Objective: To assess whether reports that exercise reduces the risk of cervical cancer could be explained by a lower prevalence of human papillomavirus (HPV) in cervical tissue of women with higher physical activity levels, and to assess whether an association exists between sexual activity variables and intensity of exercise that might be confounding the previously observed relationship between exercise and cervical cancer. Methods: Two hundred ninety-four women in the University of Michigan Family Practice HPV study were surveyed to determine their daily physical activity (measured in metabolic equivalents, or METS). The association of level of activity with the presence of HPV as determined by polymerase chain reaction (PCR) analysis, and with demographic and sexual activity variables was assessed. Results: One hundred seventy-eight women (60.5%) who received the survey completed the questionnaire. Women with and without HPV infection were similar in demographic characteristics except that those with HPV were less likely to be married (p = 0.06), and were more likely to have known their partners 24 months or less (p = 0.02). Exercise levels were higher in women who were married or living as married compared with those who weren't (home-based METS 261 vs 85, p < 0.001, and total METS 385 vs 299, p < 0.001), and were lower in those women who had known their partners 24 months or less (home-based METS 91 vs 236, p = 0.009, and total METS 230 vs 367, p = 0.02), but were not associated with any other sexual behavior or sexual history variables. Using multivariate analysis, knowing their partner for a shorter duration was not associated with exercise when controlled for marital status. There was no difference in total daily METS expended between subjects who had HPV present in their cervix and women who did not (p = 0.34). Separating activity into subcategories (home, work, and leisure) as well as controlling for demographic variables, such as marital status, did not change this finding. However, an association was seen between HPV infection and knowing one's current partner less than 24 months, independent of exercise level and of marital status. Conclusion: Decreased exercise level is not a risk factor for HPV infection but is associated with unmarried status in this population. Conversely, knowing one's partner less than 24 months was associated with HPV infection but not with exercise level when controlled for marital status. The previously reported association between exercise and cervical cancer does not appear to be related to an altered prevalence of HPV infection in women who report less exercise. The role of exercise in the development or progression of HPV-related lesions after HPV infection needs further study.
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