Experts and Doctors on cervical intraepithelial neoplasia in Bethesda, Maryland, United States


Locale: Bethesda, Maryland, United States
Topic: cervical intraepithelial neoplasia

Top Publications

  1. Castle P, Rodriguez A, Burk R, Herrero R, Wacholder S, Alfaro M, et al. Short term persistence of human papillomavirus and risk of cervical precancer and cancer: population based cohort study. BMJ. 2009;339:b2569 pubmed publisher
    ..Short term persistence of a prevalently detected carcinogenic HPV infection, especially HPV 16, strongly predicts a subsequent diagnosis of cervical intraepithelial neoplasia II+ over the next few years. ..
  2. Porras C, Wentzensen N, Rodríguez A, Morales J, Burk R, Alfaro M, et al. Switch from cytology-based to human papillomavirus test-based cervical screening: implications for colposcopy. Int J Cancer. 2012;130:1879-87 pubmed publisher
    ..Our data support the need for a nonvisual diagnostic method to guide management and treatment of HPV-positive women. ..
  3. Castle P, Fetterman B, Poitras N, Lorey T, Shaber R, Schiffman M, et al. Variable risk of cervical precancer and cancer after a human papillomavirus-positive test. Obstet Gynecol. 2011;117:650-6 pubmed publisher
    ..Optimizing screening programs will require knowledge of screening history. ..
  4. Castle P, Kreimer A, Wacholder S, Wheeler C, Koutsky L, Rydzak G, et al. Influence of loop electrosurgical excision procedure on subsequent acquisition of new human papillomavirus infections. J Infect Dis. 2009;199:1612-20 pubmed publisher
    ..44; 95% CI, 0.23-0.85) and were 40% less likely to have these genotype detected at 24-month follow-up visits (IRR, 0.60; 95% CI, 0.42-0.85). LEEP may reduce the acquisition of certain carcinogenic HPV genotypes related to HPV-16. ..
  5. Castle P, Kinney W, Cheung L, Gage J, Fetterman B, Poitras N, et al. Why does cervical cancer occur in a state-of-the-art screening program?. Gynecol Oncol. 2017;146:546-553 pubmed publisher
    ..0001). A state-of-the-art intensive screening program results in very few cervical cancers, most of which are detected early by screening. Screening may become less efficient at older ages. ..
  6. Katki H, Schiffman M, Castle P, Fetterman B, Poitras N, Lorey T, et al. Five-year risks of CIN 3+ and cervical cancer among women with HPV-positive and HPV-negative high-grade Pap results. J Low Genit Tract Dis. 2013;17:S50-5 pubmed publisher
  7. Garcia F, Cornelison T, Nuño T, Greenspan D, Byron J, Hsu C, et al. Results of a phase II randomized, double-blind, placebo-controlled trial of Polyphenon E in women with persistent high-risk HPV infection and low-grade cervical intraepithelial neoplasia. Gynecol Oncol. 2014;132:377-82 pubmed publisher
    ..Further studies may be necessary to better delineate the risk factors for persistent HPV infection and biology of the disease to facilitate the evaluation of chemopreventive strategies. ..
  8. Rodríguez A, García Piñeres A, Hildesheim A, Herrero R, Trivett M, Williams M, et al. Alterations of T-cell surface markers in older women with persistent human papillomavirus infection. Int J Cancer. 2011;128:597-607 pubmed publisher
    ..Whether phenotypic alterations observed predispose to HPV persistence or result from it should be the focus of future studies. ..
  9. Castle P, Schiffman M, Wheeler C, Solomon D. Evidence for frequent regression of cervical intraepithelial neoplasia-grade 2. Obstet Gynecol. 2009;113:18-25 pubmed publisher
    ..01). There was evidence that approximately 40% of undiagnosed CIN 2 will regress over 2 years, but CIN 2 caused by HPV-16 may be less likely to regress than CIN 2 caused by other high-risk-HPV genotypes. II. ..

