 1985). Information on the source of cases is important in the choice of the control group.…”

Section: Hpv Prevalence Surveysmentioning

confidence: 99%

“…If case and control HPV DNA prevalence rates are to be used to estimate the relative risk of HPV infection in causing cervical neoplasia, the controls must be a representative sample of the population which gave rise to the cases. For example, if cases are drawn from a radiotherapy clinic and controls from a series of women with benign gynaecological disorders (Meanwell et al, 1987), it is possible that the two series differ substantially in terms of sexual behaviour, social class or other factors which influence HPV infection rates.…”

Section: Hpv Prevalence Surveysmentioning

confidence: 99%

“…However, in studies of CIN, the definition of a case is generally based on cytological and histological criteria, and it can be difficult to distinguish, on morphological grounds only, CIN from the subclinical HPV infection sometimes referred to as 'flat and atypical condylomas' (Koss, 1987). A number of studies have reported high rates of reclassification from CINI to HPV infection using recently developed cytological criteria, which may also reflect a high prevalence of mixed CIN/HPV lesions (Meisels et al, 1982(Meisels et al, , 1983 (Crum et al, 1986;Schneider et al, 1987;Wagner et al, 1984 (Meanwell et al, 1987), and only two others even mention the mean age of cases and controls (McCance et al, 1985;Toon et al, 1986).…”

Section: Definition Of Cases and Controlsmentioning

confidence: 99%

“…Some doubt has recently been cast on the role of the virus in cervix cancer by reports of high prevalence of HPV 16 and 18 in normal cervical tissue (Cox et al, 1986;Macnab et al, 1986;Meanwell et al, 1987;Reeves et al, 1987;, and the possibility that the apparent association with cervical neoplasia disappears after age-adjustment (Meanwell et al, 1987). In the light of the continuing debate about the importance of HPV infection in the aetiology of cervical cancer (Editorial, 1987a,b;Mufioz & Bosch, 1987) and confronted by practical problems in the design of our own epidemiological study, we decided to critically evaluate the available epidemiological evidence, which consists of prevalence surveys of HPV in various population groups, and some cohort studies of women with cervical HPV infection or low-grade dysplasia.…”

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confidence: 99%

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Does human papillomavirus cause cervical cancer? The state of the epidemiological evidence

Muñóz

Bosch²,

Kaldor³

1988

Br J Cancer

188

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Summary The human papillomavirus has emerged over the past decade as the leading candidate to be the sexually transmitted aetiological factor in cervical cancer. Although it appears that papillomavirus types 16 and 18 are associated with a higher risk of advanced cervical neoplasia, most of the evidence comes from studies which do not satisfy basic epidemiological requirements, and are therefore difficult to interpret. The most significant problems are the small sample size, potentially biased selection of study subjects, the difficulties in cytologically distinguishing precancerous lesions from papilloma infection of the cervix, the unknown specificity and sensitivity of the various hybridisation methods for determining papillomavirus infection status, and the statistical analyses and presentation of results. On the basis of the existing studies, one is forced to conclude that, while experimental data suggest an oncogenic potential for HPV, the epidemiological evidence implicating it as a cause of cervical neoplasia is still rather limited.

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Section: Hpv Prevalence Surveysmentioning

confidence: 99%

Section: Hpv Prevalence Surveysmentioning

confidence: 99%

Section: Definition Of Cases and Controlsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Does human papillomavirus cause cervical cancer? The state of the epidemiological evidence

Muñóz

Bosch²,

Kaldor³

1988

Br J Cancer

188

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“…Using modern polymerase --chain reaction (PCR)-based methods, several recent studies have found an extremely strong association between high-risk types of HPV and cervical cancer (Mufioz & Bosch, 1992;Munioz et al, 1992). However, some investigators (Meanwell et al, 1987;Young et al, 1989) have observed a high proportion of HPV-positive smears in the normal population, and this has raised doubts as to its usefulness in a screening context. One explanation for this is the extreme sensitivity and proneness to contamination of the PCR assay method, which is capable of detecting extremely small amounts of HPV DNA (Gravitt & Manos, 1992).…”

mentioning

confidence: 99%

Type-specific human papillomavirus DNA in abnormal smears as a predictor of high-grade cervical intraepithelial neoplasia

Cuzick

Terry²,

Ho³

et al. 1994

Br J Cancer

202

132

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Summary Human papillomavirus (HPV) typing and quantitation by polymerase chain reaction was performed on exfoliated cells from 133 women referred for colposcopy because of an abnormal smear. High levels of HPV 16 correctly predicted cervical intraepithelial neoplasia (CIN) grade II-III in 93% of its occurrences, but only 59% of cases of CIN III were associated with high levels of this type. Eighty-four per cent of CIN III lesions contained high levels of at least one of HPV types 16, 18, 31, 33 and 35, but the other types were less specific for CIN III than HPV 16. Overall HPV testing compared favourably with cytology for predicting high-grade CIN lesions, but it would appear that some combination of the two modalities will produce better performance than either alone. In particular, HPV testing appears to be helpful in determining which women with mildly abnormal smears have high-grade underlying lesions in need of immediate referral for colposcopy.Cytological screening for cervical dysplasia is an effective method of reducing the incidence of and mortality from cervix cancer (Hakama, 1982; IARC Working Group, 1986;Laara et al., 1987;Hakama et al., 1991 (Barton et al., 1989;Szarewski et al., 1991). Possibly these can be safely left until the next routine smear, but invasive cancer can also be missed (Mitchell et al., 1990). Lastly, on the scale practised today, cytological examination of slides for dyskaryotic changes is a time-consuming, tedious and eye-fatiguing activity leading to difficulty in recruiting and keeping staff, and making the cost-effectiveness of the programme less favourable than it might be.In the past two decades much effort has been devoted towards trying to automate and simplify the preparation and reading of smears, and several prototype computer-assisted screening systems are under evaluation (Banda-Gamboa et al., 1992). However, none is currently in routine use, and interest in alternative or complementary modalities is high. The most thoroughly evaluated among these is cervicography (Stafl, 1981;Tawa et al., 1988;Szarewski et al., 1991), which is highly sensitive but does not appear to be sufficiently specific. However, the possibility that has stimulated the most interst is the detection and typing of HPV DNA in exfoliated cervical cells Schiffman et al., 1991;van den Brule et al., 1991;Koutsky et al., 1992 In this paper we extend that report by increasing the number of women studied and by looking individually at several HPV types. The specific aim was to examine the value of HPV typing for deciding which women with mild cervical abnormalities detected by cytology actually harbour a highgrade (CIN II/III) lesion and are in need of immediate referral for colposcopy. We also wished to examine the relative value of the different HPV types in predicing high-grade disease. The use of HPV DNA detection, typing and quantification in primary screening will not be addressed here and is the subject of several large ongoing studies. Patients and methodsPatients referred for colposcopy were stu...

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Interferon and Genital Warts: Much Potential, Modest Progress

Kirby¹

1988

JAMA

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HPV 16 Dna in Normal and Malignant Cervical Epithelium: Implications for the Aetiology and Behaviour of Cervical Neoplasia

Cited by 181 publications

References 26 publications

Does human papillomavirus cause cervical cancer? The state of the epidemiological evidence

Does human papillomavirus cause cervical cancer? The state of the epidemiological evidence

Type-specific human papillomavirus DNA in abnormal smears as a predictor of high-grade cervical intraepithelial neoplasia

Interferon and Genital Warts: Much Potential, Modest Progress

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