||5R01CA075455-05 Interpret this number
||University Of Alabama At Birmingham
||Smoking Cessation to Reduce Cervical Cancer Risk
DESCRIPTION: Cervical cancer is a major source of morbidity and mortality
among women, with a particularly high burden evidenced among women in
Alabama. Although HPV has been identified as the major causative agent for
cervical cancer, most women with HPV do not develop cervical neoplasia,
suggesting that progression to cervical cancer may be influenced by other
factors. Smoking has consistently been associated with increased risk for
cervical cancer, even among women already at elevated risk due to cervical
dysplasia and HPV infection. Further, available data suggest that smoking
cessation may decrease cervical cancer risk. These data justify a
prospective, controlled study, examining the efficacy of smoking cessation
in halting the progression of cervical dysplasia. The proposed 5-year
clinical trial will evaluate the effect of a theory-based smoking cessation
intervention on progression from low-grade squamous intraepithelial lesions
(LSIL) to high-grade squamous intraepithelial lesions (HSIL) in female
smokers with HPV. The plan is to recruit 220 current smokers ((10
cigarettes/day) with oncogenic HPV from the University of Alabama at
Birmingham Colposcopy Clinic and randomly assign them to one of two
treatment conditions: 1)usual care (UC); or 2) smoking cessation
intervention (SCI). Patients in both groups will receive standard
conservative management for LSIL, biannual pap smears and more aggressive
treatment, as needed. Additionally, patients in the SCI group will also
participate in an intensive smoking cessation intervention which will
include: 1) cognitive-behavioral strategies to facilitate changes in
smoking behavior; 2) short-term nicotine replacement therapy to minimize
discomfort associated with nicotine withdrawal; and 3) a motivational
intervention to promote the optimal use of cognitive-behavioral strategies
and nicotine replacement therapy. The primary outcome will be rate of
biopsy-confirmed progression to HSIL over 18-month follow-up. The
investigators also propose to collect self-report and biochemical measures
of smoking status and dysplasia progression. Finally, perceptions about
cancer risk and cancer control practices will be assessed to examine
relationships with smoking cessation program participation and changes in
Effect of folic acid fortification of foods on folate intake in female smokers with cervical dysplasia.
, Heimburger D.C.
, Piyathilake C.J.
, Desmond R.A.
, Greene P.G.
Nutrition (Burbank, Los Angeles County, Calif.), 2004 May; 20(5), p. 409-14.