Associations between smoking and adenocarcinomas and squamous cell carcinomas of the uterine cervix (United States)

Objectives: Few studies of smoking and cervical carcinoma have addressed th e rare cervical adenocarcinomas or used DNA-based tests to control for huma n papillomavirus (HPV) infection. Methods: This multicenter case-control study included 124 adenocarcinoma ca ses, 307 community controls (matched on age, race, and residence to adenoca rcinoma cases), and 139 squamous carcinoma cases (matched on age, diagnosis date, clinic, and disease stage to adenocarcinoma cases). Participants com pleted risk-factor interviews and volunteered cervical samples for PCR-base d HPV testing. Polychotomous logistic regression generated adjusted odds ra tios (ORs) and 95% confidence intervals (CIs) for both histologic types. Results: Eighteen percent of adenocarcinoma cases, 43% of squamous carcinom a cases, and 22% of controls were current smokers. After control for HPV an d other questionnaire data, adenocarcinomas were consistently inversely ass ociated with smoking (e.g. current: OR = 0.6, 95% CI 0.3-1.1; greater than or equal to1 pack per day: OR = 0.7, 95% CI 0.4-1.3), while squamous carcin omas were positively associated with smoking (e.g. current: OR = 1.6, 95% C I 0.9-2.9; greater than or equal to1 pack per day: OR = 1.8, 95% CI 1.0-3.3 ). Results in analyses restricted to HPV-positive controls were similar. Conclusion: Smoking has opposite associations with cervical adenocarcinomas and squamous carcinomas. Although both histologic types are caused by HPV and arise in the cervix, etiologic co-factors for these tumors may differ.