Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Cancer Causes & Control
Published in: Cancer Causes & Control 7/2013

01-07-2013 | Original paper

Cervical screening, high-grade squamous lesions, and cervical cancer in illicit drug users

Authors: Anne Kricker, Lucinda Burns, Chris Goumas, Bruce K. Armstrong

Published in: Cancer Causes & Control | Issue 7/2013

Login to get access

Abstract

Background and purpose

Women who use illicit drugs (“drug users”) are exposed to human papillomaviruses (HPVs) from lifestyle risks that include sex risk behaviors, human immunodeficiency virus infection, and high levels of tobacco smoking. Both HPVs and tobacco smoking are recognized causes of cervical cancer, but little is known about risk in drug users. We sought to examine risk of cervical neoplasia and to estimate cervical screening prevalence in drug users compared to non-drug-users in Australia.

Methods

Our study linked hospital admission records of women aged 20–54 in 2000–2007 to Pap Test Register and Cancer Registry records for 19,699 with an illicit drug–related admission and 194,089 without. We designed a nested case–control study of risk of cervical intraepithelial neoplasia (CIN) 2/3 and cervical cancer and a cross-sectional study of screening prevalence in this cohort of women.

Results

Drug users were less likely than non-users to be screened in the past 3 years (crude prevalence 47 vs 58 %; prevalence ratio 0.80; 95 % CI 0.78–0.81). Odds ratios (ORs) in drug users, adjusted for cervical screening history and smoking, were 1.13 (95 % CI 1.04–1.23) for CIN 2/3 and 1.43 (95 % CI 0.96–2.15) for cervical cancer. The adjusted ORs in each case were similar in cannabinoid users and users of other drugs.

