Is Smoking an Independent Risk Factor for Invasive Cervical Cancer? A Nested Case-Control Study Within Nordic Biobanks

Aline Simen Kapeu, Tapio Luostarinen, Egil Jellum, Joakim Dillner, Matti Hakama, Pentti Koskela, Per Lenner, Arthur Love, Eija Mahlamaki, Steinar Thoresen, Laufey Tryggvadottir, Goran Wadell, Linda Youngman, Matti Lehtinen

Research output: Contribution to journalArticlepeer-review

64 Citations (SciVal)

Abstract

The strong correlation between smoking and exposure to oncogenic human papillomaviruses (HPVs) has made it difficult to verify the independent role of smoking in cervical carcinogenesis. Thus, the authors evaluated this role. Five large Nordic serum banks containing samples from more than 1,000,000 subjects were linked with nationwide cancer registries (1973-2003). Serum samples were retrieved from 588 women who developed invasive cervical cancer and 2,861 matched controls. The samples were analyzed for cotinine (a biomarker of tobacco exposure) and antibodies to HPV types 16 and 18, herpes simplex virus type 2, and Chlamydia trachomatis. Smoking was associated with the risk of squamous cell carcinoma (SCC) among HPV16- and/or HPV18-seropositive heavy smokers (odds ratio = 2.7, 95% confidence interval: 1.7, 4.3). A similar risk of SCC (odds ratio = 3.2, 95% confidence interval: 2.6, 4.0) was found in heavy smokers after adjustment for HPV16/18 antibodies. The point estimates increased with increasing age at diagnosis and increasing cotinine level. This study confirms that smoking is an independent risk factor for cervical cancer/SCC in women infected with oncogenic HPVs. These findings emphasize the importance of cervical cancer prevention among women exposed to tobacco smoke.
Original languageEnglish
Pages (from-to)480-488
JournalAmerican Journal of Epidemiology
Volume169
Issue number4
DOIs
Publication statusPublished - 2009

Subject classification (UKÄ)

  • Public Health, Global Health, Social Medicine and Epidemiology

Keywords

  • neoplasms
  • uterine cervical
  • smoking
  • risk factors
  • carcinoma
  • squamous cell

Fingerprint

Dive into the research topics of 'Is Smoking an Independent Risk Factor for Invasive Cervical Cancer? A Nested Case-Control Study Within Nordic Biobanks'. Together they form a unique fingerprint.

Cite this