Determinants of incident precursor lesions of cervical cancer

Squamous intraepithelial lesions (SIL) are believed to be precursors of in situ cervical neoplasia and of invasive cervical cancer. Though the burden of this disease has been greatly reduced thanks to the availability of an effective screening test, the worldwide morbidity and mortality remain high.On the basis of a classic approach to analysis of data from a prospective cohort study, I correlated HPV status at enrollment with subsequent risk of incident SIL during up to three years of follow-up among women of Brazil enrolled to the Ludwig-McGill cohort.The risk of occurrence of a first instance of SIL among women was strongly associated with HPV infection. After adjustment for a number of socio-demographic factors that have previously been established as risk factors for cervical cancer, the magnitude of association with high-risk HPVs remained unchanged while the association with low risk types was dampened, furthering the evidence for the role of oncogenic HPV types in the development of cervical cancer.Parity was found to have an independent positive association with cervical precursor lesions, after adjustment for HPV status, age, previous history of Pap screening, number of sexual partners, age at first intercourse, and income. Income was also positively associated with the development of lesions