Human papillomavirus infection of the lower female genital tract: association with multicentric neoplasia.

Fifty-four patients with multiple condylomatous lesions and/or multicentric neoplasia were identified in a consecutive series of 2,627 colposcopic examinations (2%). Forty-one percent presented with condylomata only and 57% exhibited associated intraepithelial or invasive neoplasia in at least one site. Only one patient was found to have multicentric neoplasia with no condylomatous features. There was a significant increase in mean age between patients presenting with multiple condylomatous lesions and those who had intraepithelial neoplasia as well. An association with pregnancy was found in 17% of the cases, and with renal transplant in 5%. Virus particles compatible with human papillomavirus were found in 62% of the cases examined. Evidence for a causative role in the development of neoplasia of the lower female genital tract is considered.