Key Risk Factors for Cervical Cancer

What Increases Cervical Cancer Risk? Causes & Screening

Cervical cancer is a public health issue, especially in middle- and low-income nations, where access to treatment and screening could be lacking. This type of cancer starts in the cervix, the lower section of the uterus leading into the vagina. Its causes are largely the result of persistent infection with the high-risk subtypes of human papillomavirus (HPV).

Risk Factors for Cervical Cancer

Awareness of the principal risk factors of cervical cancer is needed to enable prevention, early diagnosis, and proper management. Here are the risk factors for cervical cancer:

1. Human Papillomavirus (HPV) Infection

The most significant risk factor for cervical cancer is infection with the high-risk types of human papillomavirus (HPV), which are HPV-16 and HPV-18. HPV is a sexually transmitted infection, and nearly all sexually active men and women will become infected at some time during their lifetime. In the vast majority of instances, the body naturally clears the infection. Sustained infections, especially those caused by oncogenic strains, can cause precancerous alterations in cervical cells, leading to cancer if untreated.

2. Early Sex and Number of Sexual Partners

Sex at a younger age heightens the risk of HPV infection and, indirectly, cervical cancer. This is largely because of the heightened susceptibility of the cervical epithelium to oncogenic viruses during young adulthood. Having multiple sexual partners increases your chances of being exposed to high-risk strains of HPV. Therefore, sexual behaviour is significant in defining cervical cancer risk.

3. Smoking

Smoking is also an important risk factor. Smokers are approximately twice as likely to get cervical cancer as non-smokers. Smoking causes tobacco by-products to interfere with the DNA of cervical cells. It compromises the immune system, making it harder for the body to fight off HPV infections. Hence, this carcinogenic exposure leads to the formation of precancerous lesions and cancer.

4. Compromised Immune System

An impaired immune system, caused by conditions such as HIV/AIDS or immunosuppressive treatment (e.g., after organ transplantation), raises the risk for chronic HPV infection and cervical cancer. Furthermore, HIV-infected women are especially at risk because their immune systems are less effective in clearing HPV infections. This can lead to cancer more quickly than among immunocompetent women.

5. Extended Use of Oral Contraceptives

Research has found that long-term oral contraceptive use (five or more years) may increase the risk of cervical cancer. Scientists are still unsure of the exact mechanism, but they suspect it may be linked to hormonal changes in the cervix's epithelial tissue. This makes it more vulnerable to HPV infection or carcinogenic change. Moreover, oral contraceptive benefits and risks must be weighed on an individual basis.

6. High Parity (Having Many Children)

Women with three or more full-term pregnancies are at risk of cervical cancer. The hormonal alterations in pregnancy and the mechanical trauma to the cervix during delivery could contribute to cellular changes that might result in malignancy. Furthermore, repeated cervical injury and inflammation could provide an environment conducive to the persistence of HPV and cause damage.

7. Inadequate Cervical Screening

Routine cervical screening (HPV testing or pap smear) is an important factor in the early identification of precancerous cervical cell changes. Women who do not receive regular screenings are at much greater risk of developing cervical cancer since abnormalities may not be detected and treated. Furthermore, barriers to screening include cultural taboos, lack of awareness, fear, or limited access to health facilities.

8. Low Socioeconomic Status

Socioeconomic determinants affect access to preventive care services, such as cervical screening and HPV vaccination. Women with lower socioeconomic status are less likely to undergo screening at an early stage or receive effective treatment, resulting in delayed diagnosis and worse outcomes. Additionally, socioeconomic status crosses with other risk factors like education, access to healthcare, and lifestyle.

Overall, cervical cancer is predominantly preventable by vaccination against HPV, screening, and control of risk factors. Awareness of the complex risk factors, spanning from HPV infection and sexual behaviour to socioeconomic status and immune system health, allows healthcare professionals and public health organisations to develop specific interventions.

Education, access to screening programs, HPV vaccination, and lifestyle modification are still crucial measures in curbing the burden of cervical cancer worldwide.