Methods: We obtained smoking history and calculated prevalence of HPV infection in women in the US from 1999-2012 National Health and Nutrition Examination Survey (NHANES) to obtain a representative sample of the US non-institutionalized civilian population. NHANES performs in-person interviews and physical examinations and collects biological samples at homes and mobile examination centers. We provided epidemiology of genital HPV infection and its types for women. All analysis took into account NHANES complex survey sampling design.
Results: Self-administered vaginal swabs revealed 42.9% of women were HPV-positive. High-risk oncogenic HPV infection were HPV types 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 82. Never smokers had the greatest burden of general (48.2%; 95%CI: 45.4-51.0) and high-risk oncogenic HPV infection (47.2%; 43.8-50.7). Former smokers had the lowest burden for both general (16.1%; 14.2-18.1) and high-risk infection (14.8%; 12.8-16.8). Current smokers were in between the two (general: 31.1%; 28.7-33.4; high-risk: 32.7%; 29.7-35.8). Compared to never smokers, both current (odds ratio=2.4; 95%CI: 2.1-2.8) and former (1.4; 1.2-1.7) smokers had greater adjusted odds of general HPV infection. Current smokers also had significantly greater odds of high-risk oncogenic HPV infection (1.3; 1.0, 1.6), but the results were not significant for former smokers (0.9; 0.7-1.2).
Conclusion: Our results reveal the associations between smoking status and the burden of genital HPV infection in women. Understanding the smoking behaviors of HPV-positive women is important for STD and cervical cancer screening and highlights a potential importance for more targeted smoking cessation programs in sexually active as well as HPV-positive women.
T. Koru-Sengul, None