title: Smoking and human papillomavirus infection: pooled analysis of the International Agency for Research on Cancer HPV Prevalence Surveys.
abstract: BACKGROUND
  Smoking increases the risk of squamous-cell carcinoma of the cervix, but it is not clear whether smoking increases the risk of acquisition or persistence of human papillomavirus (HPV) infection.
  
  
  METHODS
  Information on smoking was collected from 10 areas in four continents among population-based, age-stratified random samples of women aged 15 years or older. HPV testing was performed using PCR-based enzyme immunoassay. Unconditional logistic regression was used to estimate odds ratios (OR) and corresponding 95% confidence intervals (CI) of being HPV-positive by smoking habits, adjusted for age and lifetime number of sexual partners.
  
  
  RESULTS
  Ten thousand five hundred and seventy-seven women (mean age 41.4 years) were included. Among current smokers, the risk of being HPV-positive increased with smoking intensity, after allowing for lifetime number of sexual partners: ORs for <5, 5-14 and >/=15 cigarettes per day were 1.21 (95% CI 0.95-1.54), 1.39 (95% CI 1.04-1.87) and 2.01 (95% CI 1.32-3.08), respectively, as compared with never-smokers. The risk among former smokers (OR = 0.95, 95% CI 0.73-1.23) was similar to that among never-smokers. Analyses stratified by lifetime number of sexual partners showed a significant trend in risk only for women with one lifetime sexual partner.
  
  
  CONCLUSIONS
  Our study suggests that current, though not former, smoking is associated with an increased prevalence of HPV, after allowance for sexual covariates. Among current smokers, HPV prevalence increased with smoking intensity, but a clear dose-response relationship was exclusively seen among women who declared one lifetime sexual partner.
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Vaccarella
authors.forename: Rolando
authors.initials: R
authors.lastname: Herrero
authors.forename: Peter J F
authors.initials: PJ
authors.lastname: Snijders
authors.forename: Min
authors.initials: M
authors.lastname: Dai
authors.forename: Jaiye O
authors.initials: JO
authors.lastname: Thomas
authors.forename: Nguyen Trong
authors.initials: NT
authors.lastname: Hieu
authors.forename: Catterina
authors.initials: C
authors.lastname: Ferreccio
authors.forename: Elena
authors.initials: E
authors.lastname: Matos
authors.forename: Hector
authors.initials: H
authors.lastname: Posso
authors.forename: Silvia
authors.initials: S
authors.lastname: de Sanjosé
authors.forename: Hai Rim
authors.initials: HR
authors.lastname: Shin
authors.forename: Sukhon
authors.initials: S
authors.lastname: Sukvirach
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.forename: Nubia
authors.initials: N
authors.lastname: Muñoz
authors.forename: Chris J L M
authors.initials: CJ
authors.lastname: Meijer
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
mesh_terms: D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007390:International Agencies; D016015:Logistic Models; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods; D012747:Sexual Partners; D012907:Smoking / Q000009:adverse effects*
chemical_list: D004279:DNA, Viral