A 24-year-old woman asks why she was advised regular cervical screening despite having a single partner and no smoking history. Which single factor is the strongest determinant of whether cervical intraepithelial neoplasia will develop after acquisition of high-risk HPV?
- A Age at first sexual intercourse
- B Use of combined oral contraceptives
- C Persistence of high-risk HPV infection beyond 12 months ✓
- D Number of lifetime sexual partners
Correct answer: C. Persistence of high-risk HPV infection beyond 12 months
Explanation
Most high-risk HPV infections clear within 12 to 24 months by cell-mediated immunity. Persistence beyond 12 months is the single strongest predictor of progression to CIN and invasive carcinoma, because the virus must remain present for E6 and E7 oncogene expression to drive transformation. Early coitarche, multiple partners and smoking are risk factors only insofar as they increase the chance of acquiring or failing to clear infection.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.