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Factors associated with the risk of progression to precursor lesions or cervical cancer in women with negative cytologic findings
Author(s) -
Girianelli Vania Reis,
Azevedo e Silva Gulnar,
Thuler Luiz Claudio Santos
Publication year - 2009
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2009.07.036
Subject(s) - medicine , cervical intraepithelial neoplasia , cervical cancer , confidence interval , cohort , proportional hazards model , gynecology , cytology , obstetrics , sexual intercourse , parity (physics) , cohort study , cancer , population , pathology , environmental health , physics , particle physics
Objective To evaluate factors associated with progression to cervical cancer or moderate to severe precursor lesions (cervical intraepithelial neoplasia grade 2 [CIN 2] or higher) in women with negative cervical screening results. Method A cohort of 1236 women from the state of Rio de Janeiro, Brazil, was followed up for 36 months. Hazards ratios (HR) and related 95% confidence intervals (CIs) were calculated, and the Cox proportional hazards model was used to evaluate factors associated with the development of lesions grade CIN 2 or higher. Results After adjusting for age, education level, number of sexual partners, and parity, the presence of CIN 2 or more advanced lesions was associated with HPV infection (HR, 39.0; 95% CI, 9.8–156.0), smoking (HR, 7.7; 95% CI, 2.0–29.6), and early age at first sexual intercourse (HR, 4.1; 95% CI, 1.1–15.1). Conclusion These findings suggest that women at increased risk for cervical cancer be screened for HPV at the time of cervical screening, particularly in areas where access to health services is difficult. Antismoking strategies especially targeting young women should be a priority in a comprehensive women's health care program.