An association of cervical inflammation with high-grade cervical neoplasia in women infected with oncogenic human papillomavirus (HPV)

P. E. Castle, S. L. Hillier, L. K. Rabe, A. Hildesheim, R. Herrero, M. C. Bratti, Mark E. Sherman, R. D. Burk, A. C. Rodriguez, M. Alfaro, M. L. Hutchinson, J. Morales, M. Schiffman, P. E. Castle, S. L. Hillier, L. K. Rabe, A. Hildesheim, R. Herrero, M. C. Bratti, M. E. Sherman & 73 others R. D. Burk, A. C. Rodriguez, M. Alfaro, M. L. Hutchinson, J. Morales, M. Schiffman, P. E. Castle, S. L. Hillier, L. K. Rabe, A. Hildesheim, R. Herrero, M. C. Bratti, M. E. Sherman, R. D. Burk, A. C. Rodriguez, M. Alfaro, M. L. Hutchinson, J. Morales, M. Schiffman, P. E. Castle, S. L. Hillier, L. K. Rabe, A. Hildesheim, R. Herrero, M. C. Bratti, M. E. Sherman, R. D. Burk, A. C. Rodriguez, M. Alfaro, M. L. Hutchinson, J. Morales, M. Schiffman, P. E. Castle, S. L. Hillier, L. K. Rabe, A. Hildesheim, R. Herrero, M. C. Bratti, M. E. Sherman, R. D. Burk, A. C. Rodriguez, M. Alfaro, M. L. Hutchinson, J. Morales, M. Schiffman, P. E. Castle, S. L. Hillier, L. K. Rabe, A. Hildesheim, R. Herrero, M. C. Bratti, M. E. Sherman, R. D. Burk, A. C. Rodriguez, M. Alfaro, M. L. Hutchinson, J. Morales, M. Schiffman, P. E. Castle, S. L. Hillier, L. K. Rabe, A. Hildesheim, R. Herrero, M. C. Bratti, M. E. Sherman, R. D. Burk, A. C. Rodriguez, M. Alfaro, M. L. Hutchinson, J. Morales, M. Schiffman, P. E. Castle, P. E. Castle

Research output: Contribution to journalArticle

172 Citations (Scopus)

Abstract

Previous reports of genital conditions, such as nonspecific genital infection/sore or vaginal discharge associated with cervical cancer (L. A. Brinton et al., J. Natl. Cancer Inst. (Bethesda), 79: 23-30, 1987; C. J. Jones et al., Cancer Res., 50: 3657-3662, 1990), suggest a possible link between either genital tract inflammation or changes in bacteria flora consistent with bacterial vaginosis (BV) and cervical cancer. To test whether changes in vaginal bacterial flora or the degree of cervical inflammation are associated with women having a human papillomavirus (HPV) infection or with women infected with oncogenic HPV having high-grade cervical lesions (high-grade squamous intraepithelial lesions or cancer), we conducted a case-control study of women < 50 years old enrolled in the Costa Rican natural history study of HPV and cervical neoplasia. To test whether BV and inflammation were associated with HPV DNA positivity, Analysis 1 was restricted to women with no or mild (low-grade or equivocal) cytological abnormalities, and the degree of inflammation and Nugent score (a measure of BV) were compared between women infected (n = 220) and not infected (n = 130) with HPV. To test whether BV and inflammation were associated with high-grade lesions, Analysis 2 was restricted to women infected with oncogenic HPV, and the degree of inflammation and Nugent score were compared between women with (n = 95) and without (n = 158) high-grade cervical lesions. In Analysis 1, BV and cervical inflammation were not associated with HPV infection. In Analysis 2, BV was not associated with high-grade lesions. However, we found a marginally significant positive trend of increasing cervical inflammation associated with high-grade lesions in oncogenic HPV-infected women, (Ptrend = 0.05). Overt cervicitis was associated with a 1.9-fold increase in risk of high-grade lesions (95% confidence interval, 0.90-4.1). The results of this study suggest that cervical inflammation may be associated with high-grade lesions and may be a cofactor for high-grade cervical lesions in women infected with oncogenic HPV.

Original languageEnglish (US)
Pages (from-to)1021-1027
Number of pages7
JournalCancer Epidemiology Biomarkers and Prevention
Volume10
Issue number10
StatePublished - 2001

Fingerprint

Bacterial Vaginosis
Inflammation
Neoplasms
Papillomavirus Infections
Uterine Cervical Neoplasms
Uterine Cervicitis
Vaginal Discharge
Natural History
Case-Control Studies
Confidence Intervals
Bacteria
DNA
Infection

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Castle, P. E., Hillier, S. L., Rabe, L. K., Hildesheim, A., Herrero, R., Bratti, M. C., ... Castle, P. E. (2001). An association of cervical inflammation with high-grade cervical neoplasia in women infected with oncogenic human papillomavirus (HPV). Cancer Epidemiology Biomarkers and Prevention, 10(10), 1021-1027.

