HPV tied to cervical cancer risk regardless of cell abnormalities

  • Fröberg M, et al
  • Cancer
  • 10 Dec 2018

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Presence of HPV-16/18 with baseline negative intraepithelial lesions or malignancy (NILM) indicates significantly elevated future risk for high-grade cervical intraepithelial neoplasia grade 2 (CIN2+) or higher, especially in women
  • Increased risk seen with all subtypes in women >30 years.

Why this matters

  • Consider risk stratification genotyping for HPV-16/18 in women

Key results

  • 96 cases, 480 controls (5/case).
  • 45.8% (n=44) cases diagnosed with CIN2; 54.2% (n=52) developed CIN3 or higher.
  • Women
  • In women >30 years, both baseline positive HPV-16/18 (OR, 8.16; 95% CI, 3.28-20.3) and other HPV types (OR, 9.04; 95% CI, 3.42-23.9) significantly increased future CIN2+ risk. Corresponding future CIN3+ risk: HPV-16/18 (OR, 17.8; 95% CI, 3.84-82.9), other HPV (OR, 7.12; 95% CI, 2.05-24.8).

Study design

  • Nested, case-control study examining association of negative NILM and CIN2+ development 9 years later.
  • Funding: Swedish Cancer Foundation, others.

Limitations

  • False negatives.
  • HPV follow-up data lacking.
  • Controls CIN status inferred.

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