TY - JOUR
T1 - Smoking as a major risk factor for cervical cancer and pre-cancer
T2 - Results from the EPIC cohort
AU - Roura, Esther
AU - Castellsagué, Xavier
AU - Pawlita, Michael
AU - Travier, Noémie
AU - Waterboer, Tim
AU - Margall, Núria
AU - Bosch, F. Xavier
AU - De Sanjosé, Silvia
AU - Dillner, Joakim
AU - Gram, Inger T.
AU - Tjønneland, Anne
AU - Munk, Christian
AU - Pala, Valeria
AU - Palli, Domenico
AU - Khaw, Kay Tee
AU - Barnabas, Ruanne V.
AU - Overvad, Kim
AU - Clavel-Chapelon, Françoise
AU - Boutron-Ruault, Marie Christine
AU - Fagherazzi, Guy
AU - Kaaks, Rudolf
AU - Lukanova, Annekatrin
AU - Steffen, Annika
AU - Trichopoulou, Antonia
AU - Trichopoulos, Dimitrios
AU - Klinaki, Eleni
AU - Tumino, Rosario
AU - Sacerdote, Carlotta
AU - Panico, Salvatore
AU - Bueno-De-Mesquita, H. B.
AU - Peeters, Petra H.
AU - Lund, Eiliv
AU - Weiderpass, Elisabete
AU - Redondo, M. Luisa
AU - Sánchez, María José
AU - Tormo, Maria José
AU - Barricarte, Aurelio
AU - Larrañaga, Nerea
AU - Ekström, Johanna
AU - Hortlund, Maria
AU - Lindquist, David
AU - Wareham, Nick
AU - Travis, Ruth C.
AU - Rinaldi, Sabina
AU - Tommasino, Massimo
AU - Franceschi, Silvia
AU - Riboli, Elio
PY - 2014/7/15
Y1 - 2014/7/15
N2 - A total of 308,036 women were selected from the European Prospective Investigation into Cancer and Nutrition (EPIC) study to evaluate the association between tobacco smoking and the risk of cervical intraepithelial neoplasia of grade 3 (CIN3)/carcinoma in situ (CIS) and invasive cervical cancer (ICC). At baseline, participants completed a questionnaire and provided blood samples. During a mean follow-up time of 9 years, 261 ICC cases and 804 CIN3/CIS cases were reported. In a nested case-control study, the baseline sera from 609 cases and 1,218 matched controls were tested for L1 antibodies against HPV types 11, 16, 18, 31, 33, 35, 45, 52, 58, and antibodies against Chlamydia trachomatis (CT), and Human Herpes Virus 2 (HHV-2). Cervical samples were not available for HPV-DNA analysis in this study. Multivariate analyses were used to estimate associations between smoking and risk of CIN3/CIS and ICC in the cohort and the case-control studies. In the cohort analyses smoking status, duration and intensity showed a two-fold increased risk of CIN3/CIS and ICC, while time since quitting was associated with a two-fold reduced risk. In the nested case-control study, consistent associations were observed after adjustment for HPV, CT and HHV-2 serostatus, in both HPV seronegative and seropositive women. Results from this large prospective study confirm the role of tobacco smoking as an important risk factor for both CIN3/CIS and ICC, even after taking into account HPV exposure as determined by HPV serology. The strong beneficial effect of quitting smoking is an important finding that will further support public health policies for smoking cessation. What's new? Tobacco smoking is a cited cause of cervical cancer, but whether it causes cervical malignancy independent of human papillomavirus (HPV) infection is unclear. Here, strong associations were found between most measures of tobacco smoking and the risk of cervical intraepithelial neoplasia of grade 3/carcinoma in situ and invasive cervical cancer, after taking into account past exposure to HPV infection. Quitting smoking was associated with a 2-fold risk reduction. The findings confirm the role of tobacco smoking in cervical carcinogenesis and show that quitting the habit has important benefits for cancer protection.
AB - A total of 308,036 women were selected from the European Prospective Investigation into Cancer and Nutrition (EPIC) study to evaluate the association between tobacco smoking and the risk of cervical intraepithelial neoplasia of grade 3 (CIN3)/carcinoma in situ (CIS) and invasive cervical cancer (ICC). At baseline, participants completed a questionnaire and provided blood samples. During a mean follow-up time of 9 years, 261 ICC cases and 804 CIN3/CIS cases were reported. In a nested case-control study, the baseline sera from 609 cases and 1,218 matched controls were tested for L1 antibodies against HPV types 11, 16, 18, 31, 33, 35, 45, 52, 58, and antibodies against Chlamydia trachomatis (CT), and Human Herpes Virus 2 (HHV-2). Cervical samples were not available for HPV-DNA analysis in this study. Multivariate analyses were used to estimate associations between smoking and risk of CIN3/CIS and ICC in the cohort and the case-control studies. In the cohort analyses smoking status, duration and intensity showed a two-fold increased risk of CIN3/CIS and ICC, while time since quitting was associated with a two-fold reduced risk. In the nested case-control study, consistent associations were observed after adjustment for HPV, CT and HHV-2 serostatus, in both HPV seronegative and seropositive women. Results from this large prospective study confirm the role of tobacco smoking as an important risk factor for both CIN3/CIS and ICC, even after taking into account HPV exposure as determined by HPV serology. The strong beneficial effect of quitting smoking is an important finding that will further support public health policies for smoking cessation. What's new? Tobacco smoking is a cited cause of cervical cancer, but whether it causes cervical malignancy independent of human papillomavirus (HPV) infection is unclear. Here, strong associations were found between most measures of tobacco smoking and the risk of cervical intraepithelial neoplasia of grade 3/carcinoma in situ and invasive cervical cancer, after taking into account past exposure to HPV infection. Quitting smoking was associated with a 2-fold risk reduction. The findings confirm the role of tobacco smoking in cervical carcinogenesis and show that quitting the habit has important benefits for cancer protection.
KW - EPIC
KW - Human Papillomavirus serology
KW - cervical cancer
KW - cohort study
KW - smoking
UR - http://www.scopus.com/inward/record.url?scp=84900037223&partnerID=8YFLogxK
U2 - 10.1002/ijc.28666
DO - 10.1002/ijc.28666
M3 - Article
C2 - 24338632
AN - SCOPUS:84900037223
SN - 0020-7136
VL - 135
SP - 453
EP - 466
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 2
ER -