An association of cervical inflammation with high-grade cervical neoplasia in women infected with oncogenic human papillomavirus (HPV). / Castle, P. E.; Hillier, S. L.; Rabe, L. K.; Hildesheim, A.; Herrero, R.; Bratti, M. C.; Sherman, Mark E.; Burk, R. D.; Rodriguez, A. C.; Alfaro, M.; Hutchinson, M. L.; Morales, J.; Schiffman, M.; Castle, P. E.; Hillier, S. L.; Rabe, L. K.; Hildesheim, A.; Herrero, R.; Bratti, M. C.; Sherman, M. E.; Burk, R. D.; Rodriguez, A. C.; Alfaro, M.; Hutchinson, M. L.; Morales, J.; Schiffman, M.; Castle, P. E.; Hillier, S. L.; Rabe, L. K.; Hildesheim, A.; Herrero, R.; Bratti, M. C.; Sherman, M. E.; Burk, R. D.; Rodriguez, A. C.; Alfaro, M.; Hutchinson, M. L.; Morales, J.; Schiffman, M.; Castle, P. E.; Hillier, S. L.; Rabe, L. K.; Hildesheim, A.; Herrero, R.; Bratti, M. C.; Sherman, M. E.; Burk, R. D.; Rodriguez, A. C.; Alfaro, M.; Hutchinson, M. L.; Morales, J.; Schiffman, M.; Castle, P. E.; Hillier, S. L.; Rabe, L. K.; Hildesheim, A.; Herrero, R.; Bratti, M. C.; Sherman, M. E.; Burk, R. D.; Rodriguez, A. C.; Alfaro, M.; Hutchinson, M. L.; Morales, J.; Schiffman, M.; Castle, P. E.; Hillier, S. L.; Rabe, L. K.; Hildesheim, A.; Herrero, R.; Bratti, M. C.; Sherman, M. E.; Burk, R. D.; Rodriguez, A. C.; Alfaro, M.; Hutchinson, M. L.; Morales, J.; Schiffman, M.; Castle, P. E.; Hillier, S. L.; Rabe, L. K.; Hildesheim, A.; Herrero, R.; Bratti, M. C.; Sherman, M. E.; Burk, R. D.; Rodriguez, A. C.; Alfaro, M.; Hutchinson, M. L.; Morales, J.; Schiffman, M.; Castle, P. E.; Castle, P. E.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 10, No. 10, 2001, p. 1021-1027.

