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document
Human papillomavirus genotypes in cervical intraepithelial neoplasia grade 3 . BACKGROUND There are few large case series describing the human papillomavirus ( HPV ) genotypes found in women diagnosed with rigorously reviewed cervical intraepithelial neoplasia grade 3 ( CIN3 ) , cervical precancer . METHODS The Atypical Squamous Cells of Undetermined Significance ( ASCUS ) and Low-Grade Squamous Intraepithelial Lesion ( LSIL ) Triage Study ( ALTS ) was a clinical trial to evaluate the best management strategies for women with equivocal ( ASCUS ) or mildly abnormal ( LSIL ) Pap tests . During enrollment and the 2-year follow-up , 608 women had a histopathologic diagnosis of CIN3 and PCR-based HPV genotyping results on cervical specimens . The genotyping results were ranked hierarchically according to cancer risk : HPV16 > other carcinogenic HPV > noncarcinogenic HPV > PCR negative . RESULTS Among the 608 women diagnosed with CIN3 , 601 ( 98.8 % ) cases were positive for any HPV genotype and 95.4 % for any carcinogenic HPV . HPV16 ( 59.9 % ) , HPV31 ( 18.1 % ) , HPV52 ( 14.8 % ) , HPV51 ( 14.0 % ) , and HPV18 ( 13.2 % ) were the five most common HPV genotypes detected . Younger age , consensus histologic confirmation , smoking , and multiparity increased the likelihood of testing HPV 16 positive . Specifically , HPV16-positive CIN3 occurred at a younger age than CIN3 positive for other carcinogenic HPV genotypes ( median of 23.5 years versus 25 years , respectively ; P = 0.0003 , Kruskal-Wallis ) . CONCLUSIONS HPV16-positive CIN3 was more commonly diagnosed in younger women ( versus older women ) , with consensus diagnosis ( versus some disagreement between reviewers ) , and in smokers ( versus nonsmokers ) , and was less commonly diagnosed in multiparous women compared CIN3 positive for other carcinogenic HPV genotypes . IMPACT In populations vaccinated against HPV16 ( and HPV18 ) , the median age of CIN3 in women with ASCUS and LSIL cytology should shift to older ages , possibly permitting later age at first screening .
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Intervention_Physical
PCR-based HPV genotyping results
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Intervention_Physical
HPV16 ( and HPV18 )
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Outcome_Physical
human papillomavirus ( HPV )
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Outcome_Physical
carcinogenic HPV . HPV16
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Outcome_Physical
HPV31
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Outcome_Physical
HPV52
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Outcome_Physical
HPV51
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Outcome_Physical
HPV18
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Outcome_Physical
Younger age , consensus histologic confirmation
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Outcome_Physical
testing HPV 16 positive
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Outcome_Physical
HPV16-positive CIN3
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Outcome_Physical
HPV16-positive CIN3
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Outcome_Physical
CIN3 positive
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Outcome_Physical
carcinogenic HPV genotypes
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Participant_Condition
cervical intraepithelial neoplasia
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Participant_Condition
CIN3
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Participant_Condition
cervical precancer
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Participant_Sex
women
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Participant_Condition
equivocal ( ASCUS ) or mildly abnormal ( LSIL ) Pap tests
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Participant_Sample-size
608
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Participant_Sex
women
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Participant_Sample-size
608
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Participant_Sex
women
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Participant_Condition
CIN3