Role of different etiological factors in progression of cervical intraepithelial neoplasia

Abstract

Implication of high risk-human Papillomavirus in the process of cervical carcinogenesis is well documented. However, carcinogenesis in the cervix is recognized as multifactorial and other unknown etiological factors are also presumed to contribute to development of cancer. The present communication was aimed to investigate the role of risk factors such as age, parity, cervical lesions, and gynecological symptoms in the progression of the intra-epithelial cervical neoplasia. The study followed 571 cytologically diagnosed cases of high-grade squamous intraepithelial lesions (HSIL) during 35 yr of cytological screening, which is in progress at Gynae OPD of Queen Mary's Hospital of the University since April 1971 and until June 2005, a total of 33,658 cervical smears have been cytologically evaluated. Analysis of different risk factors in 571 HSIL cases revealed high parity coupled with increasing age to play a significant role in the progression of SIL. Further aggravated cervical lesions such as suspicious and unhealthy cervix and persistent vaginal discharge were found to be contributing factor in the progression of SIL. All these factors were predominantly seen in 35 cases of severe dysplasia that have shown progression from moderate dysplasia. The study indicates that women of high parity, especially with high age, are more prone to progression of SIL and hence this group needs mandatory cytological evaluation. Further adequate treatment of mild cervical lesions and persistent vaginal discharge is necessary to avoid the aggravation of the lesion/symptom and subsequent progression of dysplasia.

Age trends in the prevalence of cervical squamous intraepithelial lesions among HIV-positive women in Cameroon: a cross-sectional study

“…It is conceivable that if lesions were less likely to progress in younger versus older women then targeting older women would be justified or vice versa. Prospective studies in HIV-negative women have had inconsistent results: while lesions were more likely to progress in older women in some studies [23] the majority of studies noted similar progression rates irrespective of age [24-28]. Similar studies need to be conducted in HIV-positive women with limited access to systematic screening.…”

Vaginal Infections of Albanian women Infected with HPV and their impact in intraepithelial cervical lesions evidenced by Pap test

“…We know that the intraepithelial neoplastic lesions of the uterine cervix are multifactorial in their pathogenesis. [24] We also know that HPV is the primary etiologic agent leading to malign transformation of the epithelial cells. Yet, the manner in which the latent infection progresses to CC remains unknown.…”

Grossly Abnormal Cervix: Evidence for Using Colposcopy in the Absence of Squamous Intraepithelial Lesion by Conventional Papanicolau Test

“…The researchers involved in this study suggested treating mild cervical lesions and persistent vaginal discharge to avoid or reduce the rate of progression to CIN. 10 …”