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Specific Human Papillomavirus Types and Other Factors on the Risk of Cervical Intraepithelial Neoplasia: A Case-Control Study in Korea
  1. Chan Joo Kim,
  2. Young Suk Lee,
  3. Hyun Sung Kwack,
  4. Won Sik Yoon,
  5. Tae Chul Park and
  6. Jong-Sup Park, MD, PhD
  1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea.
  1. Address correspondence and reprint requests to Jong Sup Park, MD, PhD, Division of Gynecological Oncology, Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul St Mary's Hospital, 505 Banpodong, Seochogu, Seoul, Korea 137-040. E-mail: jspark{at}


Objective: Cervical neoplasia is attributed to a persistent human papillomavirus (HPV) infection. We performed a hospital-based, case-control study to evaluate the associations of HPV genotypes and other cofactors with cervical intraepithelial neoplasia (CIN).

Methods: A total of 158 women were enrolled after we received their informed consent, and the control group (the non-CIN group; n = 80) was selected from women at St Paul's Health Promotion Center. The CIN group (n = 78) was enrolled from the outpatient clinics at Kangnam St Mary's Hospital. Cervical intraepithelial neoplasia was confirmed with colposcopic-guided biopsy or loop electrosurgical excision procedure-conization. A structured questionnaire, Papanicolaou test, and HPV testing were completed. We compared each risk factor using χ2 tests and simple logistic regression analysis between the CIN and non-CIN groups. Finally, odds ratios (ORs) were calculated again by multiple logistic regression analysis.

Results: The most frequent HPV types in CIN were HPV-16, HPV-58, HPV-31/-33, and HPV-35/−56. The OR of the A9 group (HPV-16, HPV-31, HPV-33, HPV-35, HPV-52, HPV-58) was 22.7 (95% confidence interval [CI], 8.3-62.5), that of the A6 group (HPV-53, HPV-56, HPV-66) was 2.9 (95% CI, 1.1-7.5), and that of the A7 group (HPV-18, HPV-39, HPV-45, HPV-59, HPV-68) was 1.5. Sexual debut before 20 years old had significantly higher OR than did a sexual debut after 30 years (OR, 32.9; 95% CI, 2.8-364.7). The OR for CIN in single women versus married women was 6.2 (95% CI, 2.5-15.2). Compared with parous women (parity >3), nonparous women had a higher OR (95% CI, 1.4-16.7). On the multiple logistic regression analysis including the sexual debut age, the marital status, parity, cytology, and the HPV groups, the A9 group had a significant OR for CIN (6.1; 95% CI, 1.6-23.6).

Conclusions: The risk of CIN was higher for women infected with the HPV-A9 group after multiple logistic regression analysis. The other clinical risk factors were not significant factors of CIN.

  • Human papillomavirus
  • Cervical intraepithelial neoplasia
  • Cervical cancer
  • Sexual debut

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