Cancer Causes & Control

, Volume 26, Issue 7, pp 983–991 | Cite as

Effects of active, passive, and combined smoking on cervical cancer mortality: a nationwide proportional mortality study in Chinese urban women

  • Jingmei Jiang
  • Haiyu Pang
  • Boqi Liu
  • Philip C. Nasca
  • Biao Zhang
  • Yanping Wu
  • Wei Han
  • Margaret Gates
  • Tao Lu
  • Xiaonong Zou
  • Fang Xue
  • Lei Hou
  • Zixing Wang
  • Yuyan Wang
  • Yuanli Chen
  • Junyao Li
Original paper

Abstract

Purpose

To determine whether smoking, in any form, is a risk factor in the development of cervical cancer (CC) among urban Chinese women.

Methods

We ascertained retrospectively the smoking habits of 1,865 women (aged 35+) who had died from CC (cases) and 48,781 who had died from causes unrelated to smoking (controls) in 24 cities using data from a large national survey of smoking and mortality in 1989–1991. We assessed the risk of smoking on CC mortality with and without considering passive smoke exposure from a spouse using a proportional mortality study design.

Results

Overall, there was a 51.0 % excess risk of death from CC among smokers. When the spouse’s exposure was further considered, the RR (95 % CI) for exposed versus unexposed women was 1.28 (1.04–1.57) for passive smokers, 1.49 (1.02–2.20) for active smokers, and 1.69 (1.27–2.26) for women with both exposures (all p < 0.001). Significant dose–response associations were observed between smoking and CC for all categories of exposure. For example, individuals with both smoking exposure had the highest risk of CC mortality with moderate [RR = 1.67 (1.18–2.38)] and high [RR = 1.88 (1.04–3.41)] daily cigarette consumption, and they also had the highest risk with ≤15 years exposure [RR = 1.73 (1.19–2.52)] and >15 years exposure [RR = 1.95 (1.15–3.32)], compared with the active and passive groups (p for trend <0.001).

Conclusions

Younger trend of CC death and the rapid increase in smoking among young women may have a profound impact on future incidence of CC. Our findings emphasize the need for preventive efforts among both women and men in China.

Keywords

Cervical cancer Mortality Smoking Passive smoking Chinese women 

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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Jingmei Jiang
    • 1
  • Haiyu Pang
    • 1
  • Boqi Liu
    • 2
  • Philip C. Nasca
    • 3
  • Biao Zhang
    • 1
  • Yanping Wu
    • 2
  • Wei Han
    • 1
  • Margaret Gates
    • 3
  • Tao Lu
    • 3
  • Xiaonong Zou
    • 2
  • Fang Xue
    • 1
  • Lei Hou
    • 1
  • Zixing Wang
    • 1
  • Yuyan Wang
    • 1
  • Yuanli Chen
    • 2
  • Junyao Li
    • 2
  1. 1.Department of Epidemiology and Biostatistics, Institute of Basic Medical Science, Chinese Academy of Medical Sciences and School of Basic MedicinePeking Union Medical CollegeBeijingChina
  2. 2.National Cancer InstituteChinese Academy of Medical SciencesBeijingChina
  3. 3.School of Public HealthState University of New York at AlbanyAlbanyUSA

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