Determinants of LSIL Regression in Women from a Colombian Cohort
Keywords:
Human papillomavirus, cervical intraepithelial neoplasm, risk factors, follow-up studiesAbstract
Objective: To analyze the role of Human Papillomavirus (HPV) and other risk factors in the regression of cervical lesions in women from the Bogotá Cohort.
Methods: 200 HPV positive women with abnormal cytology were included for regression analysis. The time of lesion regression was modeled using methods for interval censored survival time data. Median duration of total follow-up was 9 years.
Results: 80 (40%) women were diagnosed with Atypical Squamous Cells of Undetermined Significance (ASCUS) or Atypical Glandular Cells of Undetermined Significance (AGUS) while 120 (60%) were diagnosed with Low Grade Squamous Intra-epithelial Lesions (LSIL). Globally, 40% of the lesions were still present at first year of follow up, while 1.5% was still present at 5 year check-up. The multivariate model showed similar regression rates for lesions in women with ASCUS/AGUS and women with LSIL (HR= 0.82, 95% CI 0.59-1.12). Women infected with HR HPV types and those with mixed infections had lower regression rates for lesions than did women infected with LR types (HR=0.526, 95% CI 0.33-0.84, for HR types and HR=0.378, 95% CI 0.20-0.69, for mixed infections). Furthermore, women over 30 years had a higher lesion regression rate than did women under 30 years (HR= 1.53, 95% CI 1.03-2.27). The study showed that the median time for lesion regression was 9 months while the median time for HPV clearance was 12 months. Conclusions: In the studied population, the type of infection and the age of the women are critical factors for the regression of cervical lesions.
Author Biographies
Mónica Molano, Instituto Nacional de Cancerología de Colombia
Grupo de Investigación en Biología del Cáncer – Instituto Nacional de Cancerología de Colombia
Mauricio González, Instituto Nacional de Cancerología de Colombia
Grupo de Investigación Clínica - Instituto Nacional de Cancerología de Colombia
Óscar Gamboa, Instituto Nacional de Cancerología de Colombia
Subdirección de Investigaciones - Instituto Nacional de Cancerología de Colombia
Natasha Ortiz, Instituto Nacional de Cancerología de Colombia
Grupo de Investigación Clínica - Instituto Nacional de Cancerología de Colombia
Joaquín Luna, Instituto Nacional de Cancerología de Colombia
Grupo de Ginecología Oncológica - Instituto Nacional de Cancerología de Colombia
Gustavo Hernandez, Instituto Nacional de Cancerología de Colombia
Grupo de Investigación Epidemiológica - Instituto Nacional de Cancerología de Colombia
Héctor Posso, Liga Colombiana de Lucha Contra el Cáncer Seccional Bogotá
Liga Colombiana de Lucha Contra el Cáncer Seccional Bogotá, Bogotá, Colombia
Raúl Murillo, Instituto Nacional de Cancerología de Colombia
Subdirección de Investigaciones - Instituto Nacional de Cancerología de Colombia
Nubia Muñoz, Instituto Nacional de Cancerología, Bogotá
Profesora Emérita - Instituto Nacional de Cancerología, Bogotá, Colombia
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