OBJECTIVE: To assess the relation between two risk factors for cervical neoplasia: smoking and infection with oncogenic human papillomavirus. It has been suggested that smoking causes a local immunological defect, which could facilitate the infection and persistence of human papillomavirus. DESIGN: Cross sectional epidemiological study. Completion of a structured questionnaire by the patients, analysis of cervical scrapes for human papillomavirus, and morphological examination of biopsy specimens. SETTING: Outpatient gynaecological clinic. SUBJECTS: 181 women with a report of cervical cytological abnormality. MAIN OUTCOME MEASURES: Prevalence of infection with oncogenic human papillomavirus and smoking habits. RESULTS: Oncogenic human papillomavirus was found in the cervix of 26 (41%) of the 63 women who did not smoke, 22 (58%) of the 38 who smoked 1-10 cigarettes a day, 28 (61%) of the 46 who smoked 11-20 cigarettes a day, and 26 (76%) of the 34 who smoked > or = 21 cigarettes a day. The prevalence of the virus thus increased in accordance with the number of cigarettes smoked (p = 0.001). This relation remained after adjustment for age at first intercourse and lifetime number of sexual partners. Of the 63 non-smokers, 23 had previously smoked at least 10 cigarettes a day at some time. Of these 23 women, 14 (61%) had oncogenic human papillomavirus in their cervix. Of the 40 women who had never smoked at least 10 cigarettes a day, 12 (30%) had the virus. The prevalence of oncogenic human papillomavirus in non-smokers therefore depended on previous smoking habits (p = 0.03). CONCLUSION: The dose dependent effect of cigarette smoking on the occurrence of oncogenic human papillomavirus favours a causal relation between these risk factors for cervical neoplasia.
OBJECTIVE: To assess the relation between two risk factors for cervical neoplasia: smoking and infection with oncogenic human papillomavirus. It has been suggested that smoking causes a local immunological defect, which could facilitate the infection and persistence of human papillomavirus. DESIGN: Cross sectional epidemiological study. Completion of a structured questionnaire by the patients, analysis of cervical scrapes for human papillomavirus, and morphological examination of biopsy specimens. SETTING:Outpatient gynaecological clinic. SUBJECTS: 181 women with a report of cervical cytological abnormality. MAIN OUTCOME MEASURES: Prevalence of infection with oncogenic human papillomavirus and smoking habits. RESULTS: Oncogenic human papillomavirus was found in the cervix of 26 (41%) of the 63 women who did not smoke, 22 (58%) of the 38 who smoked 1-10 cigarettes a day, 28 (61%) of the 46 who smoked 11-20 cigarettes a day, and 26 (76%) of the 34 who smoked > or = 21 cigarettes a day. The prevalence of the virus thus increased in accordance with the number of cigarettes smoked (p = 0.001). This relation remained after adjustment for age at first intercourse and lifetime number of sexual partners. Of the 63 non-smokers, 23 had previously smoked at least 10 cigarettes a day at some time. Of these 23 women, 14 (61%) had oncogenic human papillomavirus in their cervix. Of the 40 women who had never smoked at least 10 cigarettes a day, 12 (30%) had the virus. The prevalence of oncogenic human papillomavirus in non-smokers therefore depended on previous smoking habits (p = 0.03). CONCLUSION: The dose dependent effect of cigarette smoking on the occurrence of oncogenic human papillomavirus favours a causal relation between these risk factors for cervical neoplasia.
Authors: T Rohan; V Mann; J McLaughlin; D G Harnish; H Yu; D Smith; R Davis; R M Shier; W Rawls Journal: Int J Cancer Date: 1991-12-02 Impact factor: 7.396
Authors: A J van den Brule; P J Snijders; R L Gordijn; O P Bleker; C J Meijer; J M Walboomers Journal: Int J Cancer Date: 1990-04-15 Impact factor: 7.396
Authors: W Melchers; A van den Brule; J Walboomers; M de Bruin; M Burger; P Herbrink; C Meijer; J Lindeman; W Quint Journal: J Med Virol Date: 1989-04 Impact factor: 2.327
Authors: S F Derchain; C M Roteli-Martins; K J Syrjänen; H J de Abreu; E Z Martinez; V A Alves Journal: Sex Transm Infect Date: 1999-12 Impact factor: 3.519
Authors: B Kleter; L J van Doorn; J ter Schegget; L Schrauwen; K van Krimpen; M Burger; B ter Harmsel; W Quint Journal: Am J Pathol Date: 1998-12 Impact factor: 4.307