Cervical cancer, though preventable, remains a significant concern for women’s health. Cervical cancer accounts for approximately 6–29% of all cancers diagnosed in women in India (1).
While this number is thankfully declining due to increased screening, understanding the risk factors associated with cervical cancer is vital for early detection and prevention. This article explores the key contributors to cervical cancer development.
What is Cervical Cancer?
Cervical cancer is a cancer in the cervix region in women. The cervix is the lower, narrow end of the uterus. Cervical cancer develops over a long time. Cervical cancer is caused by human papillomavirus or HPV. Cells in the cervix undergo changes known as dysplasia, in which abnormal cells begin to appear in the cervical tissue. Over time these cells start to grow and form tumor in the cervix region.
Types of Cervical Cancer
There are two types of cervical cancer based on the types of cells that cause the cancer
1. Squamous cell carcinoma
Most cervical cancers are squamous cell carcinomas. They are 90% of total cervical cancer detected in women. Squamous cell carcinoma develops from cells in the ectocervix.
3. Adenocarcinoma
This type of cervical cancer is developed in the glandular cells of the endocervix which is the lower part of the cervix. Adenocarcinoma is a rare type of cervical cancer that is diagnosed in 10% of cervical cancer cases.
4. Symptoms of Cervical Cancer
Symptoms of cervical cancer may not appear in the initial stage but may present themselves in later stages of cancer. Symptoms of cervical cancer include:
- Vaginal bleeding after intercourse
- Menstruation bleeding which is heavier and longer than usual
- Watery vaginal discharge that has a foul odor
- Pelvic pain during intercourse
Causes of Cervical Cancer
The main reason for cervical cancer is human papillomavirus (HPV). HPV is a common sexually transmitted infection, and while many strains are harmless, some can trigger abnormal cell changes on the cervix. These changes, if left undetected, can develop into cancer over time.
Not All HPV Strains Are Equal
Over 100 strains of HPV exist, but only a select few pose a significant risk for cervical cancer. Here’s a breakdown:
- High-Risk HPV: Strains like HPV 16 and 18 are the most concerning, responsible for roughly 70% of cervical cancers (2).
- Low-Risk HPV: These strains (like HPV 6 and 11) are more common and typically cause benign genital warts. While not directly linked to cancer, they can be a sign of potential exposure to other HPV strains.
Risk Factors for Cervical Cancer
As we know cervical cancer is caused by HPV, understanding other contributory factors can empower individuals to take proactive measures for prevention and early detection. Here are some crucial risk factors (3):
- Weakened Immune System: A compromised immune system poses a significant risk for cervical cancer development. Conditions such as HIV/AIDS and immunosuppressive therapy post-organ transplant weaken the body’s defense mechanism against HPV, allowing the virus to persist and potentially progress into cervical cancer. Individuals with weakened immune systems should be particularly vigilant about regular screenings and preventive measures.
- Smoking: Tobacco smoke contains numerous carcinogens that not only damage cells directly but also impair the immune system’s ability to combat HPV infections effectively. Studies have shown that smokers are at a higher risk of developing cervical cancer compared to non-smokers. Quitting smoking not only reduces the risk of cervical cancer but also improves overall health outcomes.
- Multiple Sexual Partners: Engaging in sexual activity with multiple partners increases the likelihood of HPV exposure, consequently elevating the risk of cervical cancer. Each new sexual partner introduces the potential for encountering different HPV strains, amplifying the risk of persistent infections and the development of precancerous lesions. Practicing safe sex, including consistent condom use and limiting the number of sexual partners, can significantly reduce the risk of HPV transmission and subsequent cervical cancer.
- Long-Term Use of Oral Contraceptives: Prolonged use of oral contraceptives, particularly beyond five years, has been associated with a slightly increased risk of cervical cancer. The exact mechanism behind this association is not fully understood, but it is believed that hormonal contraceptives may influence the immune response to HPV infections or promote the growth of abnormal cervical cells. Women using oral contraceptives should discuss their individual risk factors with healthcare providers and adhere to recommended cervical cancer screening guidelines.
