Effects of β-Carotene and Other Factors on Outcome of Cervical Dysplasia and Human Papillomavirus Infection

Romney, Seymour L.; Ho, Gloria Y.F.; Palan, Prabhudas R.; Basu, Jayasri; Kadish, Anna S.; Klein, S.; Mikhail, Magdy; Hagan, Robert J.; Chang, Chee Jen; Burk, Robert D.

doi:10.1006/gyno.1997.4697

Cited by 89 publications

(42 citation statements)

References 32 publications

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“…In our analysis, women who lacked detectable HPV by PCR following the biopsy had a significantly greater chance of CIN regression compared to those with persistent HPV infections. This finding is consistent with previous studies that have shown that persistent HPV infections enhance the development and persistence of squamous intraepithelial lesions (Karlsson et al, 1995;Romney et al, 1997;Ho et al, 1998). Furthermore, our patients who initially tested positive for HPV and subsequently developed undetectable levels of HPV had higher rates of CIN regression (63%) than patients with HPV persistence (41%).…”

Section: Discussionsupporting

confidence: 93%

“…Previous data have also shown that the resolution of HPV infection reflects the natural regression patterns of squamous intraepithelial lesions (Nasiell et al, 1986;Daling et al, 1996). Since most HPV infections are transient (Rosenfeld et al, 1992;Hsing et al, 1994;Hinchliffe et al, 1995;Romney et al, 1997), the patients in our study with high-grade lesions, who had no detectable HPV in their cervical scrapings following the biopsy, may have had a resolving HPV infection. Thus, based on our findings and that of other investigations, it appears that the resolution of HPV infection is predictive of the spontaneous regression of high-grade lesions.…”

Section: Discussionmentioning

confidence: 96%

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HPV infection and number of lifetime sexual partners are strong predictors for ‘natural’ regression of CIN 2 and 3

et al. 2003

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The aim of this paper was to evaluate the factors that predict regression of untreated CIN 2 and 3. A total of 93 patients with colposcopic persistent CIN 2 and 3 lesions after biopsy were followed for 6 months. Human papillomavirus (HPV) types were determined by polymerase chain reaction at enrolment. We analysed the biologic and demographic predictors of natural regression using univariate and multivariate methods. The overall regression rate was 52% (48 out of 93), including 58% (22 out of 38) of CIN 2 and 47% (26 out of 55) of CIN 3 lesions (P ¼ 0.31 for difference). Human papillomavirus was detected in 84% (78 out of 93) of patients. In univariate analysis, 80% (12 out of 15) of lesions without HPV regressed compared to 46% (36 out of 78) of lesions with HPV infection (P ¼ 0.016). Women without HPV and those who had a resolution of HPV had a four-fold higher chance of regression than those with persistent HPV (relative odds ¼ 3.5, 95% CI ¼ 1. 4 -8.6). Women with five or fewer lifetime sexual partners had higher rates of regression than women with more than five partners (P ¼ 0.003). In multivariate analysis, HPV status and number of sexual partners remained as significant independent predictors of regression. In conclusion, HPV status and number of lifetime sexual partners were strongly predictive of regression of untreated CIN 2 and 3. Cervical cancer continues to be the most deadly female cancer in developing countries. (Ponten et al, 1995) The dramatic decrease in mortality rates in Western countries is attributed to cervical cancer screening. (Harlan et al, 1991) The successful implementation of these screening programmes is based on the underlying model that cervical intraepithelial lesions (CIN) behave as progressive stages of a biologic continuum towards the development of invasive cervical cancer (Richart and Barron, 1969;Campion et al, 1986).Genital human papillomavirus (HPV) infection has been established as the critical step in the development of most cervical cancers (IARC, 1995). The cervical carcinogenesis model involves HPV infection, intraepithelial neoplasia, and invasion. Human papillomavirus infection is found in over 40% of young, sexually active, college students (Ho et al, 1998). However, the incidence of cervical cancer is uncommon compared to the lifetime cumulative incidence of viral infection. Thus, there must be essential biological mechanisms and associated risk factors other than HPV infection that are responsible for the progression of precursor lesions to invasive cervical cancer (Schiffman & Brinton, 1995).The aetiology and risk factors involved with cervical carcinogenesis are amenable to study as invasive cervical cancer typically arises after many years from a morphologically defined precancerous lesion. However, since untreated high-grade lesions can progress to invasive cancer, most women with CIN 2 or 3 are treated promptly. Accordingly, there are few reports on the natural history of high-grade dysplasia. On the other hand, not all CIN lesions progress to invasive canc...

