Sexual behaviour and smoking as determinants of cervical HPV infection and of CIN3 among those infected: a case-control study nested within the Manchester cohort.
Sexual behaviour and smoking as determinants of cervical HPV infection and of CIN3 among those infected: a case-control study nested within the Manchester cohort.
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DOI：
10.1054/bjoc.2000.1523
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发表时间：
2000-12
影响因子：
8.8
通讯作者：
中科院分区：
文献类型：
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为了区分获得宫颈人乳头瘤病毒（HPV）感染的危险因素与感染个体中肿瘤形成的决定因素，我们在一个大的以人群为基础的女性队列（曼彻斯特队列）中进行了一项三臂病例对照研究，该队列在入组时使用L1共识引物PCR筛查HPV。该研究包括181例HPV阳性对照，在随访期间未发生高度宫颈上皮内瘤变（CIN 3），203例HPV阴性对照和199例HPV阳性病例，组织学证实为CIN 3。在面对面访谈中获得了关于性、生殖和妇科史、口服避孕药使用和吸烟的详细信息。在感染的危险因素和疾病的预测因素之间有着明显的区别。比较HPV阳性和阴性对照组，感染的唯一危险因素是性伴侣的数量（六个或更多的OR = 3.89; 95%CI = 1.99-7.62），相对较新的性关系（过去2年内有新伴侣的OR = 4.17; 95%CI = 2.13-8.33），以及既往流产史（OR = 2.59; 95%CI = 1.28-5.21）。相反，感染妇女中CIN 3的决定因素是第一次性交的年龄较早（16岁或以下的OR = 3.23; 95%CI = 1.33-7.69），开始新的性关系的时间较长（6年或6年以上OR = 4.94; 95%CI = 2.51-9.71）和吸烟，有强有力的剂量反应证据（目前吸烟习惯20+/天的OR = 2.57; 95%CI = 1.49-4.45）。口服避孕药的使用与HPV感染或CIN 3无显著相关性。© 2000年癌症研究运动http://www.bjcancer.com
To distinguish risk factors for acquisition of cervical human papillomavirus (HPV) infection from the determinants of neoplasia among infected individuals we have conducted a three-arm case-control study nested within a large population-based cohort of women (the Manchester cohort) screened for HPV at entry using L1 consensus primer PCR. The study includes 181 HPV-positive controls who did not develop high-grade cervical intraepithelial neoplasia (CIN3) during follow-up, 203 HPV-negative controls, and 199 HPV-positive cases with histologically confirmed CIN3. Detailed information on sexual, reproductive and gynaecological history, oral contraceptive use and smoking was obtained at face-to-face interview. There was a striking division between risk factors for infection and those predictive of disease. Comparing the HPV-positive against the HPV-negative controls, the only risk factors for infection were number of sexual partners (OR for six or more = 3.89; 95% Cl = 1.99–7.62), a relatively recent new sexual relationship (OR for a new partner within the previous 2 years = 4.17; 95% Cl = 2.13–8.33), and a history of previous miscarriage (OR = 2.59; 95% Cl = 1.28–5.21). The determinants of CIN3 among infected women were, in contrast, early age at first intercourse (OR for 16 years old or less = 3.23; 95% Cl = 1.33–7.69), a long time since starting a new sexual relationship (OR for 6 years or more = 4.94; 95% Cl = 2.51–9.71), and cigarette smoking, with strong evidence for a dose– response (OR for current smoking habit 20+ per day = 2.57; 95% Cl = 1.49–4.45). Oral contraceptive use was not significantly associated with either HPV infection or CIN3. © 2000 Cancer Research Campaign http://www.bjcancer.com