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February 24, 1984

Diagnosis and Epidemiology of Condyloma Acuminatum

Author Affiliations

The University of Texas System Cancer Center M. D. Anderson Hospital and Tumor Institute Houston
University of Texas Graduate School of Biomedical Sciences Houston

JAMA. 1984;251(8):1028-1029. doi:10.1001/jama.1984.03340320018016

To the Editor.—  We wish to comment on the recent editorial note concerning the diagnosis and epidemiology of condyloma acuminatum.1 The Centers for Disease Control analysis of the data collected by the National Disease and Therapeutic Index (NDTI) referred to grossly visible papillomata caused by the human papilloma virus (HPV), occurring in the anogenital region in both sexes. Recently, however, many articles2-4 have appeared documenting that, at least in women, most HPV lesions are flat, subclinical epithelial proliferations occurring on the cervix or in the vagina that can only be detected by colposcopy.The previously held view that cervical HPV infection was rare has now, as a consequence of improved cytological diagnosis, given way to the recognition that HPV-associated cellular atypia is the most frequent abnormality noted on Papanicolaou smears.2 Moreover, HPV-associated changes are seen in a substantial proportion of cervical intraepithelial neoplastic lesions. Cytological diagnosis of

 Condyloma acuminatum—United States, 1966-1981 .  JAMA 1983;250:336.Crossref
Meisels A, Morin C, Casas-Cordero M:  Human papillomavirus infection of the uterine cervix .  Int J Gynecol Pathol 1982;1:75-94.Crossref
Reid R, Stanhope CR, Herschman BR, et al:  Genital warts and cervical cancer: I. Evidence of an association between subclinical papillomavirus infection and cervical malignancy .  Cancer 1982;50:377-387.Crossref
Reid R:  Genital warts and cervical cancer: II. Is human papillomavirus infection the trigger to cervical carcinogenesis?  Gynecol Oncol 1983;15:239-252.Crossref
Kurman RJ, Jenson AB, Lancaster WD:  Papillomavirus infection of the cervix: II. Relationship to intraepithelial neoplasia based on the presence of specific viral structural proteins .  Am J Surg Pathol 1983; 7:39-52.Crossref