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      • KCI등재

        Role of active and passive smoking in high-risk human papillomavirus infection and cervical intraepithelial neoplasia grade 2 or worse

        Rui-Mei Feng,Shang-Ying Hu,Fang-Hui Zhao,Rong Zhang,Xun Zhang,Asya Izraelit Wallach,You-Lin Qiao 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.5

        Objective: We performed a pooled analysis to examine cigarette smoking and householdpassive smoke exposure in relation to the risk of human papillomavirus (HPV) infection andcervical intraepithelial neoplasia grade 2+ (CIN2+). Methods: Data were pooled from 12 cross-sectional studies for cervical cancer screeningsfrom 10 provinces of China in 1999–2007. A total of 16,422 women were analyzed, alongwith 2,392 high-risk-HPV (hr-HPV) positive women and 381 CIN2+ cases. Pooled odds ratios(ORs) and 95% confidence intervals (CIs) were estimated using logistic regression modelscontrolling for sexual and non-sexual confounding factors. Results: There was an excess risk between active smoking and hr-HPV infection and CIN2+. Adjusted OR for ever smokers vs. never smokers was 1.45 (95% CI=1.10–1.91), for hr-HPVinfection and 1.89 (95% CI=1.03–3.44), for CIN2+. Passive smoking had a slightly increasedrisk on the hr-HPV infection with adjusted OR 1.11 (1.00–1.24), but no statistical associationwas observed between passive smoke exposure and CIN2+. Compared with the neither activenor passive smokers, both active and passive smokers had a 1.57-fold (95% CI=1.14–2.15)increased risk of HPV infection and a 1.99-fold (95% CI=1.02–3.88) risk of CIN2+. Conclusion: Our large multi-center cross-sectional study found active smoking couldincrease the risk of overall hr-HPV infection and CIN2+ adjusted by passive smoking andother factors. Passive smoking mildly increased the risk of HPV infection but not the CIN2+. An interaction existed between passive tobacco exposure and active smoking for hr-HPVinfection and the CIN2+.

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