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Smoking is a risk factor for cervical intraepithelial neoplasia grade 3 among oncogenic human papillomavirus DNA-positive women with equivocal or mildly abnormal cytology.
Cancer Epidemiol Biomarkers Prev. 2005 May; 14(5):1165-70.CE

Abstract

BACKGROUND

Smoking is a potential risk factor for cervical cancer and its immediate precursor, cervical intraepithelial neoplasia grade 3 (CIN3), but few studies have adequately taken into account the possible confounding effect of oncogenic human papillomavirus (HPV) infection.

METHODS

Women (n = 5,060) with minimally abnormal Papanicolaou smears were enrolled in the ASCUS and LSIL Triage Study, a clinical trial to evaluate management strategies, and were seen every 6 months for the 2-year duration of the study. Cervical specimens were tested for HPV DNA using both Hybrid Capture 2 and PGMY09/11 L1 consensus primer PCR with reverse line blot hybridization for genotyping. Multivariate logistics regression models were used to assess associations [odds ratio (OR) with 95% confidence intervals (95% CI)] between smoking behaviors and rigorously reviewed cases of cervical intraepithelial neoplasia grade 3 or cancer (> or =CIN3) identified throughout the study (n = 506) in women with oncogenic HPV (n = 3,133).

RESULTS

Current smoking was only weakly associated with increased HPV infection. Among infected women, current smokers (OR, 1.7; 95% CI, 1.4-2.1) and past smokers (OR, 1.7; 95% CI, 1.2-2.4) were more likely to be diagnosed with > or =CIN3 than nonsmokers. Greater smoking intensity (P(Trend) < 0.0005) and duration (P(Trend) < 0.0005) increased the strength of the association, with smoking > or =2 packs/d (OR, 3.3; 95% CI, 1.5-7.5) and smoking for > or =11 years (OR, 2.1; 95% CI, 1.5-2.9) most strongly associated with > or =CIN3 as compared to non-smokers. The effects of intensity and duration seemed additive.

CONCLUSIONS

Women with oncogenic HPV and minimally abnormal Papanicolaou smears who smoke were up to three times more likely to be diagnosed with > or =CIN3 than nonsmokers. Smoking cessation trials targeting this population might be warranted.

Authors+Show Affiliations

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Room 7074, 6120 Executive Boulevard, EPS MSC 7234, Bethesda, MD 20892-7234, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15894667

Citation

McIntyre-Seltman, Kathleen, et al. "Smoking Is a Risk Factor for Cervical Intraepithelial Neoplasia Grade 3 Among Oncogenic Human Papillomavirus DNA-positive Women With Equivocal or Mildly Abnormal Cytology." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 14, no. 5, 2005, pp. 1165-70.
McIntyre-Seltman K, Castle PE, Guido R, et al. Smoking is a risk factor for cervical intraepithelial neoplasia grade 3 among oncogenic human papillomavirus DNA-positive women with equivocal or mildly abnormal cytology. Cancer Epidemiol Biomarkers Prev. 2005;14(5):1165-70.
McIntyre-Seltman, K., Castle, P. E., Guido, R., Schiffman, M., & Wheeler, C. M. (2005). Smoking is a risk factor for cervical intraepithelial neoplasia grade 3 among oncogenic human papillomavirus DNA-positive women with equivocal or mildly abnormal cytology. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 14(5), 1165-70.
McIntyre-Seltman K, et al. Smoking Is a Risk Factor for Cervical Intraepithelial Neoplasia Grade 3 Among Oncogenic Human Papillomavirus DNA-positive Women With Equivocal or Mildly Abnormal Cytology. Cancer Epidemiol Biomarkers Prev. 2005;14(5):1165-70. PubMed PMID: 15894667.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Smoking is a risk factor for cervical intraepithelial neoplasia grade 3 among oncogenic human papillomavirus DNA-positive women with equivocal or mildly abnormal cytology. AU - McIntyre-Seltman,Kathleen, AU - Castle,Philip E, AU - Guido,Richard, AU - Schiffman,Mark, AU - Wheeler,Cosette M, AU - ,, PY - 2005/5/17/pubmed PY - 2005/12/15/medline PY - 2005/5/17/entrez SP - 1165 EP - 70 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol Biomarkers Prev VL - 14 IS - 5 N2 - BACKGROUND: Smoking is a potential risk factor for cervical cancer and its immediate precursor, cervical intraepithelial neoplasia grade 3 (CIN3), but few studies have adequately taken into account the possible confounding effect of oncogenic human papillomavirus (HPV) infection. METHODS: Women (n = 5,060) with minimally abnormal Papanicolaou smears were enrolled in the ASCUS and LSIL Triage Study, a clinical trial to evaluate management strategies, and were seen every 6 months for the 2-year duration of the study. Cervical specimens were tested for HPV DNA using both Hybrid Capture 2 and PGMY09/11 L1 consensus primer PCR with reverse line blot hybridization for genotyping. Multivariate logistics regression models were used to assess associations [odds ratio (OR) with 95% confidence intervals (95% CI)] between smoking behaviors and rigorously reviewed cases of cervical intraepithelial neoplasia grade 3 or cancer (> or =CIN3) identified throughout the study (n = 506) in women with oncogenic HPV (n = 3,133). RESULTS: Current smoking was only weakly associated with increased HPV infection. Among infected women, current smokers (OR, 1.7; 95% CI, 1.4-2.1) and past smokers (OR, 1.7; 95% CI, 1.2-2.4) were more likely to be diagnosed with > or =CIN3 than nonsmokers. Greater smoking intensity (P(Trend) < 0.0005) and duration (P(Trend) < 0.0005) increased the strength of the association, with smoking > or =2 packs/d (OR, 3.3; 95% CI, 1.5-7.5) and smoking for > or =11 years (OR, 2.1; 95% CI, 1.5-2.9) most strongly associated with > or =CIN3 as compared to non-smokers. The effects of intensity and duration seemed additive. CONCLUSIONS: Women with oncogenic HPV and minimally abnormal Papanicolaou smears who smoke were up to three times more likely to be diagnosed with > or =CIN3 than nonsmokers. Smoking cessation trials targeting this population might be warranted. SN - 1055-9965 UR - https://www.unboundmedicine.com/medline/citation/15894667/Smoking_is_a_risk_factor_for_cervical_intraepithelial_neoplasia_grade_3_among_oncogenic_human_papillomavirus_DNA_positive_women_with_equivocal_or_mildly_abnormal_cytology_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&amp;pmid=15894667 DB - PRIME DP - Unbound Medicine ER -