More Information


  1. Schiffman M, Rodriguez A, Chen Z, Wacholder S, Herrero R, Hildesheim A, et al. A population-based prospective study of carcinogenic human papillomavirus variant lineages, viral persistence, and cervical neoplasia. Cancer Res. 2010;70:3159-69 pubmed publisher
    ..Larger viral genomic studies are warranted, especially to identify the genetic basis for HPV16's unique carcinogenicity. ..
  2. Katki H, Gage J, Schiffman M, Castle P, Fetterman B, Poitras N, et al. Follow-up testing after colposcopy: five-year risk of CIN 2+ after a colposcopic diagnosis of CIN 1 or less. J Low Genit Tract Dis. 2013;17:S69-77 pubmed publisher
    ..For women with antecedent ASC-H or HSIL+, no single negative test result sufficed to reduce their risk to a level consistent with a 3-year return. ..
  3. Katki H, Schiffman M, Castle P, Fetterman B, Poitras N, Lorey T, et al. Five-year risk of CIN 3+ to guide the management of women aged 21 to 24 years. J Low Genit Tract Dis. 2013;17:S64-8 pubmed publisher
    ..6% of women with high-grade Pap results. The generally low risk supports conservative management of women aged 21 to 24 years. ..
  4. Katki H, Schiffman M, Castle P, Fetterman B, Poitras N, Lorey T, et al. Five-year risks of CIN 3+ and cervical cancer among women who test Pap-negative but are HPV-positive. J Low Genit Tract Dis. 2013;17:S56-63 pubmed publisher
  5. Wilson L, Pawlita M, Castle P, Waterboer T, Sahasrabuddhe V, Gravitt P, et al. Natural immune responses against eight oncogenic human papillomaviruses in the ASCUS-LSIL Triage Study. Int J Cancer. 2013;133:2172-81 pubmed publisher
  6. Katki H, Schiffman M, Castle P, Fetterman B, Poitras N, Lorey T, et al. Benchmarking CIN 3+ risk as the basis for incorporating HPV and Pap cotesting into cervical screening and management guidelines. J Low Genit Tract Dis. 2013;17:S28-35 pubmed publisher
    ..g., 5-year) return. Using the principle of "equal management of equal risks," benchmarking to implicit risk thresholds based on Pap-alone can be used to achieve safe and consistent incorporation of cotesting. ..
  7. Gage J, Schiffman M, Solomon D, Wheeler C, Gravitt P, Castle P, et al. Risk of precancer determined by HPV genotype combinations in women with minor cytologic abnormalities. Cancer Epidemiol Biomarkers Prev. 2013;22:1095-101 pubmed publisher
    ..HPV genotyping in HPV-positive women with minor cytologic abnormalities will likely not alter clinical management. Adding HPV45 to genotyping assays is not warranted. ..
  8. Kim B, Cho H, Chung J, Conway C, Ylaya K, Kim J, et al. Prognostic assessment of hypoxia and metabolic markers in cervical cancer using automated digital image analysis of immunohistochemistry. J Transl Med. 2013;11:185 pubmed publisher
    ..27; 95% CI, 1.05-10.23, P = 0.041) for overall survival in cervical cancer. We demonstrate that c-Met correlates with HIF-1? and is a poor prognostic factor in survival in cervical cancer. ..
  9. Yang H, Walmer D, Merisier D, Gage J, Bell L, Rangwala S, et al. A pilot analytic study of a research-level, lower-cost human papillomavirus 16, 18, and 45 test. J Virol Methods. 2011;176:112-4 pubmed publisher
    ..It is concluded that the HPV16/18/45 assay is a promising triage test with a minimum detection of approximately 5000 viral copies, the clinically relevant threshold. ..
  10. Santesso N, Mustafa R, Schünemann H, Arbyn M, Blumenthal P, Cain J, et al. World Health Organization Guidelines for treatment of cervical intraepithelial neoplasia 2-3 and screen-and-treat strategies to prevent cervical cancer. Int J Gynaecol Obstet. 2016;132:252-8 pubmed publisher
    ..However, high-quality evidence was not available. Such evidence is needed, in particular for screen-and-treat strategies that are relevant to low- and middle-income countries. ..
  11. Wang X, Meyers C, Guo M, Zheng Z. Upregulation of p18Ink4c expression by oncogenic HPV E6 via p53-miR-34a pathway. Int J Cancer. 2011;129:1362-72 pubmed publisher
    ..In summary, our study demonstrates an intimate connection among oncogenic HPV E6, p53, miR-34a and p18Ink4c and identifies p18Ink4c as a possible biomarker for cervical cancer. ..
  12. Sherman M, Castle P, Solomon D. Cervical cytology of atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H): characteristics and histologic outcomes. Cancer. 2006;108:298-305 pubmed
    ..Immediate colposcopy may be the appropriate management for young women with ASC-H, but the utility of HPV testing for managing older women with ASC-H requires additional study. ..
  13. Katki H, Schiffman M, Castle P, Fetterman B, Poitras N, Lorey T, et al. Five-year risks of CIN 2+ and CIN 3+ among women with HPV-positive and HPV-negative LSIL Pap results. J Low Genit Tract Dis. 2013;17:S43-9 pubmed publisher
  14. Castle P, Schiffman M, Wheeler C, Wentzensen N, Gravitt P. Human papillomavirus genotypes in cervical intraepithelial neoplasia grade 3. Cancer Epidemiol Biomarkers Prev. 2010;19:1675-81 pubmed publisher
