Published in Cancer Detection and Prevention 1998; 22(2):109-119.

Cigarette Smoking and Cervical Dysplasia Among Non-Hispanic Black Women

Peter A. Kanetsky, PhDa, Marilie D Gammon, PhDb, Jeanne Mandelblatt, MD, MPHc, Zuo-Feng Zhang, MD, PhDd, Evangelyn Ramsey, NPd, Thomas C Wright, Jr, MDe, Louys Thomas, MDf, Stephen Matseoane, MDg, Nomenida Lazaro, MDg, Hiroko T Felton, MDg, Ranjit K Sachdev, MDh, Ralph M Richart, M.De, John P Curtin, MDi

aCenter for Clinical Epidemiology and Biostatistics, University of Pennsylvania Medical Center, Philadelphia, PA; bDepartment of Epidemiology, Columbia University School of Public Health, New York, NY; cDepartment of Medicine, Lombardi Cancer Research Center, Georgetown University School of Medicine, Washington, DC; dDepartments of Epidemiology and Biostatistics, and iSurgery, Memorial Sloan-Kettering Cancer Center, New York, NY; eDepartment of Pathology, Division of Obstetrical and Gynecological Pathology, Columbia Presbyterian Medical Center; and Department of fCytology, gObstetrics and Gynecology, and hSurgical Pathology, Harlem Hospital Center, New York, NY

Address all correspondence and reprint requests to: Peter A. Kanetsky, Ph.D., Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Medical Center. 907 Blockley Hall, 423 Guardian Dr., Philadelphia. PA 19104.

ABSTRACT: This is the first case-control study to determine whether smoking is associated with cervical dysplasia, after adjustment for human papillomavirus (HPV) infection, among a group of non-Hispanic black women. Subjects were interviewed and asked questions about smoking and other risk factors for cervical cancer. HPV infection was determined by hybrid capture. Thirty-two women with histologically confirmed incident dysplasia and 113 control women with normal cytologic smears were enrolled; all women were HIV negative. Smoking was more strongly associated with dysplasia among women with high-grade lesions than among all case women combined. After adjustment, women with high-grade lesions were roughly four times more likely to be ever (odds ratio [OR]: 3.8; 95% confidence interval [CI]: 0.76-18.4) or current (OR: 4.3; 95% CI: 0.83-21.9) smokers, compared with control women. Larger studies among black women that control for HPV infection are needed to confirm these findings and to explore associations among black women with low-grade lesions.

KEY WORDS: cervical intraepithelial neoplasia, cervix neoplasms, risk factors.

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