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

Kapeu, Aline Simen; Luostarinen, Tapio; Jellum, Egil; Dillner, Joakim LU ; Hakama, Matti; Koskela, Pentti; Lenner, Per; Love, Arthur; Mahlamaki, Eija and Thoresen, Steinar, et al. (2009) In American Journal of Epidemiology 169(4). p.480-488
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... (More)
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. (Less)
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publication status
published
subject
keywords
neoplasms, uterine cervical, smoking, risk factors, carcinoma, squamous cell
in
American Journal of Epidemiology
volume
169
issue
4
pages
480 - 488
publisher
Oxford University Press
external identifiers
  • wos:000263403300012
  • scopus:60149101938
ISSN
0002-9262
DOI
10.1093/aje/kwn354
language
English
LU publication?
yes
id
bfad4012-fad3-43d4-9386-547d1bcfcf12 (old id 1372647)
date added to LUP
2009-05-08 15:05:30
date last changed
2017-09-10 03:34:56
@article{bfad4012-fad3-43d4-9386-547d1bcfcf12,
  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.},
  author       = {Kapeu, Aline Simen and Luostarinen, Tapio and Jellum, Egil and Dillner, Joakim and Hakama, Matti and Koskela, Pentti and Lenner, Per and Love, Arthur and Mahlamaki, Eija and Thoresen, Steinar and Tryggvadottir, Laufey and Wadell, Goran and Youngman, Linda and Lehtinen, Matti},
  issn         = {0002-9262},
  keyword      = {neoplasms,uterine cervical,smoking,risk factors,carcinoma,squamous cell},
  language     = {eng},
  number       = {4},
  pages        = {480--488},
  publisher    = {Oxford University Press},
  series       = {American Journal of Epidemiology},
  title        = {Is Smoking an Independent Risk Factor for Invasive Cervical Cancer? A Nested Case-Control Study Within Nordic Biobanks},
  url          = {http://dx.doi.org/10.1093/aje/kwn354},
  volume       = {169},
  year         = {2009},
}