January: Cervical Cancer Awareness Month

Ending tobacco epidemican essential step for beating cancer

Every year, 3.5 million people in the EU are diagnosed with cancer, and 1.3 million die from it. Over 40% of cancer cases are preventable. Without reversing current trends, it could become the leading cause of death in the EU. In 2020, the Commission released its Europe’s beating cancer plan aiming at reducing the cancer burden for patients, their families and health systems.Tobacco is a great risk factor for cancer, often still unknown and underestimated. Thus, every month in 2021, ENSP will dedicate a section of “The Network” to a certain type of cancer and its link to tobacco.

Since the US Surgeon General Report, many epidemiological studies with various designs have reported an association between smoking and an elevated risk of cervical cancer (1,2). Furthermore, a recently published assessment of the IARC monograph has concluded that there is sufficient evidence for a relationship between smoking and the risk of squamous cell carcinoma of the cervix (3,4).

More precisely, women who smoke are about twice as likely as non-smokers to get cervical cancer. Compounds deriving from tobacco have been found in the cervical mucus of women who smoke, and it is commonly believed that these substances damage the DNA of cervix cells and may contribute to the development of cervical cancer. Smoking also makes the immune system less effective in fighting HPV infections (5). Finally, a recent metanalysis provides evidence that passive smoking is associated with an increased risk of cervical cancer (6).


  1. 2004 Surgeon General’s Report—The Health Consequences of Smoking.
  2. WHO IARC Monograph on the Evaluation of Carcinogenic Risks to Humans Volume 100E Tobacco Smoke and Involuntary Smoking. 2012 http://monographs.iarc.fr/ENG/Monographs/vol100E/index.php
  3. Secretan B, Straif K, Baan R, et al. WHO International Agency for Research on Cancer Monograph Working Group. A review of human carcinogens–Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish. Lancet Oncol 2009;11:1033–4.
  4. Cogliano VJ, Baan R, Straif K, et al. Preventable exposures associated with human cancers. J Natl Cancer Inst 2011;103:1827–39.
  5. American Cancer Society: https://www.cancer.org/cancer/cervical-cancer/causes-risks-prevention/risk-factors.html
  6. Su, Benyu, et al. “The relation of passive smoking with cervical cancer: A systematic review and meta-analysis.” Medicine46 (2018).
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