Strickler, Howard D.; Rattray, Carole A; Escoffery, Carlos T.; Manns, Angela; Schiffman, Mark H.; Brown, Claudette; Cranston, Beverley; Hanchard, Barrie; Palefsky, Joel M.; Blattner, William A.
Author Affiliation, Ana.
Obstetrics, Gynaecology and Child Health
Human T-cell lymphotropic virus type I and severe neoplasia of the cervix in Jamaica.
International Journal of Cancer
Date of Publication
In a recent study that compared hospital cases with healthy population based controls, human T-cell lymphotropic virus type (HTLV-I) was associated with carcinoma of the cervix in Japan. To test this relationship in women more alike for cervical neoplasia risk factors - including sexual behavior and human papilloma virus (HPV) - consecutive patients from a colposcopy clinic in Kingston, Jamaica, an HTLV-I endemic area, were enrolled. Patients underwent pap smear, colposcopy, biopsy and cervical swab for detection of HPV by polymerase chain reaction. Cases were defined as women with CIN-3 or invasive cancer (CIN-3/CA). Controls included all patient with either CIN-I or koilocytotic atypia, atypical squamous cells of undetermined significance or benign cervical pathology ; all but one had at least inflammatory changes. Patients with CIN-2 were excluded to minimize the risk of case-control misclassification. Cases were much more likely to be HTLV-I seropositive than controls. Although mean age differed significantly between cases (mean age = 39 years) and controls (mean age = 33 years), control for age did not explain the relation of CIN-3/CA with HTLV-I. Among HPV DNA positive subjects, the age-adjusted association was not diminished, but lost statistical significance. HTLV-I seroprevalence may be independently associated with progression to severe neoplasia of the cervix.....