Résumé :
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[BDSP. Notice produite par INIST s4h9R0x6. Diffusion soumise à autorisation]. The authors assessed risk factors for cervical intraepithelial neoplasia (CIN) among southwestern American Indian women using case-control methods. Cases were New Mexico American Indian women with biopsyproven grade I (n=190), grade II (n=70), or grade III (n=42) cervical lesions diagnosed between November 1994 and October 1997. Controls were American Indian women from the same Indian Health Service clinics with normal cervical epithelium (n=326). All subjects underwent interviews and laboratory evaluations. Interviews focused on history of sexually transmitted diseases, sexual behavior, and cigarette smoking. Laboratory assays included polymerase chain reaction-based tests for cervical human papillomavirus infection, tests for gonorrhea and chlamydia, wet mounts, and serologic assays for antibodies to Treponema pallidum, herpes simplex virus, and hepatitis B and C viruses. In multiple logistic regression analysis, the strongest risk factors for CIN II/III among American Indian women were human papillomavirus type 16 infection (adjusted odds ratio (OR)=7.6 ; 95% confidence interval (Cl) : 2.4,23.2), any human papillomavirus infection (OR=5.8 ; 95% CI : 3.3,10.0), low income (OR=3.3 ; 95% CI : 1.7,6.2), and history of any sexually transmitted disease (OR=2.0 ; 95% CI : 1.1,3.5). Unlike previous research, this study found no strong associations between CIN and sexual activity or cigarette smoking.
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