Association of smoking with anal high-risk HPV infection and histologically confirmed anal high-grade squamous intraepithelial lesions among a clinic-based population in Puerto Rico. (2022)

• Record Type: Journal Article
• Authors: Keller, Kandyce; Ramos-Cartagena, Jeslie M.; Guiot, Humberto M.; Muñoz, Cristina; Rodríguez, Yolanda; Colón-López, Vivian; Deshmukh, Ashish A.; Tirado-Gómez, Maribel; Ortiz, Ana Patricia
• Is Part Of: Cancer treatment and research communications. Number 30(2022)
• Publication Date: 2022
• Subjects: HR-HPV infection -- Smoking -- Anal cancer -- Anal intraepithelial lesions -- Hispanic
• DOI: 10.1016/j.ctarc.2021.100503
• Languages: English
• ISSNs: 2468-2942

Abstract

Highlights: While smoking is an independent risk factor for anal cancer, information of its association with anal HR-HPV infection and anal high-grade squamous intraepithelial lesions (HSILs) is limited. Current smoking was associated with anal HSILs in this Hispanic population. Current smoking was not associated with prevalent HR-HPV infection. This study highlights the importance of smoking prevention and cessation programs geared towards populations at an increased risk for anal cancer. Abstract: Introduction: Current smoking is a risk factor for anal cancer. Yet, its association with anal human papillomavirus infection (HPV) and anal high-grade squamous intraepithelial lesions (HSIL) remains unclear. We assessed the association of smoking with 1) anal high-risk HPV (HR-HPV) infection and 2) anal HSIL. Methods: Data from the baseline visit of patients from the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (May 2015- June 2021) was analyzed. Patients were eligible if they had information on smoking status, complete high-resolution anoscopy (HRA) with biopsy, and HR-HPV testing ( n = 427). Logistic regression models estimated the odds ratio (OR) with 95% confidence intervals (CIs) adjusting for covariates. Results: Mean age was 44 ± 13 years, 69% were men, 74% were HIV-infected, and 25% reported being current smokers. 74% had anal HR-HPV infection. HSIL was diagnosed in 40% of patients. Current smokers had significantly higher odds (OR: 1.71, 95% CI: 1.04–2.82) of having HSIL compared to non-smokers after adjusting for age, sexual risk group, lifetime number of sexual partners, HIV status, and HR-HPV infection. Smoking was not associated with HR-HPV infection (OR: 1.56, 95% CI: 0.83–2.95) after adjusting for age, sexual risk group, lifetime number of sexual partners, and HIV status. Conclusions: Current smoking was associated with histologically confirmed HSIL but not with HR-HPV infection among this high-risk Hispanic population. Results highlight the need to explore targeted smoking cessation campaigns among populations at higher risk of developing HSIL, as an anal cancer prevention strategy.