Faculty of Medicine, University of Botswana, Gaborone, Botswana.
Rutgers Global Health Institute, Australia.
PLoS One. 2024 Jun 7;19(6):e0302153. doi: 10.1371/journal.pone.0302153. eCollection 2024.
Cervical cancer, a malignancy caused by infection with oncogenic human papillomavirus, disproportionally affects women from low resource settings. Persistence of human papillomavirus infection may mediate an association between tobacco use and cervical cancer. In limited resource settings, women from indigenous communities are often marginalized and do not benefit from evidence-based interventions to prevent tobacco use or cervical cancer due to the limited reach of mainstream healthcare services to these communities. This study determined the association between smoking and high-risk human papillomavirus infection among women from indigenous communities in western Botswana.
A cross-sectional study of women in indigenous communities was conducted between June and October 2022. Demographic, clinical and self-reported smoking data were collected. Cervical cytology and HPV DNA testing for high-risk human papillomavirus genotypes were performed. Multilevel multivariable logistic regression models were fit to evaluate the association between smoking and high-risk human papillomavirus infection while adjusting for potential confounders.
A total of 171 participants with a median (interquartile range) age of 40 (31-50) years from three settlements and two villages were recruited for the study. Of these, 17% were current smokers, 32.8% were living with HIV and high-risk human papillomavirus DNA was detected in 32.8% of the cervical specimens. Women who were current smokers, were nearly twice as likely to have cervical high-risk human papillomavirus infection compared to non-smokers (Adjusted Odds Ratio (95% CI); 1.74(1.09, 2.79)) after controlling for confounders.
These data underscore the need for effective tobacco control to help mitigate cervical cancer risk in this setting. These findings can help inform decisions about targeted cervical cancer prevention and tobacco cessation interventions for women from indigenous communities.
宫颈癌是一种由致癌型人乳头瘤病毒感染引起的恶性肿瘤， disproportionately 影响来自资源匮乏环境的女性。人乳头瘤病毒感染的持续存在可能介导了吸烟与宫颈癌之间的关联。在资源有限的环境中，由于主流医疗保健服务难以覆盖到这些社区，来自土著社区的女性往往被边缘化，无法受益于预防吸烟或宫颈癌的基于证据的干预措施。本研究旨在确定博茨瓦纳西部土著社区妇女吸烟与高危型人乳头瘤病毒感染之间的关联。
在 2022 年 6 月至 10 月期间，对土著社区的妇女进行了一项横断面研究。收集了人口统计学、临床和自我报告的吸烟数据。进行了宫颈细胞学检查和高危型人乳头瘤病毒 DNA 检测。拟合了多层次多变量逻辑回归模型，以评估在调整潜在混杂因素后，吸烟与高危型人乳头瘤病毒感染之间的关联。
共有 171 名来自三个定居点和两个村庄的年龄中位数（四分位间距）为 40（31-50）岁的参与者参加了这项研究。其中，17%为当前吸烟者，32.8%为 HIV 感染者，32.8%的宫颈标本中检测到高危型人乳头瘤病毒 DNA。在控制混杂因素后，当前吸烟者发生宫颈高危型人乳头瘤病毒感染的可能性几乎是非吸烟者的两倍（调整后的优势比（95%置信区间）；1.74（1.09，2.79））。
这些数据强调了需要实施有效的烟草控制措施，以帮助减轻该环境中的宫颈癌风险。这些发现可以为针对土著社区妇女的宫颈癌预防和烟草戒断干预措施的决策提供信息。
