Did you know women who smoke are twice as likely to develop cervical cancer compared to non-smokers? While HPV infection is the primary cause, smoking significantly heightens the risk. This link stems from the carcinogenic substances in tobacco smoke, such as nicotine and benzopyrene, which are found in the cervical mucus of smokers. These chemicals cause DNA damage, weaken the immune system, and create a conducive environment for cancer development. We spoke to Dr Vicky Makker, MD, Gynaecologic Oncologist, Memorial Sloan Kettering Cancer Center, New York, who explained the link between smoking and cervical cancer and why quitting matters.
The Epidemiology of Cervical Cancer
According to a 2023 study, cervical cancer remains a major health concern for women globally, with around 6,04,000 new cases and 3,42,000 deaths recorded in 2020.
“Cervical cancer often originates in the transformation zone where the endocervix meets the ectocervix. It is primarily caused by persistent infection with high-risk types of Human Papillomavirus (HPV), particularly HPV-16 and HPV-18”, said Dr Makker.
She added, however, not all women with HPV develop cervical cancer, indicating that other factors contribute to the progression of the disease. Smoking is one such factor, with smokers being twice as likely to develop cervical cancer compared to non-smokers.
Typically, cervical cancer progresses slowly, with cellular changes known as dysplasia or precancers preceding the development of invasive cancer. Fortunately, early detection and intervention during the precancerous stage can lead to successful treatment outcomes.
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Mechanisms Linking Smoking to Cervical Cancer
According to the American Cancer Society, smoking significantly elevates the risk of cervical cancer in women, doubling their likelihood of developing the disease compared to non-smokers. When someone smokes, they and those around them are exposed to numerous carcinogenic chemicals that can affect various organs beyond the lungs, said Dr Makker.
These harmful substances, absorbed through the lungs and circulated in the bloodstream, can be found in the cervical mucus of women who smoke, potentially damaging the DNA of cervix cells. This DNA damage, coupled with smoking's detrimental impact on the immune system's ability to combat HPV infections, creates a conducive environment for cervical cancer development.
Dr Makker added, “Tobacco smoke acts as a cofactor for HPV in the progression to cervical precancer and cancer by inhibiting immune responses and exposing HPV-infected cells to carcinogens like benzo[a]pyrene (BaP) and nicotine-derived nitrosamines, which exacerbates DNA damage while HPV oncoproteins prevent apoptosis and cell cycle arrest, further facilitating the cancerous transformation.”
Role of Vaccination and Early Detection
The HPV vaccine is a powerful tool in preventing various cancers caused by HPV, including cervical cancer, genital warts, and cancers of the vagina, vulva, penis, anus, mouth, throat, head, and neck. "By introducing harmless HPV strains to the body, the vaccine stimulates the immune system to recognise and combat these strains effectively, significantly reducing the risk of HPV-related cancers”, said Dr Makker.
Alongside vaccination, regular Pap smears are essential for early detection of cervical cancer, identifying abnormal or precancerous cells before they develop into cancer. “During a Pap smear, a healthcare provider collects cervical cells for laboratory analysis; if abnormalities are found, further evaluation and follow-up steps are recommended. While Pap smears may cause mild discomfort, they are crucial for early detection and timely treatment of cervical abnormalities”, added Dr Makker.
Bottomline
Dr Makker concluded, “Quitting smoking lowers cervical cancer risk, with long-term cessation leading to risk levels comparable to those who never smoked. This highlights the profound impact of smoking cessation in averting the onset of cervical cancer and other tobacco-associated ailments.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your expert if you are dealing with any health issues to get the necessary treatment.]