Smoking has been associated, in epidemiological studies, with an increased risk of cervical neoplasia. This may be in part due to the presence of tobacco-specific nitrosamines in cervical mucous of smokers, which may result in carcinogenic DNA damage. We have thus examined whether cervical DNA contains alkylation damage arising from exposure to methylating agents (N7-methyldeoxyguanosine, N7-MedG). DNA was extracted from cervical cytology samples and N7-MedG levels were measured using an immunoslotblot assay. Ninety percentage of the DNA samples were alkylated and N7-MedG levels (mean, 95% CI) in ever-smokers (1.27, 0.90-1.81 lmol/mol dG) were significantly higher than those in nonsmokers (0.42, 0.20-0.91 lmol/mol dG: p 5 0.005). N7-MedG adduct levels were significantly correlated with number of cigarettes smoked per day and pack years of cigarette smoking in current smokers. There was no association with N7-MedG levels and cervical intraepithelial neoplasia status, age, parity or contraception use. Our study suggests that cervical DNA contains alkylation damage that can arise from exposure to cigarette smoke. ' 2006 Wiley-Liss, Inc.Key words: alkylation; smoking; cervical cancer; N7-methylguanine Cervical cancer is one of the most common neoplastic diseases affecting women with a combined worldwide incidence of almost half a million new cases annually.1 Laboratory and epidemiological research has provided overwhelming evidence that some subtypes of human papillomavirus (HPV) are a ''necessary but insufficient cause'' for cervical cancer.2-5 Therefore, other risk factors are also needed for the initiation and promotion of cervical carcinogenesis.A number of epidemiological studies suggest that cigarette smoking may be an aetiological risk factor for cervical cancer.
6-10The risk for neoplasia appears to increase with longer duration and intensity of smoking. 11,12 The cervix is known to contain enzymes that can metabolise the carcinogens that are present in cigarette smoke, 13,14 and expression of these enzymes may be modified by HPV infection. 14,15 Cigarette-derived chemicals, nicotine and its major metabolite cotinine, have been found in cervical mucus at levels higher than those present in blood serum, [16][17][18][19] and the tobacco-specific nitrosamine 4-(methylnitrosamine)-1-(3-pyridyl)-1-butanone (NNK) is more prevalent in cervical mucus samples from smokers than those from nonsmokers.20 NNK alkylates DNA forming a range of DNA adducts including N7-methyldeoxyguanosine (N7-MedG), a poorly repaired adduct that can act as a biomarker of exposure to alkylating agents. 21 DNA adducts have been detected in human cervical tissues. [22][23][24][25][26][27] In most, but not all, of these studies, adduct levels were higher in smokers with the detected adducts, probably arising from exposure to polycyclic aromatic hydrocarbons present in cigarette smoke. However, other DNA adducts, in particular alkylation-induced lesions, may also be present, but would not have been detected by the procedures used. Our recent r...