Oral contraceptives and human papillomavirus infection in cervical intraepithelial neoplasia

Use of various contraceptives and human papillomavirus 16 and 18 infections in women with cervical intraepithelial neoplasia

The aim of the study was to evaluate the frequency of human papillomavirus (HPV) 16 and 18 infections in patients with cervical intraepithelial neoplasia (CIN) according to the use of various contraceptive methods. In a study group of 1435 patients with histologically proven CIN, among whom 391 (27.2%) used no contraception, 44 (3.1%) used barrier methods, 705 (49.1%) used oral contraceptives and 295 (20.7%) used an intrauterine device (IUD), the presence of HPV infection was evaluated by DNA in situ hybridization. HPV 16 or 18 infection was present in 666 (46.4%) of all patients in 348 (49.4%) patients who used oral contraceptives, in 169 (43.2%) patients with no contraception, in 128 (43.4%) patients with an IUD and in 21 (47.7%) patients who used barrier methods. There were no significant differences in HPV 16 and 18 infection frequencies among all four groups of patients regarding the contraception method used.

Contraceptive use and reproductive history in women with cervical human papillomavirus infection

The study was conducted to investigate whether cervical human papillomavirus infections (CHPI) are associated with contraceptive use and reproductive history. The contraceptive and reproductive histories in 972 women seeking contraceptive advice were noted and screening conducted for human papillomavirus infection. The interview included number of pregnancies and childbirths, legal and spontaneous abortions, and menstrual pattern. Information about current use of contraceptive methods, about casual sex, and history of combined oral contraceptive pill (OC) use was obtained. Women with a history of spontaneous abortion showed a significant correlation with CHPI, as did women who used high-dose OCs when compared with the remaining study population (odds ratio 3.0). There was no association between use of low-dose OCs and CHPI. In multifactorial analyses with adjustment for age, number of lifetime sexual partners, number of partners during the preceding six months and age at first intercourse, the significant correlation between use of high-dose OCs and CHPI remained (adjusted odds ratio 2.8). The results indicate a relationship between female steroid hormones and the occurrence of CHPI. An association with high-dose OCs could not be excluded.

Incidence of cervical smears indicating dysplasia among Austrian women during the 1980s

OBJECTIVE

To determine the incidence of cervical smears indicating cervical intraepithelial neoplasia during the 1980s and to compare two quinquennia.

DESIGN

A retrospective epidemiologic analysis was performed, based on a large collection of 238,261 cervical smears obtained from Austrian women screened between 1980 and 1989. After application of strict epidemiologic criteria to avoid bias of changes in socio-economic status and methodological changes in cytology, 12,604 women were eligible for further analysis. We calculated incidences and relative risks of cytologically indicated cervical intraepithelial neoplasia, comparing the time periods of 1980 to 1984 and 1985 to 1989 for different age cohorts.

RESULTS

We found a statistically significant increase in the incidence of cervical cytology indicating cervical intraepithelial neoplasia in the second time period for patients between 21 and 40 years of age. Women older than 40 years showed a significant decrease of this incidence.

CONCLUSIONS

In Austrian women between the ages of 21 and 40 years an unidentified risk factor or a pattern of risk factors during the period prior to 1985 resulted in an increase of cervical intraepithelial neoplasia during the last years studied. This increasing incidence of cervical intraepithelial neoplasia indicates the importance of regular cytological screening. The significant decrease of the cervical intraepithelial neoplasia incidence in women older than 40 years provides an argument for increasing screening intervals in these women.

Multiple human papillomavirus type 16 glucocorticoid response elements functional for transformation, transient expression, and DNA-protein interactions

We have previously shown that human papillomavirus type 16 (HPV-16) can efficiently transform primary baby rat kidney cells in the presence of the steroid hormones progesterone and the glucocorticoid dexamethasone. To study this effect of hormone, different combinations of the previously identified glucocorticoid response element (GRE) at nucleotide 7640 of HPV-16 and the other two GREs that we have recently identified, at nucleotides 7385 and 7474, were mutated. The previously described GRE and the other two GREs were shown to be functional for the induction of transformation by dexamethasone. In addition, transient assays in cervical HeLa cells demonstrated the functional importance of the three individual GREs. Assays for in vitro interaction demonstrated the specific binding of a 97-kDa protein, the glucocorticoid receptor, to both recently identified HPV-16 GREs.