Kandyce Keller1, Jeslie M Ramos-Cartagena2, Humberto M Guiot3, Cristina Muñoz4, Yolanda Rodríguez4, Vivian Colón-López5, Ashish A Deshmukh6, Maribel Tirado-Gómez7, Ana Patricia Ortiz8. 1. Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, U.S. 2. University of Puerto Rico/MD Anderson Cancer Center Partnership for Excellence in Cancer Research Program, PO Box 363067, San Juan, Puerto Rico, 00936, U.S. 3. School of Medicine, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, San Juan, Puerto Rico, 00936, U.S. 4. Division of Cancer Medicine, University of Puerto Rico Comprehensive Cancer Center, PO Box 363027, San Juan, Puerto Rico, 00936, U.S. 5. Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, PO Box 363027 San Juan, Puerto Rico, 00936, U.S. 6. Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, 1200 Pressler Street, Houston, Texas, 77030, U.S. 7. School of Medicine, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, San Juan, Puerto Rico, 00936, U.S.; Division of Cancer Medicine, University of Puerto Rico Comprehensive Cancer Center, PO Box 363027, San Juan, Puerto Rico, 00936, U.S. 8. Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, 1200 Pressler Street, Houston, Texas, 77030, U.S.; Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, San Juan, Puerto Rico, 00936, U.S.. Electronic address: ana.ortiz7@upr.edu.
Abstract
INTRODUCTION: Current smoking is a risk factor for anal cancer. Yet, its association with anal human papillomavirus infection (HPV) and anal high-grade squamous intraepithelial lesions (HSIL) remains unclear. We assessed the association of smoking with 1) anal high-risk HPV (HR-HPV) infection and 2) anal HSIL. METHODS: Data from the baseline visit of patients from the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (May 2015- June 2021) was analyzed. Patients were eligible if they had information on smoking status, complete high-resolution anoscopy (HRA) with biopsy, and HR-HPV testing (n = 427). Logistic regression models estimated the odds ratio (OR) with 95% confidence intervals (CIs) adjusting for covariates. RESULTS: Mean age was 44 ± 13 years, 69% were men, 74% were HIV-infected, and 25% reported being current smokers. 74% had anal HR-HPV infection. HSIL was diagnosed in 40% of patients. Current smokers had significantly higher odds (OR: 1.71, 95% CI: 1.04-2.82) of having HSIL compared to non-smokers after adjusting for age, sexual risk group, lifetime number of sexual partners, HIV status, and HR-HPV infection. Smoking was not associated with HR-HPV infection (OR: 1.56, 95% CI: 0.83-2.95) after adjusting for age, sexual risk group, lifetime number of sexual partners, and HIV status. CONCLUSIONS: Current smoking was associated with histologically confirmed HSIL but not with HR-HPV infection among this high-risk Hispanic population. Results highlight the need to explore targeted smoking cessation campaigns among populations at higher risk of developing HSIL, as an anal cancer prevention strategy.
INTRODUCTION: Current smoking is a risk factor for anal cancer. Yet, its association with anal human papillomavirus infection (HPV) and anal high-grade squamous intraepithelial lesions (HSIL) remains unclear. We assessed the association of smoking with 1) anal high-risk HPV (HR-HPV) infection and 2) anal HSIL. METHODS: Data from the baseline visit of patients from the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (May 2015- June 2021) was analyzed. Patients were eligible if they had information on smoking status, complete high-resolution anoscopy (HRA) with biopsy, and HR-HPV testing (n = 427). Logistic regression models estimated the odds ratio (OR) with 95% confidence intervals (CIs) adjusting for covariates. RESULTS: Mean age was 44 ± 13 years, 69% were men, 74% were HIV-infected, and 25% reported being current smokers. 74% had anal HR-HPV infection. HSIL was diagnosed in 40% of patients. Current smokers had significantly higher odds (OR: 1.71, 95% CI: 1.04-2.82) of having HSIL compared to non-smokers after adjusting for age, sexual risk group, lifetime number of sexual partners, HIV status, and HR-HPV infection. Smoking was not associated with HR-HPV infection (OR: 1.56, 95% CI: 0.83-2.95) after adjusting for age, sexual risk group, lifetime number of sexual partners, and HIV status. CONCLUSIONS: Current smoking was associated with histologically confirmed HSIL but not with HR-HPV infection among this high-risk Hispanic population. Results highlight the need to explore targeted smoking cessation campaigns among populations at higher risk of developing HSIL, as an anal cancer prevention strategy.
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