The relative risk of non-cervical high-risk human papillomavirus-related (pre)malignancies after recurrent cervical intraepithelial neoplasia grade 3: a population-based study
Menée en Allemagne auprès de 1 797 femmes ayant présenté de manière récurrente une néoplasie cervicale de haut grade (CIN3) entre 1990 et 2010 (âge médian : 34 ans ; durée de suivi : 31 594 personnes-années), cette étude évalue le risque de lésions pré-cancéreuses liées au papillomavirus humain au niveau de l'anus, de la vulve, du vagin et de l'oropharynx par rapport aux femmes n'ayant présenté qu'une fois ou jamais ce type de lésions
Women with cervical intraepithelial neoplasia grade 3 (CIN3) have a long-lasting increased risk for non-cervical high-risk human papillomavirus (hrHPV)-related (pre)malignancies. The aim of this study was to estimate this risk in women with recurrent CIN3 compared to women without a history of CIN3 and women with a single episode of CIN3. Women with a CIN3 diagnosis between 1990-2010 were obtained from the Dutch Pathology Registry (PALGA) and matched with a control group of women without CIN3. Analysis has been conducted in a subset of women with recurrent CIN3, defined as reoccurrence minimally two years post-treatment. Cases of non-cervical hrHPV-related (pre)malignancies of the anus, vulva, vagina, and oropharynx were identified until 2015 and incidence rate ratios (IRRs) were estimated. 1,797 women with recurrent CIN3 were included with a median age of 34 years (range 18-76) and 31,594 person-years of follow-up. Women with recurrent CIN3 had an increased risk of developing non-cervical hrHPV-related (pre)malignancies compared to women without CIN3 with an IRR of 25.96 (95%CI 6.32-106.58). The IRR was 2.48 (95% CI 1.87-3.30) compared to women with a single episode of CIN3. Studies on post-treatment follow-up and prophylactic hrHPV vaccination are warranted. This article is protected by copyright. All rights reserved.