Risk Factors for Cervical Cancer
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A risk factor is something that increases your chances of developing cancer.
It is possible to develop cervical cancer with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing cervical cancer. If you have a number of risk factors, ask your health care provider what you can do to reduce your risk.
Risk factors for cervical cancer include the following:
Human Papillomavirus (HPV) Infection
The most important risk factor for cervical cancer is infection of the cervix with human papillomavirus (HPV), a sexually transmitted disease. There are more than 70 types of viruses called papillomaviruses. Certain HPV types can cause warts on the female and male genital organs and anus. HPV is passed from one person to another during sexual contact.
Two HPV types cause most genital warts: HPV 6 and HPV 11. These are called "low risk" and rarely develop into cancer. HPV 16, 18, 33, 35, and 45C are considered high risk and have been linked with genital or anal cancers in both women and men. Large studies have found these types of HPV in more than 93% of cervical cancer cases.
There is currently no cure for papillomavirus infection. But, the warts and associated abnormal cell growth can be effectively treated by destroying the flat warts of the cervix and vagina, which can prevent them from developing into cancer.
A recent study published in the New England Journal of Medicine reported on an experimental vaccine that significantly reduced the incidence of human papillomavirus (HPV) 16 and the associated precancerous changes in the cervix. Although HPV 16 is not the only strain implicated in cervical cancers, this is an exciting finding and the first time a vaccine has been shown to significantly reduce precancerous changes. Much more study needs to be done; for true effectiveness to be proven, the vaccine would need to be administered to large populations of women. It may be years before this vaccine is available for general use.
Many aspects of your sexual history can increase your risk of cervical cancer. These include the following:
- Having sexual intercourse at an early age
- Having had many sexual partners
- Being with a partner who has had many sexual partners
- A history of sexually transmitted diseases
- Initial pregnancy before the age of 18
- Multiple pregnancies
After the age of 25, the risk of developing cervical cancer begins to increase. After age 40, the risk stays relatively stable. The average age that women are diagnosed with cervical cancer is between 50 and 55 years. However, this cancer can be diagnosed in women as young as their early 20s and even their teens. In fact, recent studies have shown an increase in cervical cancer in women in their 20s and 30s. However, the risk of dying from cervical cancer increases as women get older.
History of Not Having Pap Tests
Women who have never had a Pap test or who have not had one for several years have a higher-than-average risk of developing cervical cancer. This screening tool is quite effective for catching abnormal cell growth early, before it progresses to cancer. A Pap test, often called a Pap smear, is a test of a sample of cells from the surface of the cervix to check for abnormalities that can develop into cancer. Pap tests are done in your doctor's office, often as part of a regular physical.
Smoking exposes your body to many cancer-causing chemicals. Tobacco by-products have been found in the cervical mucus of women who smoke. The risk appears to increase with the number of cigarettes smoked per day and the number of years a woman has smoked. Smokers are about twice as likely as nonsmokers to get cervical cancer.
Exposure to Diethylstilbestrol (DES)
Between 1940 and 1971, doctors prescribed the hormone DES to pregnant women who were thought to be at an increased risk for miscarriage. About 1 out of every 1,000 women whose mother took DES when pregnant with them will develop cancer of the cervix or vagina.
Weakened Immune System
Several reports have shown that women with weakened immune systems—as with human immunodeficiency virus (HIV) or from immune-suppressing drugs taken after a transplant—are more likely to develop cervical cancer. (HIV damages the body’s immune system; this makes a woman more susceptible to HPV infection, which may increase the risk of cervical cancer.) In someone with a weakened immune system, a cervical precancer may develop into an invasive cancer faster than it normally would in a woman without a weakened immune system.
Diets low in fruits and vegetables are associated with an increased risk of cervical cancer. Particularly important nutrients for health of the cervix are vitamins A and C and folic acid.
Race and Ethnicity
In the United States, several racial and ethnic groups have higher cervical cancer death rates. In the U.S., the incidence of cervical cancer is greatest in Native American, African-American, Vietnamese, and Hispanic women. Among African Americans, the death rate from cervical cancer is more than twice the national average. Hispanic and Native American women also have death rates above the average.
Low Socioeconomic Status
Experts believe that women with low socioeconomic status are at an increased risk due to a lack of ready access to adequate health care services. This may keep women from getting the necessary screening needed to diagnose and treat cervical cancer in its early stages. Also, these women may not be eating healthful diets, which can also lead to an increased risk.
Cervical cancer. American Cancer Society Web Site.
Available at: http://www.cancer.org/ .
Accessed November 19, 2002.
DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles & Practice of Oncology , 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins;2001:1519-1549.
Otto SE. Oncology Nursing . 4th ed. St. Louis, MO: Mosby, Inc; 2001:248-257.
Last reviewed February 2003 by ]]>Jondavid Pollock, MD, PhD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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