American Journal of Epidemiology, Vol 152, Issue 8 716-726, Copyright © 2000 by Oxford University Press
M Schiff, TM Becker, M Masuk, L van Asselt-King, CM Wheeler, KK Altobelli, CQ North and AJ Nahmias
The authors assessed risk factors for cervical intraepithelial neoplasia
(CIN) among southwestern American Indian women using case- control methods.
Cases were New Mexico American Indian women with biopsy-proven grade I (n =
190), grade II (n = 70), or grade III (n = 42) cervical lesions diagnosed
between November 1994 and October 1997. Controls were American Indian women
from the same Indian Health Service clinics with normal cervical epithelium
(n = 326). All subjects underwent interviews and laboratory evaluations.
Interviews focused on history of sexually transmitted diseases, sexual
behavior, and cigarette smoking. Laboratory assays included polymerase
chain reaction- based tests for cervical human papillomavirus infection,
tests for gonorrhea and chlamydia, wet mounts, and serologic assays for
antibodies to Treponema pallidum, herpes simplex virus, and hepatitis B and
C viruses. In multiple logistic regression analysis, the strongest risk
factors for CIN II/III among American Indian women were human
papillomavirus type 16 infection (adjusted odds ratio (OR) = 7.6; 95%
confidence interval (CI): 2.4, 23.2), any human papillomavirus infection
(OR = 5.8; 95% CI: 3.3, 10.0), low income (OR = 3.3; 95% CI: 1.7, 6.2), and
history of any sexually transmitted disease (OR = 2.0; 95% CI: 1.1, 3.5).
Unlike previous research, this study found no strong associations between
CIN and sexual activity or cigarette smoking.
Risk factors for cervical intraepithelial neoplasia in southwestern American Indian women [In Process Citation]
Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, USA. mschiff@u.washington.edu
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