Invasive Cervical Cancer and Smoking in Latin America

Abstract

A case-control study of 667 patients with invasive squamous cell carcinoma of the cervix and 1,430 controls from four Latin American countries showed an age-adjusted relative risk (RR) of 1.2 [95% confidence interval (CI) = 1.0-1.4] for women who had ever smoked, with risk rising to 1.7 (95% CI, 0.8-3.6) for women who smoked greater than or equal to 30 cigarettes per day. The associations were practically eliminated after adjustment for the number of sexual partners and alcohol consumption, probably a surrogate for an unidentified life-style risk factor. Some excess risk persisted among women who smoked for extended periods (RR = 1.5 for greater than or equal to 40 yr), as well as those who began smoking at older ages (RR = 1.7 for greater than 30 yr), which suggests a late-stage effect. In addition, among women who tested positive for human papillomavirus (HPV) type 16 or 18 by filter in situ hybridization, there was an increased risk for women who had ever smoked and a dose-response relationship with the number of cigarettes smoked (adjusted RRs compared with HPV-negative nonsmokers = 5.0 for HPV-positive nonsmokers, 5.5 for less than 10 cigarettes/day, and 8.4 for greater than or equal to 10 cigarettes/day). In contrast, HPV-negative women had no increased risk associated with smoking. These results, from a high-incidence area where intensive smoking among women is still relatively rare, suggest that smoking has a limited effect on cervical cancer risk, possibly only among women with specific types of HPV.

Squamous intraepithelial lesions of the cervix, invasive cervical carcinoma, and immunosuppression induced by human immunodeficiency virus in africa

“…2 Cigarette smoking was very rare in our study and unrelated to cervical dysplasia. 25,36,40 In contrast, chewing tobacco use was associated with HSILs and was more frequent among women with ICC. Even though chewing tobacco use was rare, found mostly among women of low educational level, public health authorities must be made aware of the benefits to women's health that would result from preventing addiction to chewing tobacco in Africa.…”

Natural History of Genital Papillomavirus Infections

“…Individuals with a history of smoking have an increased risk for condylomata acuminata [164]. A dose-dependent association between cigarette smoking and the presence of high-risk HPV types as detected by consensus PCR in cervical smears of 181 women remained significant after adjust ment for age at first intercourse and lifetime number of sexual partners [169], That smoking acts synergistically with HPV for cervical carcinogenesis or just increases the risk for HPV infection awaits further clarification: in a case-control study, adjustment for HPV could decrease relative risks between smoking and SILs [ 129], whereas in another study an association was only found in HPV-positive women [170].…”

Burning wood in the kitchen increases the risk of cervical neoplasia in HPV‐infected women in Honduras

“…Inhalation of air contaminated through the combustion of tobacco (i.e., cigarette smoking) has been amply documented to cause cancer and also cervical neoplasia and invasive cancer. [1][2][3][4][5] Inhalation of air contaminated through the combustion of coal, wood and straw has been related to lung cancer 6,7 and cancers of the head and neck. 8,9 In a casecontrol study of invasive cervical cancer in Honduras, 10 we presented evidence suggestive of an increased risk of invasive cervical cancer among women who had used wood as fuel in the kitchen over many years.…”