Perceived risk of cervical cancer among high risk women smokers in Tampa, Florida

B125

Background: Epidemiologic research conducted over the past couple of decades has shown that infection with the human papillomavirus (HPV) is a cause of most cases of cervical cancer. Although HPV is the causal agent of cervical cancer, not all HPV infections lead to cervical cancer or dysplasia. Smoking has been considered a risk factor for cervical cancer for many years; however the independent association of smoking has only recently been accepted. Women who smoke are less likely to clear an HPV infection and at high risk of developing a cervical lesion. Smoking is of particular interest as a HPV cofactor becausethere is potential to modifysmoking behaviors. A smoking cessation message targeting women may be impacted by a woman’s readiness to quit smoking and her perceived risk for developing a smoking related disease, such as cervical cancer. The objective of this presentation is to characterize the smoking behaviors, perceived risk and readiness to quit among women attending gynecological clinics and to determine if perceived risk is associated with HPV status and cervical abnormalities. Methods: This cross-sectional epidemiological study has enrolled 442 women from four gynecological clinics in Tampa, Florida. All women completed a detailed questionnaire regarding demographics, lifestyle and sexual behaviors. The tobacco use questionnaire carefully assessed current smoking patterns, including a characterization of women who smoke occasionally, past smoking habits, and exposure to environmental tobacco. Smoking behavioral questions are included to determine a woman’s readiness to quit smoking and her perceived risk of cancer resulting from smoking. HPV genotyping was conducted using PGMY 09/11 primers and the Roche Linear Array assay. Cervical outcomes were collected from the clinical charts. Results: A total of 442 women between the ages of 18 and 65 were recruited into this study. Fifty three percent were never smokers and 46% were smokers. Among ever smokers, 35% are former smokers and 65% are currently smoking. Ever-smokers had a higher prevalence of HPV compared to never smokers (77% vs. 56%, p=0.02). On average, current and former smokers used cigarettes 17+11 years and 13+13 years, respectively. Of the 40% of current smokers that attempted to quit smoking in the last year, the most common reasons for attempting to quit were concerns about future health risks, high price of cigarettes and disapproval by friends and family. Factors associated with elevated perceived risk of cervical cancer as a result of smoking were age and readiness to quit. There was no difference in perceived risk by HPV status or type of appointment (Colposcopy vs. pap). There was no difference in readiness to quit between older and younger women. Of those with high-grade cervical abnormalities, 72% were HPV positive and smokers. There was no correlation between cervical diagnosis and readiness to quit smoking. Conclusions: Younger women were less likely to understand their risk of cervical cancer in relation to smoking, however there was no difference in readiness to quit between older and younger women. Women that indicated they were ready to quit smoking also perceived their risk of cervical cancer was high. Smoking cessation interventions targeting women attending family planning and gynecology clinics are needed.