title: Smoking as a risk factor for preinvasive and invasive cervical lesions in female sex workers in Venezuela.
abstract: OBJECTIVE
  To determine whether the number of cigarettes smoked per day and years of smoking were risk factors for preinvasive and invasive cervical lesions in Venezuelan female sex workers.
  
  
  METHODS
  The clinical history of 438 female sex workers (FSWs) was taken and each received a gynecological examination, a Pap smear, and a colposcopic examination. A colposcopically-guided cervical biopsy was taken when the epithelium appeared abnormal.
  
  
  RESULTS
  The FSWs' mean age was 32.16+/-8 years. Age at first sexual intercourse was 15.9+/-2 years, parity was 4.1+/-2.3, live births were 3+/-3, and age at first delivery was 16.6+/-4.7 years. Cervical biopsies were performed in 84 FSWs. Sixty-four of them (76.2%) had preinvasive or invasive lesions and 47 (73.4%) were current smokers (Relative Risk) (RR), 1.26; 95% confidence interval (CI), 1.02-1.55; P<0.03]. FSWs who smoked more than 20 cigarettes per day had an increased RR to get a premalignant or malignant cervical lesion (RR, 1.27; 95% CI, 1.02-1.52; P<0.03). There was no statistically significant difference between FSWs who smoked 20 cigarettes or more per day and FSWs who smoked less than 20 cigarettes per day (RR, 1.36; 95% CI, 0.81-2.29; P<0.25). FSWs who had been smoking for 5 years or more were at risk to develop preinvasive or invasive cervical lesions (RR, 1.37; 95% CI, 1.01-1.86; P<0.04).
  
  
  CONCLUSIONS
  The risk for FSWs to develop preinvasive or invasive cervical lesions increased with the number of cigarettes they smoked per day and their years of smoking.
authors.affiliation: Manuel Noriega Trigo Hospital, Department of Obstetrics and Gynecology, School of Medicine, University of Zulia, Maracaibo, Venezuela. jnunezt@telcel.net.ve
authors.forename: J T
authors.initials: JT
authors.lastname: Núñez
authors.forename: M
authors.initials: M
authors.lastname: Delgado
authors.forename: G
authors.initials: G
authors.lastname: Pino
authors.forename: H
authors.initials: H
authors.lastname: Girón
authors.forename: B
authors.initials: B
authors.lastname: Bolet
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D003127:Colposcopy; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D065006:Papanicolaou Test; D011336:Probability; D012307:Risk Factors; D012494:Sampling Studies; D011477:Sex Work; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D016540:Smoking Cessation; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D014626:Vaginal Smears; D014687:Venezuela / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology*