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Smoking is an independent risk factor for oncogenic human papillomavirus (HPV) infections but not for high-grade CIN

  • Infectious Diseases
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Abstract

Background Recent evidence implicates smoking as a risk factor for cervical cancer (CC), but the confounding from high-risk human papillomavirus (HPV) infections is not clear. Objectives To analyse the role of smoking as an independent predictor of CIN2+ and HR-HPV infections in a population-based prospective (NIS, New Independent States of former Soviet Union) cohort study. Study design and Methods A cohort of 3,187 women was stratified into three groups according to their smoking status: (i) women who never smoked; (ii) those smoking in the past; and (iii) women who are current smokers. These groups were analysed for predictors of (a) HR-HPV; (b) high-grade CIN, and (c) outcome of HR-HPV infections and cytological abnormalities during prospective follow-up (n = 854). Results The three groups were significantly different in all major indicators or risk sexual behaviour (or history) implicating strong confounding. There was no increase in HSIL/LSIL/ASC-US cytology or CIN1+/CIN2+/CIN3+ among current smokers. Only few predictors of HR-HPV and CIN2+ were common to all three groups, indicating strong interference of the smoking status. There was no difference in outcomes of cervical disease or HR-HPV infections between the three groups. In multivariate model, being current smoker was one of the five independent predictors of HR-HPV (P = 0.014), with adjusted OR = 1.52 (95%CI 1.09–2.14). In addition to age, HR-HPV was the only independent predictor of CIN2+ in multivariate model (OR = 14.8; 95%CI 1.72–127.31). Conclusions These data indicate that cigarette smoking is not an independent risk factor of CIN2+, but the increased risk ascribed to smoking is mediated by acquisition of HR-HPV, of which current smoking was an independent predictor in multivariate model.

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Acknowledgements

This study has been supported by the INCO-Copernicus Program of the European Commission (Contract No. ERB IC15-CT98-0321). Special thanks are due to Digene Europe, for providing the Hybrid Capture analyzer, samplers and the test kits. The skilful technical assistance of Ms. Sari Mäki, Mrs Katja Sampalahti, and Ms. Nina Wahlroos and Mrs. Tatjanan Peskova is gratefully acknowledged. The authors are indebted to IAC-certified cytotechnologists Anna-Maija Korhonen and Kirsti Hartiala for re-screening the Pap smears. Special thanks are also due to Mrs. Mervi Puotunen for secretarial work. Finally, we express our thanks to all women who participated in this study.

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Authors and Affiliations

  1. Department of Oncology and Radiotherapy, Turku University Hospital, Savitehtaankatu 1, Turku, 20521, Finland

    Kari Syrjänen

  2. N.N. Blokhin Cancer Research Centre of Russian Academy of Medical Sciences (RAMS), Moscow, Russia

    Irena Shabalova, Nicolay Petrovichev, Vladimir Kozachenko, Tatjana Zakharova, Julia Pajanidi, Jurij Podistov & Galina Chemeris

  3. Russian Academy of Post-Graduate Medical Education, Moscow, Russia

    Irena Shabalova, Larisa Sozaeva & Elena Lipova

  4. Novgorod Clinical Regional Hospital, Centralised Cytology Laboratory, Novgorod, Russia

    Irena Tsidaeva, Olga Ivanchenko & Alla Pshepurko

  5. Department of Gynaecology, Novgorod Municipal Dermato-venereological Dispensary, Novgorod, Russia

    Sergej Zakharenko

  6. Department of Gynaecology, Novgorod Female Consultative Outpatient Hospital, Novgorod, Russia

    Raisa Nerovjna

  7. Research Institute of Oncology and Medical Radiology, Republican Centre of Clinical Cytology, Minsk, Belarus

    Ludmila Kljukina & Oksana Erokhina

  8. Department of Gynaecology and Obstetrics, Minsk State Medical Institute, Minsk, Belarus

    Marina Branovskaja

  9. Department of Gynaecology, and Laboratory of Cytology, Latvian Cancer Centre, Riga, Latvia

    Maritta Nikitina, Valerija Grunberga, Alexandr Grunberg & Anna Juschenko

  10. Department of Pathology, University of Siena, Siena, Italy

    Rosa Santopietro, Marcella Cintorino & Piero Tosi

  11. Department of Oral Pathology, Institute of Dentistry, and MediCity Research Laboratory, University of Turku, Turku, Finland

    Stina Syrjänen

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  1. Kari Syrjänen
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  26. Stina Syrjänen
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Correspondence to Kari Syrjänen.

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Syrjänen, K., Shabalova, I., Petrovichev, N. et al. Smoking is an independent risk factor for oncogenic human papillomavirus (HPV) infections but not for high-grade CIN. Eur J Epidemiol 22, 723–735 (2007). https://doi.org/10.1007/s10654-007-9180-8

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  • DOI: https://doi.org/10.1007/s10654-007-9180-8

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