Conclusions

The increased risks of CIN 2/3 and cervical cancer we observed are probably due to sex risk behaviors and their associated high risk of HPV. Interventions in drug users, such as HPV vaccination and barrier contraception and more cervical screening, might reduce the risk of cervical neoplasia.
Literature
1.
Australian Institute of Health and Welfare (2007) Statistics on drug use in Australia 2006. AIHW, Canberra
2.
Turner C, Russell A, Brown W (2003) Prevalence of illicit drug use in young Australian women, patterns of use and associated risk factors. Addiction 98(10):1419–1426PubMedCrossRef
3.
Roxburgh A, Degenhardt L (2008) Characteristics of drug-related hospital separations in Australia. Drug Alcohol Depend 92(1–3):149–155PubMedCrossRef
4.
Smith AM, Ferris JA, Simpson JM, Shelley J, Pitts MK, Richters J (2010) Cannabis use and sexual health. J Sex Med 7(2 Pt 1):787–793PubMedCrossRef
5.
International Agency for Research on Cancer (1995) Human Papillomaviruses, vol 64. International Agency for Research on Cancer, Lyon
6.
International Agency for Research on Cancer (2007) Human Papillomaviruses, vol 90. International Agency for Research on Cancer, Lyon
7.
Bosch FX, de Sanjose S (2007) The epidemiology of human papillomavirus infection and cervical cancer. Dis Markers 23(4):213–227PubMed
8.
Plummer M, Schiffman M, Castle PE, Maucort-Boulch D, Wheeler CM (2007) A 2-year prospective study of human papillomavirus persistence among women with a cytological diagnosis of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion. J Infect Dis 195(11):1582–1589PubMedCrossRef
9.
Moscicki AB, Hills N, Shiboski S et al (2001) Risks for incident human papillomavirus infection and low-grade squamous intraepithelial lesion development in young females. JAMA 285(23):2995–3002PubMedCrossRef
10.
Vaccarella S, Franceschi S, Herrero R et al (2006) Sexual behavior, condom use, and human papillomavirus: pooled analysis of the IARC human papillomavirus prevalence surveys. Cancer Epidemiol Biomarkers Prev 15(2):326–333PubMedCrossRef
11.
Vaccarella S, Herrero R, Snijders PJ et al (2008) Smoking and human papillomavirus infection: pooled analysis of the International Agency for Research on Cancer HPV Prevalence Surveys. Int J Epidemiol 37(3):536–546PubMedCrossRef
12.
International Collaboration of Epidemiological Studies of Cervical Cancer (2006) Carcinoma of the cervix and tobacco smoking: collaborative reanalysis of individual data on 13,541 women with carcinoma of the cervix and 23,017 women without carcinoma of the cervix from 23 epidemiological studies. Int J Cancer 118(6):1481–1495CrossRef
13.
Iversen J, Topp L, Maher L (2011) Australian NSP survey National Data Report 1995–2010. The Kirby Institute, UNSW, England
14.
Ramsey SE, Bell KM, Engler-Field PA (2010) HIV risk behavior among female substance abusers. J Addict Dis 29(2):192–199CrossRef
15.
Taylor R, Morrell S, Mamoon H, Wain G, Ross J (2006) Decline in cervical cancer incidence and mortality in New South Wales in relation to control activities (Australia). Cancer Causes Control 17(3):299–306PubMedCrossRef
16.
Canfell K, Sitas F, Beral V (2006) Cervical cancer in Australia and the United Kingdom: comparison of screening policy and uptake, and cancer incidence and mortality. Med J Aust 185(9):482–486PubMed
17.
Alam N, Banks C, Chen W, Baker D, Kwaan G, Bishop J (2008) Cervical cancer screening in New South Wales: annual statistical report 2005. Cancer Institute NSW, Sydney
18.
Australian Institute of Health and Welfare (2011) Cervical screening in Australia 2008–2009. CAN 57. AIHW, Canberra
19.
Australian Institute of Health and Welfare (2007) Cervical screening in Australia 2004–2005. CAN 33. AIHW, Canberra
20.
Reece A (2007) Lifetime prevalence of cervical neoplasia in addicted and medical patients. Aust N Z J Obstet Gynaecol 47(5):419–423PubMedCrossRef
21.
Syrjanen K, Naud P, Derchain S et al (2008) Drug addiction is not an independent risk factor for oncogenic human papillomavirus infections or high-grade cervical intraepithelial neoplasia: case-control study nested within the Latin American Screening study cohort. Int J STD AIDS 19(4):251–258PubMedCrossRef
22.
D’Souza G, Palefsky JM, Zhong Y et al (2010) Marijuana use is not associated with cervical human papillomavirus natural history or cervical neoplasia in HIV-seropositive or HIV-seronegative women. Cancer Epidemiol Biomarkers Prev 19(3):869–872PubMedCrossRef
23.
Sidney S, Quesenberry CP Jr, Friedman GD, Tekawa IS (1997) Marijuana use and cancer incidence (California, United States). Cancer Causes Control 8(5):722–728PubMedCrossRef
24.
Lawrence G, Dinh I, Taylor L (2008) The centre for health record linkage: a new resource for health services research and evaluation. HIM J 37(2):60–62
