Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia

Nicolas F. Schlecht, Robert W. Platt, Eliane Duarte-Franco, Maria C. Costa, Jaão P. Sobrinho, José C M Prado, Alex Ferenczy, Thomas E. Rohan, Luisa L. Villa, Eduardo L. Franco

Research output: Contribution to journalArticle

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Abstract

Background: Little is known about the duration of precancerous cervical lesions in relation to human papillomavirus (HPV) infection. We estimated rates of progression and regression and sojourn times of cervical squamous intraepithelial lesions (SILs) according to HPV status. Methods: We used data from a longitudinal study of HPV infection and cervical neoplasia in São Paulo, Brazil. Cervical specimens were taken from 2404 women for Pap cytology and polymerase chain reaction-based HPV testing every 4-6 months over a period of 8 years. We used actuarial and non-actuarial analyses to measure time to and rates of lesion progression and regression according to status and type of HPV infection. Results: During follow-up, 118 low-grade SIL (LSIL), 24 high-grade SIL (HSIL), and 173 atypical squamous cells of undetermined significance (ASCUS) events were detected. Mean time to progression from ASCUS to LSIL or worse and from LSIL to HSIL or worse was shorter in women with oncogenic HPV types than in women with no HPV infection (mean times for ASCUS progression were 67.0 and 88.0 months, respectively, in women with oncogenic HPV and no HPV, difference = 21.0 months, 95% confidence interval [CI] = 11.3 to 30.7 months; mean times for LSIL progression were 73.3 and 83.5 months, respectively, difference = 10.2 months, 95% CI = -0.15 to 20.6 months). Half of the LSILs regressed to normal or ASCUS within 6 months. Mean times for regression from ASCUS to normal, from LSIL to ASCUS or normal, and from HSIL/cervical intraepithelial neoplasia 2 to ASCUS or normal were longer for women with oncogenic HPV types (16.8 months, 95% CI = 7.5 to 26.2 months; 13.8 months, 95% CI = 8.8 to 18.7 months; and 17.1 months, 95% CI = 4.1 to 30.1 months, respectively) than for women with non-oncogenic HPV types (7.7 months, 95% CI = 5.2 to 10.2 months; 7.8 months, 95% CI = 5.3 to 10.2 months; 8.9 months, 95% CI = 3.3 to 14.6 months) or for women with no HPV infection (7.6 months, 95% CI = 6.9 to 8.4 months; 7.6 months, 95% CI = 6.4 to 8.7 months; and 7.0 months, 95% CI = 5.0 to 8.9 months, respectively). Conclusion: Precursor lesions of the cervix persist longer and progress more quickly in women with oncogenic HPV infections than in women with non-oncogenic infections or without HPV. Testing cervical lesions for oncogenic HPVs may help identify those that are likely to progress rapidly.

Original languageEnglish (US)
Pages (from-to)1336-1343
Number of pages8
JournalJournal of the National Cancer Institute
Volume95
Issue number17
StatePublished - Sep 3 2003

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Cervical Intraepithelial Neoplasia
Papillomavirus Infections
Confidence Intervals
Atypical Squamous Cells of the Cervix
Cervix Uteri
Brazil
Longitudinal Studies
Cell Biology

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Schlecht, N. F., Platt, R. W., Duarte-Franco, E., Costa, M. C., Sobrinho, J. P., Prado, J. C. M., ... Franco, E. L. (2003). Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia. Journal of the National Cancer Institute, 95(17), 1336-1343.

Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia. / Schlecht, Nicolas F.; Platt, Robert W.; Duarte-Franco, Eliane; Costa, Maria C.; Sobrinho, Jaão P.; Prado, José C M; Ferenczy, Alex; Rohan, Thomas E.; Villa, Luisa L.; Franco, Eduardo L.

In: Journal of the National Cancer Institute, Vol. 95, No. 17, 03.09.2003, p. 1336-1343.

Research output: Contribution to journalArticle

Schlecht, NF, Platt, RW, Duarte-Franco, E, Costa, MC, Sobrinho, JP, Prado, JCM, Ferenczy, A, Rohan, TE, Villa, LL & Franco, EL 2003, 'Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia', Journal of the National Cancer Institute, vol. 95, no. 17, pp. 1336-1343.
Schlecht NF, Platt RW, Duarte-Franco E, Costa MC, Sobrinho JP, Prado JCM et al. Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia. Journal of the National Cancer Institute. 2003 Sep 3;95(17):1336-1343.
Schlecht, Nicolas F. ; Platt, Robert W. ; Duarte-Franco, Eliane ; Costa, Maria C. ; Sobrinho, Jaão P. ; Prado, José C M ; Ferenczy, Alex ; Rohan, Thomas E. ; Villa, Luisa L. ; Franco, Eduardo L. / Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia. In: Journal of the National Cancer Institute. 2003 ; Vol. 95, No. 17. pp. 1336-1343.
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abstract = "Background: Little is known about the duration of precancerous cervical lesions in relation to human papillomavirus (HPV) infection. We estimated rates of progression and regression and sojourn times of cervical squamous intraepithelial lesions (SILs) according to HPV status. Methods: We used data from a longitudinal study of HPV infection and cervical neoplasia in S{\~a}o Paulo, Brazil. Cervical specimens were taken from 2404 women for Pap cytology and polymerase chain reaction-based HPV testing every 4-6 months over a period of 8 years. We used actuarial and non-actuarial analyses to measure time to and rates of lesion progression and regression according to status and type of HPV infection. Results: During follow-up, 118 low-grade SIL (LSIL), 24 high-grade SIL (HSIL), and 173 atypical squamous cells of undetermined significance (ASCUS) events were detected. Mean time to progression from ASCUS to LSIL or worse and from LSIL to HSIL or worse was shorter in women with oncogenic HPV types than in women with no HPV infection (mean times for ASCUS progression were 67.0 and 88.0 months, respectively, in women with oncogenic HPV and no HPV, difference = 21.0 months, 95{\%} confidence interval [CI] = 11.3 to 30.7 months; mean times for LSIL progression were 73.3 and 83.5 months, respectively, difference = 10.2 months, 95{\%} CI = -0.15 to 20.6 months). Half of the LSILs regressed to normal or ASCUS within 6 months. Mean times for regression from ASCUS to normal, from LSIL to ASCUS or normal, and from HSIL/cervical intraepithelial neoplasia 2 to ASCUS or normal were longer for women with oncogenic HPV types (16.8 months, 95{\%} CI = 7.5 to 26.2 months; 13.8 months, 95{\%} CI = 8.8 to 18.7 months; and 17.1 months, 95{\%} CI = 4.1 to 30.1 months, respectively) than for women with non-oncogenic HPV types (7.7 months, 95{\%} CI = 5.2 to 10.2 months; 7.8 months, 95{\%} CI = 5.3 to 10.2 months; 8.9 months, 95{\%} CI = 3.3 to 14.6 months) or for women with no HPV infection (7.6 months, 95{\%} CI = 6.9 to 8.4 months; 7.6 months, 95{\%} CI = 6.4 to 8.7 months; and 7.0 months, 95{\%} CI = 5.0 to 8.9 months, respectively). Conclusion: Precursor lesions of the cervix persist longer and progress more quickly in women with oncogenic HPV infections than in women with non-oncogenic infections or without HPV. Testing cervical lesions for oncogenic HPVs may help identify those that are likely to progress rapidly.",
author = "Schlecht, {Nicolas F.} and Platt, {Robert W.} and Eliane Duarte-Franco and Costa, {Maria C.} and Sobrinho, {Ja{\~a}o P.} and Prado, {Jos{\'e} C M} and Alex Ferenczy and Rohan, {Thomas E.} and Villa, {Luisa L.} and Franco, {Eduardo L.}",
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TY - JOUR

T1 - Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia

AU - Schlecht, Nicolas F.

AU - Platt, Robert W.

AU - Duarte-Franco, Eliane

AU - Costa, Maria C.

AU - Sobrinho, Jaão P.

AU - Prado, José C M

AU - Ferenczy, Alex

AU - Rohan, Thomas E.

AU - Villa, Luisa L.

AU - Franco, Eduardo L.

