International Journal of STD & AIDS > Volume 19, Number 1 > Pp. 16-25

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ORIGINAL RESEARCH ARTICLE

Age at menarche is not an independent risk factor for high-risk human papillomavirus infections and cervical intraepithelial neoplasia

Kari Syrjänen MD PhD* ^*, Irena Shabalova MD PhD  , Nicolay Petrovichev MD PhD , Vladimir Kozachenko MD PhD , Tatjana Zakharova MD , Julia Pajanidi MD , Jurij Podistov MD , Galina Chemeris MD , Larisa Sozaeva MD , Elena Lipova MD , Irena Tsidaeva MD , Olga Ivanchenko MD , Alla Pshepurko MD , Sergej Zakharenko MD ^**, Raisa Nerovjna MD , Ludmila Kljukina MD , Oksana Erokhina MD , Marina Branovskaja MD , Maritta Nikitina MD PhD ^*** , Valerija Grunberga MD ^*** , Alexandr Grunberg MD PhD ^*** , Anna Juschenko MD ^***, Rosa Santopietro MD , Marcella Cintorino MD PhD , Piero Tosi MD PhD  and Stina Syrjänen DDS PhD ^*  ****

^* Department of Oncology and Radiotherapy, Turku University Hospital, Savitehtaankatu 1, Turku FIN-20521, Finland; NN Blokhin Cancer Research Centre of Russian Academy of Medical Sciences (RAMS); Russian Academy of Post-Graduate Medical Education, Moscow; Centralised Cytology Laboratory, Novgorod Clinical Regional Hospital; ^** Department of Gynaecology, Novgorod Municipal Dermato-venereological Dispensary; Department of Gynaecology, Novgorod Female Consultative Outpatient Hospital, Novgorod, Russia; Republican Centre of Clinical Cytology, Research Institute of Oncology and Medical Radiology; Department of Gynaecology and Obstetrics, Minsk State Medical Institute, Minsk, Belarus; ^*** Department of Gynaecology, Latvian Cancer Centre; Laboratory of Cytology, Riga, Latvia; Department of Pathology, University of Siena, Siena, Italy; Department of Oral Pathology, Institute of Dentistry; ^**** MediCity Research Laboratory, University of Turku, Turku, Finland

Correspondence to: Professor Kari Syrjänen Email: kari.syrjanen{at}tyks.fi

Data are controversial as to the role of menarche age as a risk factor of high-risk human papillomavirus (HR-HPV) infections. The objective of this study was to analyse the risk estimates for age at menarche as determinant of cervical intraepithelial neoplasia (CIN) and HR-HPV infections. A cohort of 3187 women were stratified into three groups according to their age at menarche: (i) women <13 years of age; (ii) those between 13 and 14 years and (iii) women >15 years of age. These groups were analysed for predictors of (a) HR-HPV, (b) high-grade CIN and (c) outcome of HR-HPV and cytological abnormalities during prospective follow-up. All the three groups had identical prevalence of HR-HPV, Papanicolaou smear abnormalities and CIN grades. In contrast to menarche age itself, the time from menarche to the first intercourse (TMI), to the first pregnancy (TMP) and to the first delivery (TMD) were all significant (P = 0.0001) predictors of HR-HPV (but not CIN2) in univariate analysis, but lost their significance in a multivariate model. Outcome of cervical disease and HR-HPV infection was unrelated to menarche age, the latter and the three intervals being not predictors of CIN2 in a multivariate model. In conclusion, age at menarche and the intervals between menarche and (i) onset of sexual activity, (ii) first pregnancy and iii) first delivery, are not independent predictors of HR-HPV infections and CIN2 in multivariate analysis.

Key Words: menarche • age • intervals • intercourse • pregnancy • delivery • risk factors • HPV • CIN • cervical cancer

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