The natural history of human papillomavirus infection as measured by repeated DNA testing in adolescent and young women

Moscicki, Anna Barbara; Shiboski, Stephen; Broering, Jeanette M.; Powell, Kimberly; Clayton, Lisa M.; Jay, Naomi; Darragh, Teresa M.; Brescia, Robert; Kanowitz, Saul; Miller, Susanna; Stone, Joanna; Hanson, Evelyn; Palefsky, Joel M.

doi:10.1016/s0022-3476(98)70445-7

Cited by 488 publications

(373 citation statements)

References 20 publications

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“…1) was estimated from follow-up data of 290 women in the POBASCAM study that had normal cytology and an hrHPVpositive test (GP5þ6þ PCR-EIA 20 ) at baseline. After 6 months, 37% of the women had cleared the hrHPV infection (95% confidence interval [CI] [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46], which is consistent with published percentages of 39% 36 and 36%. 37 The viral clearance did not depend on age.…”

Section: Clearance and Age-dependent Incidence Of Hrhpv Infectionsupporting

confidence: 77%

“…Such rapidly progressive lesions without distinguishable phases of CIN1/2 have been mentioned in the literature. [39][40][41] The 6-month incidence of CIN3 after hrHPV infection was set at 0.01 and the 6-month incidence of a progressive CIN1 lesion was set at 0.025. By combining the 6-month incidences of direct and indirect progression from CIN0 to CIN3, it follows that the CIN0-CIN3 duration is 2.5 years and the probability of progressing to CIN3 after hrHPV infection is 0.073.…”

Section: Progression Of Hrhpv-positive Womenmentioning

confidence: 99%

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Natural history and screening model for high‐risk human papillomavirus infection, neoplasia and cervical cancer in the Netherlands

Berkhof

Bruijne

Zielinski

et al. 2005

Intl Journal of Cancer

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A simulation model is presented that assumes that persistent infection with high-risk human papillomavirus (hrHPV) is a necessary cause of cervical cancer. For the estimation of the model parameters, data of recent Dutch follow-up studies were reanalyzed. The predicted incidences of cervical cancer, cervical intraepithelial neoplasia (CIN1, CIN2 and CIN3) and abnormal cytology were validated with nationwide figures and population-based screening results. The model predicted a lifetime risk for cervical cancer of 2.9% with a peak at age 48 years. The predicted lifetime risk dropped to 0.4% when attending cervical screening. For women who were not hrHPV infected at 30 years, the lifetime risk was 1.6%. Sensitivity analyses were performed to check natural history assumptions that were only weakly identified from available data sets. The incidence of CIN3 observed with screening appeared a useful clinical end point as the predicted incidence was robust against changes in the sensitivity of cervical cytology and the duration to CIN3. The model can be used to study the healtheconomic benefits that can be achieved in nationwide screening when including an hrHPV test. ' 2005 Wiley-Liss, Inc.Key words: cervical neoplasms; cytology; cost effectiveness; human papillomavirus; longitudinal studies; models; screening Population-based screening is regarded as an effective method for reducing the incidence of invasive cervical cancer. Epidemiologic studies report that in countries where cytologic screening has been implemented, the incidence of cervical cancer has shown a larger decrease than in countries without screening. 1,2 Although many countries subscribe to the necessity of screening, each country has its own screening program and different opinions about the optimal program remain.Because persistent infection with the high-risk human papillomavirus (hrHPV) is the key causative agent of cervical cancer, 3,4 many recent and ongoing longitudinal studies have examined whether a test for detection of hrHPV in addition to cytologic inspection increases the efficacy of screening. 5-9 Combined screening (hrHPV and cytology) leads to an earlier detection of women who are at risk for developing high-grade lesions 10 and has a higher sensitivity for the detection of high-grade lesions. 11 However, hrHPV testing also induces extra screening costs so that the determination of the optimal screening scenario involves an elaborate cost-effectiveness analysis.An attractive way to study the efficacy of different screening scenarios is simulation modeling. 12-16 Simulation enables us to combine the results of several studies, compare a large number of scenarios and provides an assessment of the costs and effectiveness in preventing cancer. A simulation model requires the specification of an underlying natural history model that describes health trajectories of women in an unscreened population. We present a natural history model for women in the Netherlands between 30 and 80 years of age and apply the model to predict the incidence of ne...

