Smoking and HPV-Related Anogenital Cancers

Smoking and HPV-Related Anogenital Cancers

Being Alive Newsletter, Being Alive/Los Angeles - May 1993
Garance Franke-Ruta

People with HIV are at increased risk for developing anogenital cancers and pre-cancerous abnormalities due to their suppressed immunity and high incidence of infection with the human papilloma virus (HPV). HPV is thought to cause most genital warts, lesions, and cervical or anal cancers. However, the development of anogenital cancers and lesions, especially cervical cancer, is associated with factors other than just HPV infection. Suppressed immunity is one of them, but so is poor nutrition.

Vitamin C and beta carotene seem especially important. Smoking dramatically reduces the body's stores of vitamin C, and smoking has been associated with the development of precancerous cervical lesions and cervical cancer. Tobacco products (like nicotine) are also found in high concentrations in cervical secretions, where they may act as carcinogens or suppress local immunity. Former smokers do not have as high a risk of cervical cancer as current smokers.

While there is no study that shows that quitting smoking decreases the risk of anogenital cancer or lesions in people with HIV, quitting smoking is known to reduce the risk of cervical cancer in women in general, especially in women who have precancerous lesions. The same would very likely hold true for men with HPV-related anal or penile lesions. Quitting smoking is something that people with HPV and HIV who are concerned about anogenital cancer can do to reduce their risk of cancer.

One abstract presented at the VIIIth International Conference on AIDS found an association between abnormal anal cell growth (running the spectrum from lesions to warts to cancer) and smoking in men with late-stage HIV disease. Joel Palefsky, M.D., found that in addition to HIV infection and T4 counts of under 200, current smoking was associated with a 13-fold higher risk of developing anal cellular abnormalities in men.
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