Lifetime cigarette smoke and second-hand smoke and cervical intraepithelial neoplasm--a community-based case-control study.
BACKGROUND
Both active cigarette smoking and human papillomavirus (HPV) infection are known risk factors for cervical intraepithelial neoplasm (CIN). The association between second-hand smoke (SHS) and CIN has not been conclusively determined. We conducted a community-based case-control study to estimate the relationship between SHS and CIN.


METHODS
Potential study subjects were selected through Pap smear screening in Kaohsiung County, Taiwan. A total of 171 subjects with either their first case of inflammation (benign epithelial lesion) or > or = CIN1 by biopsy confirmation were assigned to a case group; 513 normal subjects with negative findings by Pap smears or biopsies were assigned to a control group.


RESULTS
Non-smoking women exposed to more than 20 pack-years of cigarette smoke had a significantly greater risk of developing > or = CIN2 than unexposed non-smokers (adjusted OR=7.2, 95% CI=2.5-20.6). Among the women without HPV infections, the greater the severity of disease found in the groups (normal, inflammation, CIN1, to > or = CIN2), the more likely it was for the women to be exposed to SHS, a significant increasing trend (p=0.037).


CONCLUSIONS
In addition to HPV infection and active cigarette smoking, exposure to SHS is a major risk factor for CIN among Taiwanese women.
Tsai
Hsiu-Ting
HT
School of Nursing, College of Nursing, Chung Shan Medical University, Taichung, Taiwan.
Tsai
Ying-Mei
YM
Yang
Sheau-Fang
SF
Wu
Kuen-Yuh
KY
Chuang
Hung-Yi
HY
Wu
Trong-Neng
TN
Ho
Chi-Kung
CK
Lin
Cheng-Chieh
CC
Kuo
Ying-Se
YS
Wu
Ming-Tsang
MT
D000328:Adult; D001706:Biopsy; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology
D014028:Tobacco Smoke Pollution