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QUESTION: In women with a first normal cervical smear during screening, what is the association between human papillomavirus (HPV) DNA levels and development of cervical carcinoma in situ (CIS)?
Nested case control study of women in a screening programme from 1969 to 1995.
Uppsala County, Sweden.
Women who were <50 years of age at entry, were born in Sweden, and had a normal first cervical smear and smears that contained genomic DNA as measured by β actin. The case group consisted of 478 women (2081 smears). 5 women in the control group were matched to each woman with CIS by date of entry to the cohort, age, and time of first smear. Women in the control group had to be alive without developing CIS or invasive cervical cancer or having a hysterectomy before the date of diagnosis for their matched case; when only 1 smear was available for a woman randomly selected from the original pool of women in the control group, a second matched woman from the control group was randomly selected (n=608 [478 first controls and 130 second controls], 1754 smears).
Assessment of risk factors
The level of HPV-16 DNA was estimated by using quantitative polymerase chain reaction (5` exonuclease …
Sources of funding: National Institutes of Health; Swedish National Cancer Society; Danish National Science Foundation.
For correspondence: Professor U B Gyllensten, Department of Genetics and Pathology, Unit of Medical Genetics, Rudbeck Laboratory, University of Uppsala, SE-751 85 Uppsala, Sweden. Fax +46 18 471 4931.