- Early Initiation of Sexual Activity: Initiating sexual activity at a young age, especially before the age of 18, has been linked to an elevated risk of cervical cancer. Early sexual debut increases the likelihood of encountering HPV infections when the cervix is still immature and more susceptible to viral entry. Education programs focusing on delaying sexual initiation and promoting comprehensive sexual health can help mitigate this risk factor.
Understanding these additional risk factors alongside HPV can guide individuals in adopting preventive strategies and making informed healthcare decisions. Regular cervical cancer screenings, vaccination against HPV, maintaining a healthy lifestyle, and practicing safe sex are vital steps in reducing the incidence and burden of cervical cancer. By addressing these risk factors comprehensively, individuals can empower themselves in the fight against cervical cancer and safeguard their long-term health.
Prevention for Cervical Cancer
Here are some tips on how to prevent cervical cancer
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Take HPV vaccine
Taking an HPV vaccine is the best way to prevent cervical cancer and other HPV infections. Consult with your doctor if taking the HPV vaccine is right for you.
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Take a pap test
A pap test can detect precancerous conditions of the cervix. These conditions can then be managed or treated to prevent cervical cancer.
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Practice safe sex
Practicing safe sex is also a great way to prevent cervical cancer. This includes using a condom every time you have sex and limiting the number of sexual partners you have.
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Avoid Smoking
Avoid smoking as it is one of the factors that can improve the chances of getting cervical cancer. If you don’t smoke, then don’t start.
Treatment for Cervical Cancer
Cervical cancer is treatable with treatment depending on factors like
- Size and type of cervical cancer
- Location of the cancer
- How much it has spread
- Overall health
There are four major treatments, surgery, chemotherapy, radiotherapy and targeted medicine.
1. Surgery
Surgery is the most common approach to treat cervical cancer. There are different types of surgeries which are performed depending on the location and spread of cancer
- Part of the cervix if the cancer is really small
- Cervix and upper part of the vagina
- Cervix and womb
- Cervix, womb, ovaries and fallopian tubes, and all or parts of the bladder, bowel, vagina or rectum
2. Chemotherapy
Chemotherapy is used to kill cancer cells in the body. The chemotherapy course for cervical cancer includes:
- With radiotherapy as a main treatment
- Before the surgery to reduce the cancer
- After surgery to prevent cancer from coming back
- If cancer has come back and spread to the other parts
3. Radiotherapy
Radiotherapy is the use of high energy rays to kill cancer cells. Radiotherapy as the treatment for cervical cancer is used:
- As the main treatment
- After surgery to help stop cancer
- To help improve symptoms like bleeding
4. Targeted Medicine
Medicine like Avastin is recommended for advanced cervical cancer or cancer has come back. It is important to understand that medicine only helps to make the cancer smaller or stop it from getting any larger, not to cure the cancer.
Conclusion
In conclusion, understanding the multifaceted nature of cervical cancer risk factors is crucial for effective prevention and early detection. Cervical cancer is primarily caused by persistent infection with high-risk strains of the human papillomavirus (HPV). However, several other factors, including weakened immune systems, smoking, multiple sexual partners, long-term use of oral contraceptives, and early initiation of sexual activity, can also contribute to its development.
By recognizing these risk factors, individuals can take proactive steps to mitigate their risk and protect their health. Prevention strategies such as receiving the HPV vaccine, practicing safe sex, quitting smoking, and attending regular cervical cancer screenings are paramount in reducing the incidence and mortality associated with this disease.
By addressing the causes and risk factors comprehensively, we can work towards a future where cervical cancer becomes a rarity rather than a prevalent health concern.
FAQs
1. What is a high-risk factor of cervical cancer?
The high-risk factors of cervical factors include HPV type, immune status, the presence of other sexually transmitted infections, number of births, young age at first pregnancy, hormonal contraceptive use, and smoking.
2. What is the main cause of cervical cancer?
The main cause of cervical cancer is human papillomavirus (HPV).
3. What age is high-risk for cervical cancer?
Women between the ages of 35 to 44 are at high-risk of cervical cancer.
4. What can increase the risk of cervical cancer?
Factors like smoking, sexual activity, weak immune system and other types of STDs can increase the risk of cervical cancer.
5. What to eat to prevent cervical cancer?
Foods rich in antioxidants are the best foods to eat to prevent cervical cancer.
