STOCKHOLM, Nov. 17 -- Smoking and human papillomavirus (HPV) may work together to increase the risk of cervical cancer in situ, according to researchers here.

In a case-control study, smokers infected with HPV-16, the most prevalent of the oncogenic types, had 14 times the risk of progressing to cancer than did smokers who weren't carrying the virus, found Anthony Gunnell, a doctoral candidate at the Karolinska Institute here.

These HPV-16-positive smokers also had more than double the risk of non-smokers with an HPV-16 infection, Gunning and colleagues reported in the November issue of Cancer Epidemiology, Biomarkers & Prevention.

The researcher also found that the higher the viral load, the greater the risk of cancer among smokers. "We were surprised to see this dramatically increased risk among women with high viral loads who smoked," Gunnell said.

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