Human papillomavirus and cervical intraepithelial neoplasia grade II-III: a population-based case-control study

Int J Cancer. 1995 May 4;61(3):312-5. doi: 10.1002/ijc.2910610306.


The association between certain human papillomaviruses (HPV) and cervical intraepithelial neoplasia (CIN) is well documented, but there is uncertainty about the strength of association and the role of co-factors is unclear. This population-based case-control study in Norwegian women 20-44 years of age included 103 cases with histologically confirmed CIN II-III and 234 age-matched and randomly selected controls. Cytological specimens from the cervix were analyzed using the polymerase chain reaction (PCR). In all, 91% of the cases and 15% of the controls were HPV DNA positive, giving a crude odds ratio (OR) of 67.2 (95% confidence interval: 28.6-157.5). The association between HPV 16 and CIN II-III was even stronger (crude OR = 123.9; 46.7 - 328.5). In logistic regression analysis, additional to HPV, only a high number of sexual partners and a low educational level contributed independently to the risk. The adjusted OR for the association between HPV and CIN II-III was 72.8 (95% CI: 27.6-191.9). The association between HPV and CIN remains very strong even after adjustment for proposed confounding factors. The results therefore support the role of HPV as a causative agent in the development of CIN.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Analysis of Variance
  • Case-Control Studies
  • DNA, Viral / analysis
  • Female
  • Humans
  • Medical History Taking
  • Menarche
  • Multivariate Analysis
  • Norway
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / pathology
  • Polymerase Chain Reaction / methods
  • Random Allocation
  • Sexual Behavior
  • Tumor Virus Infections / pathology
  • Uterine Cervical Dysplasia / pathology*
  • Uterine Cervical Dysplasia / virology*
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / virology*
  • Vaginal Smears


  • DNA, Viral