Cancer of the cervix is almost entirely preventable. Regular Pap smears can detect the presence of pre-cancerous cells. These pre-cancerous cells appear 10-12 years prior to cancer. Therefore, with routine Pap smears cervical cancer can be caught in its very earliest stages. During the precancerous stage, the cells of the cervix undergo changes called dysplasia. The Pap smear detects these abnormal cells.
Nearly all cervical cancers are associated with a sexually transmitted virus called the human papillomavirus (HPV). HPV is usually asymptomatic and typically goes away by itself, and most people with HPV never even know they have it. Most women infected with HPV will not develop cervical cancer. However, yearly Pap smears will continue to be necessary if you have had an abnormal Pap smear due to HPV.
HPV can be categorized into two groups based on the chance of developing cancer:
Low Risk: Most LR-HPV (low risk HPV) are associated with genital warts and not cancer. The two most common LR-HPV strains are 6 and 11. These two LR-HPV strains account for about 90% of genital warts.
High risk: HR-HPV (high risk HPV) is associated with pre-cancerous and cancerous cells of the cervix. The two most common HR-HPV strains are 16 and 18. If these abnormal cells are not found and treated, they may become cancerous. They account for more than 75% of all cervical cancers. They may also be responsible for a small number of vaginal and vulvar cancers.
Other Risk Factors Include:
Age: The risk of cervical cancer is directly related to your age. Most cancers are diagnosed in women older than 40, though younger women are often diagnosed with pre-cancerous lesions and aggressive tumor types. Adenocarcinomas may be more common in younger women that have used birth control pills in the past, although this is somewhat controversial.
Smoking: Cigarette smoking is a well-recognized risk factor for cervical cancer. The smoke contains chemicals that are secreted in the cervical cells and hinder the cells’ ability to repair local damage. It also increases the risk of persistent HPV infections that lead to the development of precancerous changes in the cervix, especially in women with HPV.
Sexual Behavior: The risk of cancer is directly related to the infection rate of HR-HPV and certain sexual histories are more prone to HR-HPV infections. These include multiple sexual partners, or high-risk male partners, early age at first intercourse and using non-barrier birth control methods.
Lack of Regular Pap Tests: All but a very small percentage of cervical cancers may be prevented with yearly Pap smears. Women who have a history of not having a Pap smear within the last 10 years are at highest risk of developing cervical cancer. The Pap smear is a screening test that helps doctors find precancerous cells.
Sexually Transmitted Diseases: HR-HPV is a known risk factor for cervical cancer. It is also more common in women with other STD’s.
Diethylstilbestrol (DES) Exposure: DES was used in the past to attempt to prevent miscarriages. This did not work and was discontinued but female children of mothers that were exposed to DES have an increased chance of clear cell cancers of the lower genital tract.
HIV Infection or Weakened Immune System: Women who have HIV are at an increased risk of cervical cancer due to a decreased immune response to either an HR-HPV infection or recognition of pre-cancerous cells. Weakened immune systems occur in women who have undergone an organ transplant or take steroids for other reasons. These women have a higher than average risk of developing cervical cancer.
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