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A population-based study of age-related associations between vaginal pH and the development of cervical intraepithelial neoplasia.
- Source :
-
Cancer medicine [Cancer Med] 2020 Mar; Vol. 9 (5), pp. 1890-1902. Date of Electronic Publication: 2020 Jan 14. - Publication Year :
- 2020
-
Abstract
- The association between vaginal pH and the risk of cervical intraepithelial neoplasia (CIN) is unclear. We evaluated the dose-response relationship between vaginal pH and CIN risk, as well as the combined influence of vaginal pH and high-risk human papillomavirus (hrHPV) on the risk of CIN and the mediation effects of hrHPV infection on vaginal pH level and the development of CIN. We investigated 2304 women in Shanxi, China. The dose-response relationship between vaginal pH and CIN risk was assessed using categoric and spline analyses. We established interaction and mediation models to determine the correlation between pH and hrHPV in the development of CIN. After adjusting covariates, a positive association was observed between hrHPV infection and the development of CIN [OR (95% CI) = 4.75 (3.52-6.40) for CIN2+; OR (95% CI) = 7.30 (4.10-13.00) for CIN3+], while a negative correlation was showed between vaginal pH level and CIN3+ [OR (95% CI) = 1.04 (0.59-1.84); high vs low: OR (95% CI) = 0.32 (0.15-0.69), P = .002]. The highest risk of CIN (5.24 of CIN2+ and 5.80 of CIN3+) were observed when hrHPV infection was combined with middle vaginal pH (4.6-5.0). A significant mediation effect of hrHPV infection was observed in the association between vaginal pH level with CIN2+ (P = .002) and CIN3+ (P = .004). In conclusion, abnormal vaginal pH significantly induced the risk of high-stage CIN in Chinese women infected with hrHPV. Therefore, maintaining normal vaginal pH levels may reduce the risk of CIN.<br /> (© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
- Subjects :
- Adult
Aged
Cervix Uteri pathology
Cervix Uteri virology
China epidemiology
Female
Humans
Hydrogen-Ion Concentration
Incidence
Middle Aged
Papillomaviridae isolation & purification
Papillomavirus Infections pathology
Papillomavirus Infections prevention & control
Papillomavirus Infections virology
Risk Assessment statistics & numerical data
Risk Factors
Uterine Cervical Neoplasms pathology
Uterine Cervical Neoplasms prevention & control
Uterine Cervical Neoplasms virology
Vaginal Smears
Young Adult
Uterine Cervical Dysplasia pathology
Uterine Cervical Dysplasia prevention & control
Uterine Cervical Dysplasia virology
Cervix Uteri chemistry
Papillomavirus Infections epidemiology
Uterine Cervical Neoplasms epidemiology
Uterine Cervical Dysplasia epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 2045-7634
- Volume :
- 9
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Cancer medicine
- Publication Type :
- Academic Journal
- Accession number :
- 31943830
- Full Text :
- https://doi.org/10.1002/cam4.2845