U.S. investigators undertook the current study "to define the prognostic significance of HPV 18 and its phylogenetically related viruses and smoking on survival in patients with early stage cervical cancer."

Human papillomavirus typing was performed in stage IB-IIB cervical tumors. Patient tobacco use was ascertained by questionnaire. "Subjects positive for HPV 18 or 45 were compared to the remainder of the cohort and to women with tumors containing HPV 16, 31, or 52," reported J.D. Wright and colleagues.

The researchers evaluated tumors from 255 women. "The presence of HPV 18 or 45 was associated with decreased survival. In a multivariable Cox proportional hazards analysis comparing patients with HPV 18 or 45 containing tumors to the rest of the cohort, the hazard ratio for death from cervical cancer was 2.08 (95% CI, 1.07-4.04). The hazard ratio for death from cervical cancer was 2.41 (95% CI, 1.17-4.96) when the HPV 18 and 45 group was compared to women with HPV 16 or its related viruses, 31 and 52."

"Smoking was associated with a decreased survival for women with HPV 18 or 45, even after adjusting for other known prognostic factors (p=0.031)," the researchers found. "In addition to pathologic indicators, molecular and environmental co-factors are important determinates of outcome in early stage cervical cancer."

The researchers concluded: "The presence of HPV 18 or 45 is associated with a decreased survival. The adverse effect of HPV 18 and 45 on survival is compounded by tobacco use."

The full report, "Human Papillomavirus Type and Tobacco Use as Predictors of Survival in Early Stage Cervical Carcinoma," was published in Gynecologic Oncology (2005;98(1):84-91).

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