Persistent infection with human papillomavirus (HPV) is associated with a high risk of cervical intraepithelial neoplasia (CIN) and disease progression is influenced by host hormonal factors. The role of fetal exposure to sex steroids has not been explored. The study compared the second to fourth digit ratio (2D:4D), a marker of exposure to fetal androgens, among women with and without HPV and CIN. Data were available from two studies in which HPV, 2D:4D and descriptive variables were assessed cross-sectionally at sexual health clinics. One study (case-control) also assessed cervical smears or biopsies, and some women were retested for persistent HPV. Using these data, 2D:4D was compared among groups defined by cervical smear and HPV result. The cross-sectional data included 90 adolescents and 240 nonadolescents. White women had a significantly higher 2D:4D than other ethnic groups. In the case-control analysis (n = 263), after controlling for ethnicity, women who developed CIN were significantly more likely to have a higher 2D:4D compared with HPV-negative women. A similar, nonsignificant trend was observed among women with a persistent HPV infection.
Conclusion: Lower fetal androgen exposure may predispose to persistent HPV and increased risk of CIN.