Abstract
BACKGROUND/AIM: Tobacco use is a recognized cofactor risk for cervical cancer induced by high-risk Human Papilloma Virus (HR-HPV). This study aimed to evaluate the specific influence of tobacco use on colposcopic examination results in women infected by HR-HPV. PATIENTS AND METHODS: HR-HPV-positive women undergoing a loop electrosurgical excision procedure (LLETZ) after colposcopic examination were considered for this study. A total of 819 patients from a regional screening program were included, of whom 320 were smokers and 499 non-smokers. RESULTS: Smokers were significantly younger (41.1 vs. 43.8, p<0.01), more frequently exhibited grade II colposcopic changes (63.9% vs. 53.3%, p<0.05), had worse histopathological outcomes (CIN2+: 75.7% vs. 67.9%, p<0.05; CIN3+: 51.4% vs. 44.0%, p<0.05), and higher rates of affected surgical margins, with borderline significance (22.6% vs. 17.8%, p=0.055). While no significant differences in viral clearance were observed at six months, smokers showed a trend toward worse outcomes at two years (p=0.07). CONCLUSION: Smoking in any amount is associated with worse colposcopic and histopathological findings, and this occurs at younger ages.