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 96%

HPV infection and number of lifetime sexual partners are strong predictors for ‘natural’ regression of CIN 2 and 3

et al. 2003

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“…Although data from cervical cancer chemoprevention trials failed to show a preventive effect of β-carotene (Romney et al, 1997), other carotenoids such as α-carotene and lycopene may prevent cervical cancer. It is also possible that β-carotene may not work after the genesis of cervical dysplasia.…”

Section: Discussionmentioning

confidence: 99%

Serum carotenoids and vitamins and risk of cervical dysplasia from a case–control study in Japan

et al. 1999

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SummaryThe relationships between risk of cervical dysplasia and dietary and serum carotenoids and vitamins were investigated in a case-control study. Cases were 156 women who attended Papanicolaou test screening in nine institutes affiliated with Japan Study Group of Human Papillomavirus (HPV) and Cervical Cancer and had cervical dysplasia newly histologically confirmed. Age-matched controls were selected from women with normal cervical cytology attending the same clinic. Blood sample and cervical exfoliated cells were obtained for measuring serum retinol, α-carotene, β-carotene, zeaxanthin/lutein, cryptoxanthin, lycopene and α-tocopherol and for HPV detection. Higher serum level of α-carotene was significantly associated with decreased risk of cervical dysplasia after controlling for HPV infection and smoking status (odds ratio (OR) = 0.16, 95% confidence interval (CI) 0.04-0.62 for the highest as compared with the lowest tertile). Decreased risk for the highest tertile of serum lycopene (OR = 0.28) was marginally significant. Decreased risks observed for the highest tertiles of β-carotene (OR = 0.65) and zeaxanthin/lutein (OR = 0.53), were not statistically significant. © 1999 Cancer Research Campaign Keywords: cervical dysplasia; carotenoids; human papillomavirus; diet 1234British Journal of Cancer (1999) 81(7), 1234-1237© 1999 Cancer Research Campaign Article no. bjoc.1999 Received 12 November 1998 Revised 8 April 1999 Accepted 13 April 1999Correspondence to: C Nagata Serum carotenoids and cervical dysplasia 1235British Journal of Cancer (1999) 81(7), 1234-1237 © 1999 Cancer Research Campaign match) after the identification of case was approached. About 90% of the first eligible controls agreed to participate in the study.A self-administered questionnaire including demographic factors, smoking and drinking habits, diet, reproductive history and sexual behaviour was distributed to each case and control when she visited the institute to know the result of Papanicolaou test. Diet was assessed by asking about the intake amounts of 22 foods that are retinol-and carotene-rich during the past 7 days. Daily intake of retinol and carotene were estimated using the Standard Tables of Food Composition in Japan (4th revised edition published by the Science and Technology Agency of Japan). The detailed information about the dietary questionnaire including validity was described elsewhere (Shimizu et al, 1996). A total of 167 cases and matched controls responded to the questionnaire.Blood sampling as well as collection of cervical smear samples were performed on the same day. Serum was isolated and frozen at -80°C. The fraction of carotenoids, retinol and tocopherol of the serum samples were extracted into n-hexane, and the concentrations of α-carotene, β-carotene, cryptoxanthin, lutein/zeaxanthin, lycopene, and α-tocopherol were determined by high-performance liquid chromatography (HPLC) using a slight modification of Nells and Leenheer's method (Nells and De Leenheer, 1983). The serum of cases and matched controls was a...

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“…[39][40][41] The reason for the increase in lung cancers in smokers in these trials is not known but does highlight the fact that seemingly safe dietary substances administered in pharmacologic doses must be regarded as potentially toxic. Enthusiasm for β-carotene has also been tempered by the negative results of several other randomized trials for other types of cancer, including skin cancer, 42 colon polyps, 43 and cervical intraepithelial neoplasia, 44 in which β-carotene had no effect. To date, β-carotene has not been tested in a large randomized trial using either changes in premalignant lesions or appearance of second aerodigestive malignancies as end points.…”

Section: Carotenoidsmentioning

confidence: 99%

Chemoprevention of head and neck cancer

Armstrong

Meyskens

2000

Otolaryngol.--head neck surg.

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728Increasing emphasis has been placed on chemoprevention as understanding of the genetic and molecular events of carcinogenesis has evolved. More than 1000 compounds that inhibit cancer development in vitro or in animal models have been identified, and active research is under way to determine which of these agents will be both effective and nontoxic in human beings. Currently, 13-cis-retinoic acid is the most studied chemopreventive agent against head and neck cancers. Unfortunately, this vitamin A derivative has significant clinical toxicity, which limits its utility in a practice setting. The efficacy of the retinoids, however, has stimulated efforts to find other chemopreventive compounds that are both effective and nontoxic. This review discusses head and neck premalignancy, chemoprevention strategies, retinoids, and several other classes of chemopreventive agents with potential efficacy against head and neck premalignancy.

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Effects of β-Carotene and Other Factors on Outcome of Cervical Dysplasia and Human Papillomavirus Infection

Cited by 89 publications

References 32 publications

HPV infection and number of lifetime sexual partners are strong predictors for ‘natural’ regression of CIN 2 and 3

HPV infection and number of lifetime sexual partners are strong predictors for ‘natural’ regression of CIN 2 and 3

Serum carotenoids and vitamins and risk of cervical dysplasia from a case–control study in Japan

Chemoprevention of head and neck cancer

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