Which gynecologic cancer has smoking as a risk factor?

• A. Ovarian cancer
• B. Endometrial cancer
• C. Cervical cancer
• D. Vulvar cancer

Answer: (C)

Smoking is a known cofactor that increases the risk of cervical cancer. The carcinogens in tobacco can damage cervical cells and, importantly, impair local immune responses, making persistent infection with high‑risk HPV types more likely and allowing progression from HPV infection to cervical intraepithelial neoplasia and ultimately cancer. This strong link with smoking is why cervical cancer is the gynecologic cancer most clearly associated with tobacco use.

Ovarian cancer has weaker or different risk factors, such as age, family history, and certain genetic mutations. Endometrial cancer risk is actually reduced in smokers, due in part to anti-estrogenic effects of tobacco. Vulvar cancer is more closely tied to HPV infection and inflammatory conditions like lichen sclerosus rather than smoking.