J Gynecol Oncol.  2017 Sep;28(5):e47. 10.3802/jgo.2017.28.e47.

Role of active and passive smoking in high-risk human papillomavirus infection and cervical intraepithelial neoplasia grade 2 or worse

• Feng RM
• Hu SY
• Zhao FH
• Zhang R
• Zhang X
• Wallach AI
• Qiao YL

• KMID: 2413216
• DOI: http://doi.org/10.3802/jgo.2017.28.e47

Abstract

OBJECTIVE
We performed a pooled analysis to examine cigarette smoking and household passive smoke exposure in relation to the risk of human papillomavirus (HPV) infection and cervical intraepithelial neoplasia grade 2+ (CIN2+).
METHODS
Data were pooled from 12 cross-sectional studies for cervical cancer screenings from 10 provinces of China in 1999-2007. A total of 16,422 women were analyzed, along with 2,392 high-risk-HPV (hr-HPV) positive women and 381 CIN2+ cases. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models controlling for sexual and non-sexual confounding factors.
RESULTS
There was an excess risk between active smoking and hr-HPV infection and CIN2+. Adjusted OR for ever smokers vs. never smokers was 1.45 (95% CI=1.10-1.91), for hr-HPV infection and 1.89 (95% CI=1.03-3.44), for CIN2+. Passive smoking had a slightly increased risk on the hr-HPV infection with adjusted OR 1.11 (1.00-1.24), but no statistical association was observed between passive smoke exposure and CIN2+. Compared with the neither active nor passive smokers, both active and passive smokers had a 1.57-fold (95% CI=1.14-2.15) increased risk of HPV infection and a 1.99-fold (95% CI=1.02-3.88) risk of CIN2+.
CONCLUSION
Our large multi-center cross-sectional study found active smoking could increase the risk of overall hr-HPV infection and CIN2+ adjusted by passive smoking and other factors. Passive smoking mildly increased the risk of HPV infection but not the CIN2+. An interaction existed between passive tobacco exposure and active smoking for hr-HPV infection and the CIN2+.

Keyword

Cervical Intraepithelial Neoplasia; Papillomaviridae; Infection; Smoking; Tobacco Smoke Pollution; Chinese; Women

MeSH Terms

Adolescent
Adult
Cervical Intraepithelial Neoplasia/epidemiology/pathology/*virology
China/epidemiology
Cross-Sectional Studies
Female
Humans
Middle Aged
Papillomavirus Infections/*epidemiology
Risk Factors
Sexual Behavior
Smoking/*adverse effects
Tobacco Smoke Pollution/*adverse effects
Uterine Cervical Neoplasms/epidemiology/pathology/*virology
Young Adult
Tobacco Smoke Pollution