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Portsmouth Regional Hospital
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Risk Factors for Cervical Cancer

A risk factor is something that increases your chances of developing a disease or condition.

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 doctor what you can do to reduce your risk.

Some factors, like age, cannot be modified. After the age of 25, the risk of developing cervical cancer begins to increase. This cancer, or its precancerous changes, can be diagnosed in young women in their teens and early 20s. After age 40, the risk of developing cervical cancer stays about the same, but the risk of dying from cervical cancer increases as women get older.

Human Papillomavirus Infection

Human papillomavirus (HPV) is the biggest risk factor, accounting for nearly 90% of all cervical cancers. HPV is transmitted through intimate and sexual contact. The viruses cause warts on the genitals and anus of both males and females. Other types of HPV are associated with cancers of the vulva, vagina, penis, anus, and the back of the throat.

Though most HPV goes away on its own, persistent infection can affect the cells of the cervix.

Abnormal Cervical Cells

Dysplasia is an abnormal change in cells. Cervical intraepithelial neoplasia (CIN) is abnormal change in cervical cells. CIN does not cause symptoms, but rather, is diagnosed during Pap testsor biopsies.

CIN is graded as 1 (mild), 2 (moderate), or 3 (severe). All grades of CIN increase the risk of cervical cancer, but grade 3 carries the highest risk of invasive cervical cancer, even with treatment. The main cause of CIN is persistent HPV infection. CIN usually resolves on its own. If it does not, it may be surgically removed.

History of Not Having Pap Tests

A Pap test is a highly effective screening tool used to detect early abnormal cell growth. Early detection is key to stopping dysplasia before it progresses to cancer.

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.

Sexual History

Women who had sexual intercourse at an early age or women who have had many sexual partners are at an increased risk of cervical cancer. If a woman is with a partner who has had many sexual partners, this also increases risk.

A history of sexually transmitted diseases (STDs), such as chlamydia, can increase the risk of cervical cancer. Chlamydia, like many STDs, do not always have noticeable symptoms until the disease has progressed. Regular screening is important to detect the presence of chlamydia (and other STDs) so treatment can be started early.

Smoking

Smoking affects every cell in the body. Smoke and carcinogens (cancer-causing agents) enter the bloodstream after being inhaled. Tobacco by-products have been found in the cervical mucus of women who smoke. Regular exposure to carcinogenic agents increases the risk of irritation that causes changes in cells. These changes can lead to cervical and other cancers. The more cigarettes smoked and the number of years as a smoker increase this risk. Generally, women who smoke double their risk of cervical cancer.

Weakened Immune System

Conditions or medications that weaken the immune system increase the risk of cervical cancer. Infections are more likely in people with weakened immune systems. Once an infection is present, it is harder to fight off. For example, an HPV infection can persist, increasing the risk of cervical cell damage and dysplasia.

Women with weakened immune systems, such 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 likely to get an HPV infection, which may increase the risk of cervical cancer. In someone with a weakened immune system, a cervical dysplasia may develop into an invasive cancer faster than it normally would in a woman without a weakened immune system.

Other Risk Factors

Other factors that may increase your chance of cervical cancer include:

  • Diethylstilbestrol (DES) exposure—Women born between 1940 and 1972 who were exposed to DES by their mothers during pregnancy. DES is a hormone prescribed to reduce the risk of miscarriage. Some women exposed to DES have a higher risk of cervical cancer, as well as a specific type of vaginal cancer.
  • Poor nutrition— Diets low in fruits and vegetables are associated with an increased risk of cervical cancer. Poor nutrition habits can lead to weight gain and obesity. Obesity can increase your chance of cervical and other cancers.
  • Race and ethnicity—In the United States, several racial and ethnic groups have higher cervical cancer death rates. Among African Americans, the death rate from cervical cancer is more than twice the national average. Hispanics and American Indians also have death rates above the average.
  • Low socioeconomic status—Women with low socioeconomic status are at an increased risk of cervical cancer because may have difficulty accessing healthcare services. This may keep women from getting the screening needed to diagnose and treat cervical cancer in its early stages.

Revision Information

  • Cervical cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003094-pdf.pdf. Accessed November 16, 2015.

  • Cervical cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 29, 2015. Accessed November 16, 2015.

  • Cervical cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/cervical-cancer. Updated May 2013. Accessed November 16, 2015.

  • General information about cervical cancer. National Cancer Institute website. Available at: http://www.cancer.gov/types/cervical/patient/cervical-treatment-pdq. Updated June 12, 2015. Accessed November 16, 2015.

  • Murthy NS, Mathew A. Risk factors for pre-cancerous lesions of the cervix. Eur J Cancer Prev. 2000;9(1):5-14.

  • 10/1/2014 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Bhaskaran K, Douglas I, Forbes H, et al. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5.24 million UK adults. Lancet. 2014;384(9945):755-765.