Research output: Contribution to journalArticle

Castle, PE, Hillier, SL, Rabe, LK, Hildesheim, A, Herrero, R, Bratti, MC, Sherman, ME, Burk, RD, Rodriguez, AC, Alfaro, M, Hutchinson, ML, Morales, J, Schiffman, M, Castle, PE, Hillier, SL, Rabe, LK, Hildesheim, A, Herrero, R, Bratti, MC, Sherman, ME, Burk, RD, Rodriguez, AC, Alfaro, M, Hutchinson, ML, Morales, J, Schiffman, M, Castle, PE, Hillier, SL, Rabe, LK, Hildesheim, A, Herrero, R, Bratti, MC, Sherman, ME, Burk, RD, Rodriguez, AC, Alfaro, M, Hutchinson, ML, Morales, J, Schiffman, M, Castle, PE, Hillier, SL, Rabe, LK, Hildesheim, A, Herrero, R, Bratti, MC, Sherman, ME, Burk, RD, Rodriguez, AC, Alfaro, M, Hutchinson, ML, Morales, J, Schiffman, M, Castle, PE, Hillier, SL, Rabe, LK, Hildesheim, A, Herrero, R, Bratti, MC, Sherman, ME, Burk, RD, Rodriguez, AC, Alfaro, M, Hutchinson, ML, Morales, J, Schiffman, M, Castle, PE, Hillier, SL, Rabe, LK, Hildesheim, A, Herrero, R, Bratti, MC, Sherman, ME, Burk, RD, Rodriguez, AC, Alfaro, M, Hutchinson, ML, Morales, J, Schiffman, M, Castle, PE, Hillier, SL, Rabe, LK, Hildesheim, A, Herrero, R, Bratti, MC, Sherman, ME, Burk, RD, Rodriguez, AC, Alfaro, M, Hutchinson, ML, Morales, J, Schiffman, M, Castle, PE & Castle, PE 2001, 'An association of cervical inflammation with high-grade cervical neoplasia in women infected with oncogenic human papillomavirus (HPV)', Cancer Epidemiology Biomarkers and Prevention, vol. 10, no. 10, pp. 1021-1027.
Castle, P. E. ; Hillier, S. L. ; Rabe, L. K. ; Hildesheim, A. ; Herrero, R. ; Bratti, M. C. ; Sherman, Mark E. ; Burk, R. D. ; Rodriguez, A. C. ; Alfaro, M. ; Hutchinson, M. L. ; Morales, J. ; Schiffman, M. ; Castle, P. E. ; Hillier, S. L. ; Rabe, L. K. ; Hildesheim, A. ; Herrero, R. ; Bratti, M. C. ; Sherman, M. E. ; Burk, R. D. ; Rodriguez, A. C. ; Alfaro, M. ; Hutchinson, M. L. ; Morales, J. ; Schiffman, M. ; Castle, P. E. ; Hillier, S. L. ; Rabe, L. K. ; Hildesheim, A. ; Herrero, R. ; Bratti, M. C. ; Sherman, M. E. ; Burk, R. D. ; Rodriguez, A. C. ; Alfaro, M. ; Hutchinson, M. L. ; Morales, J. ; Schiffman, M. ; Castle, P. E. ; Hillier, S. L. ; Rabe, L. K. ; Hildesheim, A. ; Herrero, R. ; Bratti, M. C. ; Sherman, M. E. ; Burk, R. D. ; Rodriguez, A. C. ; Alfaro, M. ; Hutchinson, M. L. ; Morales, J. ; Schiffman, M. ; Castle, P. E. ; Hillier, S. L. ; Rabe, L. K. ; Hildesheim, A. ; Herrero, R. ; Bratti, M. C. ; Sherman, M. E. ; Burk, R. D. ; Rodriguez, A. C. ; Alfaro, M. ; Hutchinson, M. L. ; Morales, J. ; Schiffman, M. ; Castle, P. E. ; Hillier, S. L. ; Rabe, L. K. ; Hildesheim, A. ; Herrero, R. ; Bratti, M. C. ; Sherman, M. E. ; Burk, R. D. ; Rodriguez, A. C. ; Alfaro, M. ; Hutchinson, M. L. ; Morales, J. ; Schiffman, M. ; Castle, P. E. ; Hillier, S. L. ; Rabe, L. K. ; Hildesheim, A. ; Herrero, R. ; Bratti, M. C. ; Sherman, M. E. ; Burk, R. D. ; Rodriguez, A. C. ; Alfaro, M. ; Hutchinson, M. L. ; Morales, J. ; Schiffman, M. ; Castle, P. E. ; Castle, P. E. / An association of cervical inflammation with high-grade cervical neoplasia in women infected with oncogenic human papillomavirus (HPV). In: Cancer Epidemiology Biomarkers and Prevention. 2001 ; Vol. 10, No. 10. pp. 1021-1027.
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TY - JOUR

T1 - An association of cervical inflammation with high-grade cervical neoplasia in women infected with oncogenic human papillomavirus (HPV)

AU - Castle, P. E.

AU - Hillier, S. L.

AU - Rabe, L. K.

AU - Hildesheim, A.

AU - Herrero, R.

AU - Bratti, M. C.

AU - Sherman, Mark E.

AU - Burk, R. D.

AU - Rodriguez, A. C.

AU - Alfaro, M.

AU - Hutchinson, M. L.

AU - Morales, J.

AU - Schiffman, M.

AU - Castle, P. E.

AU - Hillier, S. L.

AU - Rabe, L. K.

AU - Hildesheim, A.

AU - Herrero, R.

AU - Bratti, M. C.

AU - Sherman, M. E.

AU - Burk, R. D.

AU - Rodriguez, A. C.

AU - Alfaro, M.

AU - Hutchinson, M. L.

AU - Morales, J.

AU - Schiffman, M.

AU - Castle, P. E.

AU - Hillier, S. L.

AU - Rabe, L. K.

AU - Hildesheim, A.

AU - Herrero, R.

AU - Bratti, M. C.

AU - Sherman, M. E.

AU - Burk, R. D.

AU - Rodriguez, A. C.

AU - Alfaro, M.

AU - Hutchinson, M. L.

AU - Morales, J.

AU - Schiffman, M.

AU - Castle, P. E.

AU - Hillier, S. L.

AU - Rabe, L. K.

AU - Hildesheim, A.

AU - Herrero, R.

AU - Bratti, M. C.

AU - Sherman, M. E.

AU - Burk, R. D.

AU - Rodriguez, A. C.

AU - Alfaro, M.

AU - Hutchinson, M. L.

AU - Morales, J.

AU - Schiffman, M.

AU - Castle, P. E.

AU - Hillier, S. L.

AU - Rabe, L. K.

AU - Hildesheim, A.

AU - Herrero, R.

AU - Bratti, M. C.

AU - Sherman, M. E.

AU - Burk, R. D.

AU - Rodriguez, A. C.

AU - Alfaro, M.

AU - Hutchinson, M. L.

AU - Morales, J.

AU - Schiffman, M.

