The association between cigarette smoking and low-grade cervical abnormalities in reproductive-age women.
OBJECTIVE
To evaluate the association between smoking and the occurrence of low-grade cervical cytological abnormalities.


METHODS
We conducted a population-based cross-sectional study of smoking and other exposures in reproductive-age women with normal and abnormal cytology results (Class 1-4 Pap tests). Participants (n = 2,448) were enrollees of the Group Health Cooperative of Puget Sound, a health maintenance organization (HMO) in Washington state, USA. Non-pregnant women were selected monthly from the HMO's cytology database during 1995-6, with over-sampling of women with low-grade abnormalities. All participants completed a structured telephone-administered survey.


RESULTS
Of the 2,448 participants, 19% (n = 465) had Class 2 Pap results, and 5% (n = 117) had Class 3-4 results. Forty percent of the sample (n = 975) reported ever smoking. Women reporting current/recent smoking (n = 514, 21%) had an increased likelihood of cervical abnormalities (adjusted odds ratio (OR) 1.4, 95% confidence interval (CI 1.1-1.8). Women who had never smoked but who reported recent passive smoking exposure also had a greater likelihood of abnormal test results (OR 1.4, 95% CI 1.0-2.0). Prior smoking was not associated with cytology status.


CONCLUSIONS
Our results, examining low-grade cervical abnormalities, are compatible with those from studies of more severe cervical lesions, lending added support to the hypothesis that smoking predisposes to development of a spectrum of cervical abnormalities. Thus, even cytologic screening visits represent an opportunity to counsel women smokers about their health risks, particularly the more proximal risks of cervical abnormalities and cancer.
Scholes
D
D
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA, USA.
McBride
C
C
Grothaus
L
L
Curry
S
S
Albright
J
J
Ludman
E
E
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects*; D002577:Uterine Cervical Diseases / Q000453:epidemiology* / Q000209:etiology