PY - 2003/9/3

Y1 - 2003/9/3

N2 - Background: Little is known about the duration of precancerous cervical lesions in relation to human papillomavirus (HPV) infection. We estimated rates of progression and regression and sojourn times of cervical squamous intraepithelial lesions (SILs) according to HPV status. Methods: We used data from a longitudinal study of HPV infection and cervical neoplasia in São Paulo, Brazil. Cervical specimens were taken from 2404 women for Pap cytology and polymerase chain reaction-based HPV testing every 4-6 months over a period of 8 years. We used actuarial and non-actuarial analyses to measure time to and rates of lesion progression and regression according to status and type of HPV infection. Results: During follow-up, 118 low-grade SIL (LSIL), 24 high-grade SIL (HSIL), and 173 atypical squamous cells of undetermined significance (ASCUS) events were detected. Mean time to progression from ASCUS to LSIL or worse and from LSIL to HSIL or worse was shorter in women with oncogenic HPV types than in women with no HPV infection (mean times for ASCUS progression were 67.0 and 88.0 months, respectively, in women with oncogenic HPV and no HPV, difference = 21.0 months, 95% confidence interval [CI] = 11.3 to 30.7 months; mean times for LSIL progression were 73.3 and 83.5 months, respectively, difference = 10.2 months, 95% CI = -0.15 to 20.6 months). Half of the LSILs regressed to normal or ASCUS within 6 months. Mean times for regression from ASCUS to normal, from LSIL to ASCUS or normal, and from HSIL/cervical intraepithelial neoplasia 2 to ASCUS or normal were longer for women with oncogenic HPV types (16.8 months, 95% CI = 7.5 to 26.2 months; 13.8 months, 95% CI = 8.8 to 18.7 months; and 17.1 months, 95% CI = 4.1 to 30.1 months, respectively) than for women with non-oncogenic HPV types (7.7 months, 95% CI = 5.2 to 10.2 months; 7.8 months, 95% CI = 5.3 to 10.2 months; 8.9 months, 95% CI = 3.3 to 14.6 months) or for women with no HPV infection (7.6 months, 95% CI = 6.9 to 8.4 months; 7.6 months, 95% CI = 6.4 to 8.7 months; and 7.0 months, 95% CI = 5.0 to 8.9 months, respectively). Conclusion: Precursor lesions of the cervix persist longer and progress more quickly in women with oncogenic HPV infections than in women with non-oncogenic infections or without HPV. Testing cervical lesions for oncogenic HPVs may help identify those that are likely to progress rapidly.

AB - Background: Little is known about the duration of precancerous cervical lesions in relation to human papillomavirus (HPV) infection. We estimated rates of progression and regression and sojourn times of cervical squamous intraepithelial lesions (SILs) according to HPV status. Methods: We used data from a longitudinal study of HPV infection and cervical neoplasia in São Paulo, Brazil. Cervical specimens were taken from 2404 women for Pap cytology and polymerase chain reaction-based HPV testing every 4-6 months over a period of 8 years. We used actuarial and non-actuarial analyses to measure time to and rates of lesion progression and regression according to status and type of HPV infection. Results: During follow-up, 118 low-grade SIL (LSIL), 24 high-grade SIL (HSIL), and 173 atypical squamous cells of undetermined significance (ASCUS) events were detected. Mean time to progression from ASCUS to LSIL or worse and from LSIL to HSIL or worse was shorter in women with oncogenic HPV types than in women with no HPV infection (mean times for ASCUS progression were 67.0 and 88.0 months, respectively, in women with oncogenic HPV and no HPV, difference = 21.0 months, 95% confidence interval [CI] = 11.3 to 30.7 months; mean times for LSIL progression were 73.3 and 83.5 months, respectively, difference = 10.2 months, 95% CI = -0.15 to 20.6 months). Half of the LSILs regressed to normal or ASCUS within 6 months. Mean times for regression from ASCUS to normal, from LSIL to ASCUS or normal, and from HSIL/cervical intraepithelial neoplasia 2 to ASCUS or normal were longer for women with oncogenic HPV types (16.8 months, 95% CI = 7.5 to 26.2 months; 13.8 months, 95% CI = 8.8 to 18.7 months; and 17.1 months, 95% CI = 4.1 to 30.1 months, respectively) than for women with non-oncogenic HPV types (7.7 months, 95% CI = 5.2 to 10.2 months; 7.8 months, 95% CI = 5.3 to 10.2 months; 8.9 months, 95% CI = 3.3 to 14.6 months) or for women with no HPV infection (7.6 months, 95% CI = 6.9 to 8.4 months; 7.6 months, 95% CI = 6.4 to 8.7 months; and 7.0 months, 95% CI = 5.0 to 8.9 months, respectively). Conclusion: Precursor lesions of the cervix persist longer and progress more quickly in women with oncogenic HPV infections than in women with non-oncogenic infections or without HPV. Testing cervical lesions for oncogenic HPVs may help identify those that are likely to progress rapidly.

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