genital warts
A colposcopic case-control study of cervical squamous intraepithelial lesions in women with anogenital warts.

Evans BA, Bond RA, MacRae KD.

Department of Genitourinary Medicine, Charing Cross Hospital, London, UK.

OBJECTIVE--To assess whether anogenital warts, present or past, are an indication for women to be referred for colposcopy. DESIGN--A case control study comparing patients with and without a history of anogenital warts. SETTING--A department of genitourinary medicine in West London. PATIENTS--468 patients examined by colposcopy between January 1985 and December 1987 of whom 147 (31%) had abnormal cytology, 163 (35%) had anogenital warts and 158 (34%) had both. MAIN OUTCOME MEASURES--Colposcopic findings and histology of cervical biopsies compared with behavioural and disease variables. RESULTS--Human papillomavirus infection (HPVI) of the cervix showed no relationship with a life time history of vulval warts, or with the presence of anogenital warts on clinical examination, or with any parameter of sexual behaviour included in the study. Cervical intraepithelial neoplasia (CIN) was strongly associated with current IUCD usage (RR = 7.75) and coitarche under 16 years of age (RR = 3.72), but a history of vulval warts yielded a negative association (RR = 0.34), suggesting a protective effect. This relationship held true when cytological dyskaryosis was made the dependent variable (RR = 0.24). CONCLUSIONS--Anogenital warts are not a risk for subclinical cervical HPVI or for CIN and therefore not an indication for colposcopy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1427800&dopt=Abstract genital wart


genital warts
Ten year follow-up study of women presenting to a genitourinary medicine clinic with anogenital warts.

Handley J, Lawther H, Horner T, Maw R, Dinsmore W.

Department of Genitourinary Medicine, Royal Victoria Hospital, Belfast, Northern Ireland.

One hundred heterosexual women presenting at our clinic in 1979 with anogenital warts, were reviewed 10 years later. Median duration of warts following initial clinic attendance was 2 months (range 0-120 months). In 1979 cervical PAP smear results were available for 76 patients; cervical intraepithelial neoplasia (CIN) was seen in 15/76 (19.7%) women; 3 (4%) women had low grade CIN, 12 (15.7%) women had high grade CIN. Nineteen women had had treatment for CIN between 1979 and 1989, 7 laser ablation, 9 cone biopsy, 2 laser ablation and cone biopsy, and one woman laser ablation, cauterization and cone biopsy. At 10-year follow-up in 1989 4/100 women had anogenital warts, 12/100 women had cytological evidence of CIN (7 low grade, 5 high grade), and 37/100 women had CIN detected on colposcopic biopsy (31 low grade, 6 high grade). No women developed invasive cervical carcinoma during the study period. CIN lesions, detected in 1979, regressed without any treatment in 2 women. Colposcopic biopsy was 3.1 times more sensitive than single cervical PAP smear at detecting CIN (4.4 times as sensitive in detecting low grade CIN; 1.2 times as sensitive in detecting high grade CIN). In 1989 CIN was detected in 7/19 (36.8%) of women who had undergone cervical treatment between 1979 and 1989, and in 35/81 (43.2%) of women having no cervical treatment within this period (chi squared P greater than 0.5). These findings suggest that cervical laser ablative therapy and cone biopsy do not in the long term influence the natural history of cervical human papilloma virus-associated disease (CIN) in women with anogenital warts.(ABSTRACT TRUNCATED AT 250 WORDS)

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1543764&dopt=Abstract genital wart


genital warts
The National Surveillance System for Sexually Transmitted Diseases in Italy. STD Surveillance Working Group.

Suligoi B, Giuliani M, Binkin N.

Istituto Superiore di Sanita, Rome, Italy.

Sexually transmitted diseases (STDs) have increased in importance in recent decades as a result of their wider dissemination, the emergence of new etiologic agents, and changes in sexual behaviors. In Italy, gonorrhea and syphilis are among the 71 diseases for which reporting is legally mandated. Despite these legal requirements, however, considerable underreporting has been documented. The need for more reliable data has led to the establishment of a formal sentinel surveillance system for STDs. The Italian National STD Surveillance Network, which involves 47 reporting centers, was established in 1990. A total of 5,049 patients were reported during the pilot study and the first 6 months of surveillance. For men, the most frequently reported diseases were genital warts and nongonococcal urethritis; for women, the most frequent diagnoses were nonspecific vaginitis and genital warts. The objectives of this system are threefold: a) to obtain a rapid and accurate assessment of the occurrence and spread of STDs; b) to identify trends in disease occurrence; and c) to monitor changes over time by geographic area.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1557021&dopt=Abstract genital wart


genital warts
Attitudes of adolescent/young adult women toward human papillomavirus vaccination and clinical trials.

Hoover DR, Carfioli B, Moench EA.

Department of Statistics and Center for Health, Health Care Policy and Aging Research, Rutgers University, Hill Building Room 473, Piscataway, NJ 08854, USA. dhoover stat.rutgers.edu

Human papillomavirus (HPV) is the most common sexually transmitted infection. It often inflicts adolescents and young adults shortly after onset of sexual activity. More than 30 types of HPV infect the anogenital area; some HPV types cause cervical cancer in women decades after infection, whereas other types cause genital warts in both men and women within a year after infection. Vaccines are being developed against oncogenic and wart-producing HPV. Knowledge of HPV and attitudes toward HPV vaccination/clinical trial participation among 60 female adolescents and young adults were evaluated. Knowledge of HPV in this group was limited, but almost all participants would be interested in receiving vaccines that prevented cervical cancer and genital warts. Only 30% were likely to participate in an HPV clinical trial that required shots and pelvic examinations. A key motivating factor for clinical trial participation was the potential for a vaccine to help other women.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11261108&dopt=Abstract genital wart


genital warts
Increased incidence of cervical cytological abnormalities in women with genital warts or contact with genital warts: a need for increased vigilance?

Rowen D, Carne CA, Sonnex C, Cooper P.

Department of Genito-Urinary Medicine, Addenbrooke's Hospital, Cambridge, UK.

OBJECTIVE--To determine whether women who have a history of genital warts or whose sexual partners have such a history were more likely to have borderline or dyskaryotic cervical smears than other women. DESIGN--Prospective study conducted over a five month period. SETTING--A genitourinary medicine clinic in Cambridge, UK. PATIENTS--One hundred and eighty five women who attended the clinic during the study period, on whom cervical cytology was performed. Ninety-seven had a history of genital warts and twenty had partners with genital warts. METHODS--Cervical cytology taken by standard methods. Demographic data and sexual history obtained by questionnaire. Colposcopy was performed on patients with a history of warts or wart contact. OUTCOME MEASURED--Relative incidence of cytological abnormalities in the various groups of patients. RESULTS--"Borderline" nuclear change was the most frequent abnormality reported in the wart contact group (six cases) whereas mild dyskaryosis was the most frequent abnormal finding in those women with a history of warts (21 cases). CONCLUSIONS--Women with warts or contact with genital warts were more likely to have borderline or dyskaryotic cervical smears than women without such a history. Recommendations for follow-up of these patients are made.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1774050&dopt=Abstract genital wart