Smoking exposure and cervical cancer risk: Integrating observational and genetic evidence

Abstract

Objective: To investigate the relationship between smoking exposure and cervical cancer risk by integrating observational and genetic evidence. Methods: We analyzed data from the National Health and Nutrition Examination Survey (1999–2018) and performed a genetic instrumental variable analysis using genome-wide association studies data. Smoking exposure was assessed using self-reported status and serum cotinine concentrations. Logistic regression models were used to evaluate observational associations, while inverse variance weighting was used for genetic analysis. Results: Observational analysis showed that current smokers had a significantly higher cervical cancer risk than nonsmokers and former smokers (adjusted odds ratio = 3.05, 95% confidence interval: 1.61–5.78, p < 0.001). Higher serum cotinine concentrations were also positively associated with cervical cancer risk. Genetic analysis further supported a causal link between smoking exposure and cervical cancer. Conclusions: Smoking exposure significantly increases cervical cancer risk, emphasizing the importance of smoking cessation for prevention of cervical cancer. Incorporating tobacco control into cervical cancer prevention strategies could reduce disease burden.