AU - Castle, P. E.

AU - Hillier, S. L.

AU - Rabe, L. K.

AU - Hildesheim, A.

AU - Herrero, R.

AU - Bratti, M. C.

AU - Sherman, M. E.

AU - Burk, R. D.

AU - Rodriguez, A. C.

AU - Alfaro, M.

AU - Hutchinson, M. L.

AU - Morales, J.

AU - Schiffman, M.

AU - Castle, P. E.

AU - Hillier, S. L.

AU - Rabe, L. K.

AU - Hildesheim, A.

AU - Herrero, R.

AU - Bratti, M. C.

AU - Sherman, M. E.

AU - Burk, R. D.

AU - Rodriguez, A. C.

AU - Alfaro, M.

AU - Hutchinson, M. L.

AU - Morales, J.

AU - Schiffman, M.

AU - Castle, P. E.

AU - Castle, P. E.

PY - 2001

Y1 - 2001

N2 - Previous reports of genital conditions, such as nonspecific genital infection/sore or vaginal discharge associated with cervical cancer (L. A. Brinton et al., J. Natl. Cancer Inst. (Bethesda), 79: 23-30, 1987; C. J. Jones et al., Cancer Res., 50: 3657-3662, 1990), suggest a possible link between either genital tract inflammation or changes in bacteria flora consistent with bacterial vaginosis (BV) and cervical cancer. To test whether changes in vaginal bacterial flora or the degree of cervical inflammation are associated with women having a human papillomavirus (HPV) infection or with women infected with oncogenic HPV having high-grade cervical lesions (high-grade squamous intraepithelial lesions or cancer), we conducted a case-control study of women < 50 years old enrolled in the Costa Rican natural history study of HPV and cervical neoplasia. To test whether BV and inflammation were associated with HPV DNA positivity, Analysis 1 was restricted to women with no or mild (low-grade or equivocal) cytological abnormalities, and the degree of inflammation and Nugent score (a measure of BV) were compared between women infected (n = 220) and not infected (n = 130) with HPV. To test whether BV and inflammation were associated with high-grade lesions, Analysis 2 was restricted to women infected with oncogenic HPV, and the degree of inflammation and Nugent score were compared between women with (n = 95) and without (n = 158) high-grade cervical lesions. In Analysis 1, BV and cervical inflammation were not associated with HPV infection. In Analysis 2, BV was not associated with high-grade lesions. However, we found a marginally significant positive trend of increasing cervical inflammation associated with high-grade lesions in oncogenic HPV-infected women, (Ptrend = 0.05). Overt cervicitis was associated with a 1.9-fold increase in risk of high-grade lesions (95% confidence interval, 0.90-4.1). The results of this study suggest that cervical inflammation may be associated with high-grade lesions and may be a cofactor for high-grade cervical lesions in women infected with oncogenic HPV.

AB - Previous reports of genital conditions, such as nonspecific genital infection/sore or vaginal discharge associated with cervical cancer (L. A. Brinton et al., J. Natl. Cancer Inst. (Bethesda), 79: 23-30, 1987; C. J. Jones et al., Cancer Res., 50: 3657-3662, 1990), suggest a possible link between either genital tract inflammation or changes in bacteria flora consistent with bacterial vaginosis (BV) and cervical cancer. To test whether changes in vaginal bacterial flora or the degree of cervical inflammation are associated with women having a human papillomavirus (HPV) infection or with women infected with oncogenic HPV having high-grade cervical lesions (high-grade squamous intraepithelial lesions or cancer), we conducted a case-control study of women < 50 years old enrolled in the Costa Rican natural history study of HPV and cervical neoplasia. To test whether BV and inflammation were associated with HPV DNA positivity, Analysis 1 was restricted to women with no or mild (low-grade or equivocal) cytological abnormalities, and the degree of inflammation and Nugent score (a measure of BV) were compared between women infected (n = 220) and not infected (n = 130) with HPV. To test whether BV and inflammation were associated with high-grade lesions, Analysis 2 was restricted to women infected with oncogenic HPV, and the degree of inflammation and Nugent score were compared between women with (n = 95) and without (n = 158) high-grade cervical lesions. In Analysis 1, BV and cervical inflammation were not associated with HPV infection. In Analysis 2, BV was not associated with high-grade lesions. However, we found a marginally significant positive trend of increasing cervical inflammation associated with high-grade lesions in oncogenic HPV-infected women, (Ptrend = 0.05). Overt cervicitis was associated with a 1.9-fold increase in risk of high-grade lesions (95% confidence interval, 0.90-4.1). The results of this study suggest that cervical inflammation may be associated with high-grade lesions and may be a cofactor for high-grade cervical lesions in women infected with oncogenic HPV.

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M3 - Article

VL - 10

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JF - Cancer Epidemiology Biomarkers and Prevention

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