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Descriptive Evidence That Risk Profiles for Cervical Intraepithelial Neoplasia 1, 2, and 3 Are Unique

¹ Department of Preventive Medicine, Northwestern University, Chicago, Illinois; ² Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; ³ Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina; ⁴ Department of Obstetrics and Gynecology, The Cleveland Clinic Foundation, Cleveland, Ohio; ⁵ Department of Obstetrics and Gynecology, Kaiser Permanente, Fontana, California; ⁶ Department of Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Beijing, China; and ⁷ Institute for Medicine and Public Health, Vanderbilt University, Nashville, Tennessee

Requests for reprints: Suzanne Belinson, Department of Preventive Medicine, Northwestern University, Chicago, IL 60622. Phone: 312-908-9324; Fax: 312-908-9588. E-mail: s-belinson{at}northwestern.edu

Objective: This study aimed to estimate if risk factor profiles for histologically confirmed cervical intraepithelial neoplasia (CIN) 2 lesions differ from those for CIN 1 or 3.

Methods: A total of 2,055 women positive for high-risk human papillomavirus, with a minimum of five cervical biopsies, were enrolled in the Shanxi Province Cervical Cancer Screening Study II. We evaluated risk factor profiles for CIN 2 in comparison with CIN 1 and 3. Polytomous logistic regression was used to generate odds ratios and corresponding 95% confidence intervals and to test for differences in odds ratios across histologic grades.

Results: The risk for CIN 3 associated with three or more pregnancies and sexual intercourse within 4 months of childbirth was higher than that for CIN 2 (P_difference = 0.02 and 0.0007, respectively). Significant differences in the associations of age groups with CIN 1 and 2 were observed, such that there were positive associations with CIN 2 but none for CIN 1. There was no difference in the association of number of sexual partners or reported number of abortions between CIN 1 and 2 or between CIN 3 and 2.

Conclusions: In our study, the patterns of risk factor profiles for CIN 1, 2, and 3 were unique. Conventional grouping of CIN 2 with 3 for analysis of risk factors may need revisiting. (Cancer Epidemiol Biomarkers Prev 2008;17(9):2350–5)