Tobacco smoking and HPV – silent killers
Affiliation and adress for correspondence
1 Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
2 Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
3 Institute of Psychiatry and Neurology, Warsaw, Poland
Correspondence: Barbara Kozakiewicz, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Wawelska 15, 02-034 Warsaw, Poland, e-mail:
Curr Gynecol Oncol 2018, 16 (4), p. 234–244
DOI: 10.15557/CGO.2018.0027

Introduction: Cervical cancer is one of few cancers for which effective early diagnostic workup has been developed. A free program for early detection of cervical cancer has been introduced for the group of the most vulnerable women in the whole Poland. Despite these measures, five women die of cervical cancer each day in Poland due to a low screening rate and inadequate knowledge among women about the causes of this cancer. Material and method: The knowledge about modifiable risk factors of cervical cancer was analyzed in 570 women. Data were collected over a period of nine years, from 2009 to 2017, by means of direct contact with 100 subjects at outpatient clinics and 70 patients treated for cervical cancer at Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, and from 400 Internet responders. Results: In 2009, the greatest knowledge about the impact of HPV infection on the incidence of cervical cancer was noted in women treated for cervical cancer (98% of the respondents) and in 85% of healthy women. In 2012 and 2017, a substantially lower number of the respondents (30% and 46%, respectively) knew about the influence of HPV on cancer incidence. Knowledge about the influence of smoking on the risk of the disease was low in the entire studied group: throughout the 9-year period from 2009 to 2017, it was declared by 33%, 35%, 5% and 14% of the respondents, respectively. The magnitude of the influence of HPV infection coexisting with tobacco smoking could be assessed mainly by women undergoing treatment (87%). Only 7–8% of the subjects recognized this relationship as the most significant in the pathogenesis of cervical cancer. The study also demonstrated how low the contribution of nurses and midwives is in providing women with knowledge about modifiable risk factors of cervical cancer. Conclusions: 1) The study showed that it is necessary to undertake better educational activities in the field of modifiable risk factors for cervical cancer, which include smoking tobacco. 2) It seems that policy makers in the field of health care should verify whether the funds absorbed by the National Program of Early Cervical Cancer Detection should also be transferred for HPV vaccination of the young generation as this virus is the cause of many cancers, not only cervical cancer. Data on the decline of cervical cancer incidence in countries that vaccinate young people should be a strong argument for the introduction of vaccinations in Poland.

Keywords: cervical cancer, HPV infection, modifiable risk factors