Effects Of Active And Passive Smoking On Human Papillomavirus Infection And Cervical Intraepithelial Neoplasia Grade 2 Or Worse In China: A Pooled Analysis
Rui-Mei FENG, Cancer Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College, China
HU S. 1
, ZHAO F. 1
, ZHANG R. 2
, ZHANG X. 3
, WALLACH A. 4
, DELOSO K. 5
, QIAO Y. 1
1 Department of Cancer Epidemiology,Cancer Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing,P.R. China
2 Department for Chronic and Non-communicable Diseases Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control And Prevention, Urumqi, P.R. China
3 Department of Pathology,Cancer Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing,P.R. China
4 Neurology, New York University School of Medicine,New York, US
5 Biological Sciences Division,University of Chicago, Chicago, US
Purpose: We performed a pooled analysis to examine cigarette smoking and household passive smoke exposure in relation to the risk of HPV infection and CIN2+.
Methods: Data were pooled from 12 cross-sectional studies for cervical cancer screenings from 10 provinces of China in 1999 – 2007. A total of 16,949 women were analyzed, along with 2,531 HPV positive women and 410 CIN2+ cases. Pooled odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models controlling for sexual and non-sexual confounding factors.
Results: There was an excess risk between active smoking and HPV infection and CIN2+. Adjusted OR for ever smokers vs. never smokers was 1.45 (95% CI: 1.10-1.91), for HPV infection and 1.89 (95% CI: 1.03-3.44), for CIN2+. Passive smoking had a slightly increased risk on the HPV infection with adjusted OR 1.11 (1.00-1.24), but no statistical association was observed between passive smoke exposure and CIN2+.Compared with the neither active nor passive smokers, both active and passive smokers had a 1.57-fold (95% CI: 1.14-2.15) increased risk of HPV infection and a 1.99-fold (95% CI: 1.02-3.88) risk of CIN2+.
Conclusions: Our large multi-center cross-sectional study found active smoking could increase the risk of overall HPV infection and CIN2+ adjusted by passive smoking and other factors. Passive smoking mildly increased the risk of HPV infection but not the development of CIN2+ following infection. An interaction exists between passive tobacco exposure and active smoking for HPV infection and the CIN2+ risk, but needs to be confirmed in further prospective studies including more cases.
Funding source: Our work was supported by the National Natural Science of Foundation of China (No 81322040).