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Section: Clearance and Age-dependent Incidence Of Hrhpv Infectionsupporting

confidence: 77%

Section: Progression Of Hrhpv-positive Womenmentioning

confidence: 99%

Natural history and screening model for high‐risk human papillomavirus infection, neoplasia and cervical cancer in the Netherlands

Berkhof

Bruijne

Zielinski

et al. 2005

Intl Journal of Cancer

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“…27 Epidemiological studies have shown that about 10% of women with high-risk HPV infection develop high-grade CIN. 5,6,16 It is speculated that persistent infection by specific viral types, particularly HPV 16 and 18 has the greatest tendency to cause CIN 2/3. 3, 27 Kjaer et al 25 demonstrated that the risk for low-grade and high-grade CIN was markedly increased if there were repeat positive tests for HPV, but the most substantial increase in risk was for high-grade CIN if the repeat positive test was for the same HPV type.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Woodman et al 4 reported that adolescents infected with HPV 16,18, and 31 had a higher risk of developing high-grade CIN than persons infected with other oncogenic HPV types. Moscicki et al 6 observed that persistently positive high-risk HPV testing precedes the development of high-grade CIN.…”

mentioning

confidence: 99%

“…3,9 In susceptible adolescents, either repeated exposure or an inability to suppress immunologically an infection may promote the oncogenic potential of the virus. 6 The cyclin-dependent kinase (CDK) inhibitor p16 INK4a overexpression in high-grade CIN and cervical cancer appears to be related to viral integration during the neoplastic transformation of cervical cells. [12][13][14][15][16] The purpose of this study was to observe in CIN of adolescents from high-risk clinics in Mississippi the distribution of HPV types 16,18,31,33,35,45,52, and 58 that are considered oncogenic by the International Agency for Research on Cancer (IARC).…”

mentioning

confidence: 99%

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Human papillomavirus genotyping and p16INK4a expression in cervical intraepithelial neoplasia of adolescents

Guo

et al. 2005

Modern Pathology

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Adolescents have high rates of human papillomavirus (HPV) infection, and persistent high-risk HPV infection can lead to the development of cervical cancer. The cyclin-dependent kinase inhibitor, p16 INK4a is overexpressed in cervical intraepithelial neoplasia (CIN), probably due to a persistent and integrated HPV infection. This study investigated p16 INK4a expression, grades of CIN, and high-risk HPV infection in adolescent cervical biopsies. Biopsies were immunohistochemically stained for p16 INK4a . The presence of wide-spectrum, low-risk, or highrisk HPV was determined by amplifying DNA extracted from the cervical biopsies. Early sexual activity with multiple partners places many female adolescents at high risk for the future development of cervical cancer. The prevalence of human papillomavirus (HPV) infection in adolescents ranges from 19 to 46%, but the cervical intraepithelial neoplasia (CIN) in adolescents are predominantly low-grade and in the great majority of cases they resolve spontaneously. Only 0.12-3% of adolescents known to be infected with high-risk HPV develop high-grade CIN, and cervical carcinoma is extremely rare. 1-5 Woodman et al 4 reported that adolescents infected with HPV 16, 18, and 31 had a higher risk of developing high-grade CIN than persons infected with other oncogenic HPV types. Moscicki et al 6 observed that persistently positive high-risk HPV testing precedes the development of high-grade CIN.High-risk HPV DNA can be detected in almost all high-grade CIN and cervical cancers. 7,8 From a screening study of 7932 women aged 21-30 years, Clavel et al 9 reported that 23% had high-risk HPV infections. For the majority of women, the infections are transient and last 8-10 months. 9-11 It was the repeated positive high-risk HPV test results, reflecting persistent infection that predicted a likelihood of having a high-grade CIN. 3,9 In susceptible adolescents, either repeated exposure or an inability to suppress immunologically an infection may promote the oncogenic potential of

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Cigarette Smoking and Infection

Arcavi¹,

Benowitz²

2004

Arch Intern Med

867

663

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The clinical implications of our findings include emphasizing the importance of smoking cessation as part of the therapeutic plan for people with serious infectious diseases or periodontitis, and individuals who have positive results of tuberculin skin tests. Controlling exposure to secondhand cigarette smoke in children is important to reduce the risks of meningococcal disease and otitis media, and in adults to reduce the risk of influenza and meningococcal disease. Other recommendations include pneumococcal and influenza vaccine in all smokers and acyclovir treatment for varicella in smokers.

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The natural history of human papillomavirus infection as measured by repeated DNA testing in adolescent and young women

Cited by 488 publications

References 20 publications

Natural history and screening model for high‐risk human papillomavirus infection, neoplasia and cervical cancer in the Netherlands

Natural history and screening model for high‐risk human papillomavirus infection, neoplasia and cervical cancer in the Netherlands

Human papillomavirus genotyping and p16INK4a expression in cervical intraepithelial neoplasia of adolescents

Cigarette Smoking and Infection

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