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

被引：59

作者：

Kapeu, Aline Simen ^{[1
]}

Luostarinen, Tapio ^{[2
]}

Jellum, Egil ^{[3
]}

Dillner, Joakim ^{[4
]}

Hakama, Matti ^{[2
]}

Koskela, Pentti ^{[1
]}

Lenner, Per ^{[5
]}

Love, Arthur ^{[6
]}

Mahlamaki, Eija ^{[7
]}

Thoresen, Steinar ^{[8
]}

Tryggvadottir, Laufey ^{[9
]}

Wadell, Goran ^{[10
]}

Youngman, Linda ^{[11
,12
]}

Lehtinen, Matti ^{[13
]}

机构：

[1] Natl Publ Hlth Inst, Oulu 90101, Finland

[2] Finnish Canc Registry, Inst Stat & Epidemiol Canc Res, FIN-00170 Helsinki, Finland

[3] Univ Oslo, Inst Clin Biochem, Oslo, Norway

[4] Lund Univ, Dept Med Microbiol, Lund, Sweden

[5] Umea Univ Hosp, Dept Radiat Sci, S-90185 Umea, Sweden

[6] Univ Iceland, Landspitali Univ Hosp, Reyjavik, Iceland

[7] Tampere Univ Hosp, Lab Ctr, Tampere, Finland

[8] Canc Registry Norway, Inst Epidemiol Canc Res, Montebello, Norway

[9] Iceland Canc Registry, Reykjavik, Iceland

[10] Umea Univ, Dept Virol, Umea, Sweden

[11] Univ Oxford, Clin Trial Serv Unit, Oxford, England

[12] Univ Oxford, Epidemiol Studies Unit, Oxford, England

[13] Univ Tampere, Sch Publ Hlth, FIN-33101 Tampere, Finland

来源：

AMERICAN JOURNAL OF EPIDEMIOLOGY | 2009年 / 169卷 / 04期

关键词：

carcinoma; squamous cell; risk factors; smoking; uterine cervical neoplasms; HUMAN-PAPILLOMAVIRUS TYPE-16; SQUAMOUS-CELL CARCINOMA; CIGARETTE-SMOKING; SEXUAL-BEHAVIOR; UTERINE CERVIX; INTRAEPITHELIAL NEOPLASIA; SERUM COTININE; INFECTION; WOMEN; ASSOCIATIONS;

D O I：

10.1093/aje/kwn354

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

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.

引用

页码：480 / 488

页数：9

共 49 条

[11] Sexual behaviour and smoking as determinants of cervical HPV infection and of CIN3 among those infected: a case-control study nested within the Manchester cohort [J].