    ..In populations vaccinated against HPV16 (and HPV18), the median age of CIN3 in women with ASCUS and LSIL cytology should shift to older ages, possibly permitting later age at first screening. ..
  15. Castle P, Fetterman B, Akhtar I, Husain M, Gold M, Guido R, et al. Age-appropriate use of human papillomavirus vaccines in the U.S. Gynecol Oncol. 2009;114:365-9 pubmed publisher
    ..It is increasingly evident that prophylactic HPV vaccines will provide the greatest public health or population benefit only when delivered to adolescent, mostly HPV-naive women. ..
  16. Katki H, Schiffman M, Castle P, Fetterman B, Poitras N, Lorey T, et al. Five-year risk of recurrence after treatment of CIN 2, CIN 3, or AIS: performance of HPV and Pap cotesting in posttreatment management. J Low Genit Tract Dis. 2013;17:S78-84 pubmed publisher
    ..However, negative cotests after treatment provided more reassurance against recurrent CIN 2+ than either negative Pap tests or HPV tests alone. ..
  17. Chung H, Cho H, Perry C, Song J, Ylaya K, Lee H, et al. Downregulation of ERp57 expression is associated with poor prognosis in early-stage cervical cancer. Biomarkers. 2013;18:573-9 pubmed publisher
    ..19, p?=?0.018). Low ERp57 expression independently predicts a poor outcome for patients with cervical cancer, supporting the notion that ERp57 may be a promising novel cancer target. ..
  18. Bodelon C, Vinokurova S, Sampson J, den Boon J, Walker J, Horswill M, et al. Chromosomal copy number alterations and HPV integration in cervical precancer and invasive cancer. Carcinogenesis. 2016;37:188-196 pubmed publisher
  19. Heselmeyer Haddad K, Sommerfeld K, White N, Chaudhri N, Morrison L, Palanisamy N, et al. Genomic amplification of the human telomerase gene (TERC) in pap smears predicts the development of cervical cancer. Am J Pathol. 2005;166:1229-38 pubmed
    ..We conclude that the detection of 3q gain and amplification of TERC in routinely collected Pap smears can assist in identifying low-grade lesions with a high progression risk and in decreasing false-negative cytological screenings. ..
  20. Katki H, Schiffman M, Castle P, Fetterman B, Poitras N, Lorey T, et al. Five-year risks of CIN 3+ and cervical cancer among women with HPV testing of ASC-US Pap results. J Low Genit Tract Dis. 2013;17:S36-42 pubmed publisher
    ..Our findings also support managing HPV-positive/ASC-US and LSIL similarly. ..
  21. Schiffman M, Glass A, Wentzensen N, Rush B, Castle P, Scott D, et al. A long-term prospective study of type-specific human papillomavirus infection and risk of cervical neoplasia among 20,000 women in the Portland Kaiser Cohort Study. Cancer Epidemiol Biomarkers Prev. 2011;20:1398-409 pubmed publisher
    ..Adding HPV testing to cytology is recommended for women ?30 but long-term prospective studies of HPV testing are rare...
  22. Wang S, Wheeler C, Hildesheim A, Schiffman M, Herrero R, Bratti M, et al. Human leukocyte antigen class I and II alleles and risk of cervical neoplasia: results from a population-based study in Costa Rica. J Infect Dis. 2001;184:1310-4 pubmed
    ..2-23.7). These results support the hypothesis that multiple risk alleles are needed in order to increase risk for cervical neoplasia, but a single protective allele may be sufficient for protection. ..
  23. Clarke M, Rodriguez A, Gage J, Herrero R, Hildesheim A, Wacholder S, et al. A large, population-based study of age-related associations between vaginal pH and human papillomavirus infection. BMC Infect Dis. 2012;12:33 pubmed publisher
    ..Future research should include studies of vaginal pH in a more complex assessment of hormonal changes and the cervicovaginal microbiome as they relate to the natural history of cervical neoplasia. ..
  24. Hoover R, Hyer M, Pfeiffer R, Adam E, Bond B, Cheville A, et al. Adverse health outcomes in women exposed in utero to diethylstilbestrol. N Engl J Med. 2011;365:1304-14 pubmed publisher
    ..In utero exposure of women to DES is associated with a high lifetime risk of a broad spectrum of adverse health outcomes. (Funded by the National Cancer Institute.). ..
  25. Schiffman M, Wentzensen N, Wacholder S, Kinney W, Gage J, Castle P. Human papillomavirus testing in the prevention of cervical cancer. J Natl Cancer Inst. 2011;103:368-83 pubmed publisher
    ..The greatest potential for reduction in cervical cancer rates from HPV screening is in low-resource regions that can implement infrequent rounds of low-cost HPV testing and treatment. ..
  26. Castle P, Sideri M, Jeronimo J, Solomon D, Schiffman M. Risk assessment to guide the prevention of cervical cancer. J Low Genit Tract Dis. 2008;12:1-7 pubmed
  27. Carreon J, Martin M, Hildesheim A, Gao X, Schiffman M, Herrero R, et al. Human leukocyte antigen class I and II haplotypes and risk of cervical cancer. Tissue Antigens. 2005;66:321-4 pubmed
    ..No HLA haplotype was significantly associated with cervical neoplasia, suggesting that individual allele associations reported to date (e.g. HLA-DR*13) are not likely explained by underlying haplotypes. ..