Al. Coker et al., HUMAN PAPILLOMAVIRUSES AND CERVICAL NEOPLASIA IN SOUTH-CAROLINA, Cancer epidemiology, biomarkers & prevention, 2(3), 1993, pp. 207-212
Human Papillomaviruses (HPVs), particularly types 16, 18, and 33, have
recently been suggested as etiological agents for cervical neoplasia.
However, few studies have explored this relationship among low-income
, minority women. This case-control study of cervical intraepithelial
neoplasia (CIN), detected by Pap smear screening among South Carolina
women, investigates the association between HPV positivity and the cyt
ological continuum of CIN. Cervical spatulas and cytobrushes used to c
ollect Pap smears from all women attending health department family pl
anning clinics in three coastal South Carolina counties were saved for
subsequent HPV detection and typing. Among this cohort of approximate
ly 6000 cervical samples collected from March through December 1991, t
hose with CIN, atypia, and other cervical abnormalities and women with
normal cervical cytology were identified. Women with CIN II or III (n
= 28) were 21.9 times more likely to be HPV 16, 18, or 33 positive, w
hile women with CIN I (n = 114) were 11.7 times more likely to be HPV
16/18/33 positive when compared with women having normal cervical cyto
logy (n = 223) and adjusting for potential confounders. Women with aty
pia (n = 115) were 3.0 times more likely to be HPV 16/18/33 positive.
A chi2 test for trend in increasing HPV 16/18/33 prevalence with incre
asing severity of cervical lesions was highly significant (P = 0.0001)
. HPV 6 and 11 were not associated with CIN, nor was there a significa
nt trend of increasing prevalence with increasing severity of cervical
lesions. Worthy of further research is our finding that the overall p
revalence of HPV positivity was low in this relatively high-risk popul
ation of low-income, primarily black women.