ArticleAnnals of epidemiology2017
Smoking and subsequent human papillomavirus infection: a mediation analysis.
Article in Annals of epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 50 citations in OpenAlex.
- Cervicovaginal microbiome and natural history of HPV in a longitudinal study.PLoS pathogens · 2020Trial
- Analysis of Age, Period and Cohort Trends in Cervical In Situ and Invasive Carcinomas for Assessing the Utility of Screening Approaches-Results From the Saarland Cancer Registry.Cancer medicine · 2026Article
- Human Papillomavirus and Other Relevant Issues in Cervical Cancer Pathogenesis.International journal of molecular sciences · 2025Review
- Impact of HPV test results and emotional responses on psychosocial burden among Taiwanese women: a cross-sectional study.BMC women's health · 2025Observational
- Smoking and alcohol by HPV status in head and neck cancer: a Mendelian randomization study.Nature communications · 2024Article
- Human Papilloma Virus Positive Oropharyngeal Squamous Cell Carcinoma and the Immune System: Pathogenesis, Immunotherapy and Future Perspectives.International journal of molecular sciences · 2024Review
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- Molecular pathways in the development of HPV-induced oropharyngeal cancer.Cell communication and signaling : CCS · 2023Article
- Association of naturally acquired type-specific HPV antibodies and subsequent HPV re-detection: systematic review and meta-analysis.Infectious agents and cancer · 2023Review
- Second-hand smoke exposure and cervical cancer: a systematic review and meta-analysis.Journal of cancer research and clinical oncology · 2023Review
- Influenza vaccination is associated with lower risk of renal cell carcinoma among chronic kidney disease patients: a population-based cohort study.Clinical kidney journal · 2023Article
- Cervicovaginal Gardnerella sialidase-encoding gene in persistent human papillomavirus infection.Scientific reports · 2023Article
- Joint effect of human papillomavirus exposure, smoking and alcohol on risk of oral squamous cell carcinoma.BMC cancer · 2023Article
- Epidemiology of human papillomavirus-associated anogenital cancers in Granada: a three-decade population-based study.Frontiers in public health · 2023Observational
- Impact of smoking exposure on human papillomavirus clearance among Chinese women: A follow-up propensity score matching study.Tobacco induced diseases · 2023Article
- The prevalence of high-risk human papillomavirus genotypes and related risk factors among Iranian women.Journal of medicine and life · 2022Article
- GSTT1 and GSTM1 polymorphisms with human papillomavirus infection in women from southern Brazil: a case-control study.Molecular biology reports · 2022Article
- Reducing Poverty-Related Disparities in Cervical Cancer: The Role of HPV Vaccination.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021Article
- Detection of human papillomavirus (HPV) DNA in benign laryngeal lesions and role of cigarette smoking as an inducing factor.Virusdisease · 2021Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
Abstract
purposeSmoking is an established risk factor for a human papillomavirus (HPV) infection advancing to cervical precancer and cancer, but its role earlier in the natural history is less clear. Smoking is inversely associated with possessing HPV antibodies from a past infection suggesting that smoking may influence acquiring subsequent infections.
methodsIn a cohort of 1976 U.S. women, we evaluate whether reduced antibodies to HPV-16 is a mechanism for smoking's role on acquiring a subsequent HPV-16 infection, through the analytic technique of causal mediation analysis. We posit a causal model and estimate two counterfactually defined effects: a smoking impaired antibody-mediated indirect effect and a nonmediated direct effect representing all other potential mechanisms of smoking.
resultsCompared to never smokers, current smokers had increased odds of HPV-16 infection by the antibody-mediated indirect effect (odds ratio [OR] = 1.29; 95% confidence interval [CI]: 1.11, 1.73); the estimated direct effect was very imprecise (OR = 0.57; 95% CI, 0.26-1.13). We observed a stronger estimated indirect effect among women who smoked at least half a pack of cigarettes daily (OR = 1.61, 95% CI, 1.27-2.15) than among women who smoked less than that threshold (OR = 1.09; 95% CI, 0.94-1.44).
conclusionsThis is the first study to directly test the mechanism underlying smoking as an HPV cofactor. The results support current smoking as a risk factor earlier in the natural history of HPV and are consistent with the hypothesis that smoking increases the risk of a subsequent infection by reducing immunity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.