This study describes the distribution of DQB1genes in Norwegian women treated for high-grade cervical intraepithelial neoplasia (CIN). Formalin-fixed, paraffin-embedded tissue sections from 170 biopsy specimens with diagnoses of CIN II (n = 54) or CIN III (n = 116) were DQB1-typed using allele-specific polymerase chain reaction. The follow-up period for cases was 13 to 15 years. The control material comprised blood samples and endocervical brushes from 213 women without CIN. Both cases and controls had previously been human papillomavirus (HPV)-typed. The DQB1*0301 allele was overrepresented among cases compared with controls (odds ratio [OR] = 1.8). Presence of CIN was related to HPV infection, and HPV 16 positivity was significantly associated with the presence of DQB1*0301 (OR 1.8). The DQBI*0301 allele was significantly more prevalent in CIN III than in CIN II cases. The lesions in two women recurred in the follow-up period, one of whom was carrying the DQB1*0301 allele. Women carrying the HLA-DQB1*0301 allele have an increased risk of developing CIN when infected by HPV 16, although there was not an increased frequency of recurrent disease among women carrying this allele.
In this population-based case-control study we explored the association of antiphospholipid antibodies with pregnancy-related venous thrombosis. From 1990 through 2003 615 pregnant women were identified at 18 hospitals in Norway with a diagnosis of first time VT. In 2006, 531 of 559 eligible cases and 1092 of 1229 eligible controls were invited for further investigations. The final study population comprised 313 cases and 353 controls, who completed a comprehensive questionnaire and donated a single blood sample, 3-16 years after index pregnancy. We report the results on lupus anticoagulant, anticardiolipin antibodies, and anti-ss(2) glycoprotein-1 antibodies alone, in combination, and with the contribution of the factor V Leiden and the prothrombin gene G20210A polymorphisms. Cut-off values for APAs were chosen according to current international consensus. 29 (9.3%) of the cases and 24 (6.8%) of the controls had at least one positive test for APAs (OR 1.4; 95% CI 0.8-2.5). Nine cases (2.8%) and no controls had more than one positive test (multi-positivity) for APAs. After excluding women with factor V Leiden or prothrombin polymorphisms, still 6 cases were multi-positive for APAs. We conclude that multi-positivity, but not single-positivity, for APAs was weakly associated with a history of ante- and postnatal VT.
While waiting for sterilization at the Department of Gynaecology, University Hospital of Trondheim (Regionsykehuset), 687 women were sent a questionnaire by mail concerning the experience of waiting for surgery. At the time of asking, about 30% of the women did not need the surgery they were scheduled for. The expected waiting time has increased in recent years and is now more than two years. During the waiting period 22 women became pregnant. 15 of these pregnancies were terminated by induced abortion. The conception rate was highest during the first year on the waiting list. In order to prevent unplanned pregnancies, the capacity for sterilization must be increased until the waiting time is less than three months.
BACKGROUND: Cervical cancer is the third most frequent cancer among women worldwide. Human papillomavirus (HPV) infection is a necessary risk factor and the first step in cervical carcinogenesis. MATERIAL AND METHODS: This article reviews the current literature concerning the possibility of preventing cervical cancer by HPV testing and vaccination. RESULTS: HPV testing cannot replace cytology, but will reduce false negative cytology and may improve the screening programme for cervical neoplasia. It has not yet been incorporated in any national cervical cancer screening program, but trials are ongoing in Scandinavia and in the Netherlands. The cost-effectiveness of HPV testing in screening has to be proven and whether it can affect the recommended screening-intervals. Therapeutic and prophylactic vaccines for HPV associated disease are in progress. Evaluating the clinical trials that are ongoing will take several years. Several anti-HPV vaccines are now in clinical trials; Norway will also participate. Therapeutic vaccines against cervical cancer have so far not been successful, but anogenital dysplasias and condylomas may be more susceptible. Prophylactic vaccines against HPV 6, 11, 16 and 18 have been evaluated in clinical phase I and II trials, and phase III trials are in progress. INTERPRETATION: HPV testing improves the specificity and sensitivity of cervical cytology and it can be used to clarify cases with atypical cells of undetermined significance (ASCUS) and low-grade intraepithelial neoplasia. In the near future it may also be included in the cervical cancer screening programme for women above the age of 30. The first results in clinical vaccine trials are encouraging, and final conclusions about the effectiveness of these vaccines may be achieved in five years' time.
In April and May 1991 all women requesting abortion in Norway were screened for Chlamydia trachomatis and Neisseria gonorrhoeae. During the study period 2,194 abortions were carried out. The study included 2,110 women with representative tests for C trachomatis from the cervix uteri. Only 1,702 women were tested for N gonorrhoeae. The prevalence of N gonorrhoeae was 0.5% (8:1,702), and of C trachomatis 5.4% (113:2,100). The prevalence of C trachomatis decreased from 9.1% among women less than or equal to 19 years to 2.0% among women greater than or equal to 35 years of age. Prevalence of C trachomatis was significantly lower among subjects resident in health region no. IV (mid-western part of Norway) than among candidates for abortion from the other four health regions. Being less than 25 years of age was the best single parameter for identifying chlamydia-positive cases. The prevalence of N gonorrhoeae among women seeking abortion in Norway is so low that screening is not recommended. However, the prevalence of C trachomatis is still high enough to recommend screening of all women less than 25 years of age who request abortion. Chlamydia-positive cases should be tested for N gonorrhoeae.
In a study at the University Hospital in Trondheim during 1983, the frequency of Chlamydia trachomatis among women terminating their pregnancies was 8.2%. Younger women were infected by C. trachomatis at a more frequent rate than older women (p less than 0.001). Treatment of chlamydia-positive women was initiated within the first two weeks after the abortion. However, among women readmitted to the hospital, chlamydia-positive women showed a higher frequency of salpingitis than chlamydia-negative women (p less than 0.08). Preabortion examination for C. trachomatis and treatment of chlamydia-positive women by practitioners before the abortion is carried out, may reduce the postabortal frequency of salpingitis.
To investigate the use of contraception in a representative sample of Norwegian women.
Frequency distribution of contraceptive methods by age, marital status and partly strata.
A sample of 4,933 women were selected at random from the Central Population Register as participants in the second Norwegian fertility study (1988). The response rate was 81% (n = 4,019) and personal interviews of contraceptive use were carried out among 2,782 women who were fecund, sexually active and not pregnant. These women comprise the study population.
2,782 women were sexually active during the last month prior to the interview and thus in potential need of contraception. More than 50% of the women used either oral contraceptives (21%) or IUDs (30%). The use of oral contraceptives decreased linearly with age from a user rate of 60% among women 20-24 years old to 1.5% among women 40-44 years of age. The use of IUDs increased from 6% in the youngest age group to nearly 40% among women aged 30-39 years of age. Oral contraceptives were preferentially used by childless women or those with only one child, while IUDs were most often used by women with two or more children. The sterilisation rate increased by age and in the 40-44 age group one out of every three women was sterilised. Non-use was most frequent among the subgroups of women who planned children in the future. Use of condoms and other coitus-dependent contraceptives varied less with age, marital status and parity than did the use of OC, IUDs or sterilisation.
The user pattern concerning different contraceptive methods reflects the general guidelines for contraceptives in Norway. The fact that nearly 70% of the women were in one of the three categories--OC or IUD users, or one of the partners was sterilised--reveals that the awareness and knowledge of modern contraception is high in Norwegian society.