Anaerobic (bacterial) vaginosis and premalignant disease of the cervix.

Nitrosamines are carcinogenic substances found in cigarette smoke, and it is known that female smokers have an increased risk of cervical carcinoma and premalignant change. Nitrosamines may also be formed due to the combination of amines and nitrites in an acidic medium. This study has shown a statistically significant association between anaerobic vaginosis which produce amines and cervical intraepithelial neoplasia 2 and 3. In addition nitrate reducing organisms are found in the acidic lower genital tract in a significant number of cases. It is therefore theoretically possible that nitrosamines may be an important agent in the development of premalignant disease of the cervix.