25.
Kelman CW, Bass AJ, Holman CD (2002) Research use of linked health data: a best practice protocol. Aust N Z J Public Health 26(3):251–255PubMedCrossRef
26.
Richardson DB (2004) An incidence density sampling program for nested case-control analyses. Occup Environ Med 61(12):e59PubMedCrossRef
27.
International Agency for Research on Cancer (2002) Tobacco Smoking and tobacco smoke, vol 38. IARC, Lyon
28.
McDermott L, Dobson A, Owen N (2009) Determinants of continuity and change over 10 years in young women’s smoking. Addiction 104(3):478–487PubMedCrossRef
29.
Australian Bureau of Statistics (2006) SEIFA: Socio-Economic Indexes for Areas. Australia, 2006. Australian Bureau of Statistics, Canberra
30.
McKnight B, McKnight I, Kerr T, Li K, Montaner J, Wood E (2006) Prevalence and correlates of cervical cancer screening among injection drug users. J Obstet Gynaecol Can 28(8):695–699PubMed
31.
Morrell S, Perez DA, Hardy M, Cotter T, Bishop JF (2010) Outcomes from a mass media campaign to promote cervical screening in NSW, Australia. J Epidemiol Community Health 64(9):777–783PubMedCrossRef
32.
Taylor RJ, Mamoon HA, Morrell SL, Wain GV (2001) Cervical screening by socio-economic status in Australia. Aust N Z J Public Health 25(3):256–260PubMedCrossRef
33.
Lofters AK, Moineddin R, Hwang SW, Glazier RH (2011) Predictors of low cervical cancer screening among immigrant women in Ontario, Canada. BMC Womens Health 11:20PubMedCrossRef
34.
Lofters AK, Hwang SW, Moineddin R, Glazier RH (2010) Cervical cancer screening among urban immigrants by region of origin: a population-based cohort study. Prev Med 51(6):509–516PubMedCrossRef
35.
Day NE (1986) The epidemiological basis for evaluating different screening policies. In: Hakama M, Miller AB, Day NE (eds) Screening for cancer of the uterine cervix. International Agency for Research on Cancer, Lyon, pp 199–212
36.
Brooks A, Meade CS, Potter JS, Lokhnygina Y, Calsyn DA, Greenfield SF (2010) Gender differences in the rates and correlates of HIV risk behaviors among drug abusers. Subst Use Misuse 45(14):2444–2469PubMedCrossRef
37.
Strickler HD, Burk RD, Fazzari M et al (2005) Natural history and possible reactivation of human papillomavirus in human immunodeficiency virus-positive women. J Natl Cancer Inst 97(8):577–586PubMedCrossRef
38.
Massad LS, Seaberg EC, Wright RL et al (2008) Squamous cervical lesions in women with human immunodeficiency virus: long-term follow-up. Obstet Gynecol 111(6):1388–1393PubMedCrossRef
39.
Lawrinson P, Ali R, Buavirat A et al (2008) Key findings from the WHO collaborative study on substitution therapy for opioid dependence and HIV/AIDS. Addiction 103(9):1484–1492PubMedCrossRef
40.
National Centre in HIV Epidemiology and Clinical Research (2005) HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2005. National Centre in HIV Epidemiology and Clinical Research, Sydney
41.
National Centre in HIV Epidemiology and Clinical Research (2008) Australian NSP Survey National Data Report 2003–2007. National Centre in HIV Epidemiology and Clinical Research, Sydney
42.
Australian Institute of Health and Welfare (2005) 2004 National drug strategy household survey: State and territory supplement. PHE 61. AIHW, Canberra
43.
Miller M, Draper G (2001) Statistics on drug use in Australia. PHE 30. AIHW, Canberra
44.
Australian Institute of Health and Welfare (2005) Statistics on drug use in Australia 2004. PHE 62. AIHW, Canberra
45.
Ridolfo B, Stevenson C (2001) The quantification of drug-caused mortality and morbidity in Australia, 1998. PHE 29. Australian Institute of Health and Welfare, Canberra
Metadata
Title
Cervical screening, high-grade squamous lesions, and cervical cancer in illicit drug users
Authors
Anne Kricker
Lucinda Burns
Chris Goumas
Bruce K. Armstrong
Publication date
01-07-2013
Publisher
Springer Netherlands
Published in
Cancer Causes & Control / Issue 7/2013
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-013-0224-y

Other articles of this Issue 7/2013

Cancer Causes & Control 7/2013 Go to the issue

Original paper

Relationship between cancer survival and ambient ultraviolet B irradiance in China

Original paper

Decennial trends of social differences in smoking habits in Italy: a 30-year update

Original paper

Cancer incidence and mortality of Surinamese migrants in the Netherlands: in-between Surinamese and Dutch levels?

Original paper

Association between Helicobacter pylori infection and liver cancer mortality in 67 rural Chinese counties

Original paper

Iron metabolism and risk of cancer in the Swedish AMORIS study

Original paper

Intake of whole grains from different cereal and food sources and incidence of colorectal cancer in the Scandinavian HELGA cohort
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits