HPV and cervical cancer risk factors

A risk factor is anything that augments your chances of getting a disease such as cancer. Cancers have different and shared risk factors. For example, smoking is a risk factor for many cancers. And although, having one or more of these risk factors means an increased risk of cervical cancer, it does not guarantee you will get the disease.

As mentioned above, the primary cause for cervical cancer is human papilloma virus (HPV). While it is mentioned in passing in this section, we will cover it in-depth below. Other risk factors for cervical cancer include:

  • HPV – The most important risk factor for cervical cancer is infection by the human papilloma virus (HPV). HPV is a group of more than 150 related viruses, some of which cause a type of growth called papillomas, which are more commonly known as warts.
  • Smoking – Women who smoke are about twice as likely to non-smokers to get cervical cancer. Harmful substances inhaled when smoking are absorbed through the lungs are carried in the bloodstream throughout the body. Smoking also makes the immune system less effective in fighting HPV infections.
  • Immunosuppression – Human immunodeficiency virus (HIV), the virus that causes AIDS, damages the immune system and puts women at higher risk for HPV infections. Another group of women at risk of cervical cancer are those taking drugs to suppress their immune response, such as those being treated for an autoimmune disease (in which the immune system sees the body’s own tissues as foreign and attacks them, as it would a germ) or those who have had an organ transplant.
  • Chlamydia infection – Chlamydia is a relatively common kind of bacteria that can infect the reproductive system. An infection of chlamydia can cause pelvic inflammation, leading to infertility. Women who have been infected with chlamydia often have no symptoms. Some studies have seen a higher risk of cervical cancer in women whose blood test results show evidence of past or current chlamydia infection compared to those who have normal results.
  • A diet low in fruits and vegetables –Women whose diets don’t include enough fruits and vegetables may be at increased risk for cervical cancer
  • Weight – Overweight women are more likely to develop adenocarcinoma of the cervix.
  • Long-term use of oral contraceptives –There is evidence that taking oral contraceptives (OCs) for a long time increases the risk of cervical cancer. Research suggests that the risk of cervical cancer goes up the longer a woman takes oral contraceptives, but the risk goes back down again after the OCs are stopped.
  • Intrauterine device use – A recent study found that women who had ever used an intrauterine device (IUD) had a lower risk of cervical cancer and, potentially, uterine cancer. The effect on risk was seen even in women who had an IUD for less than a year, and the protective effect remained after the IUDs were removed.
  • Having multiple full-term pregnancies – Women who have had 3 or more full-term pregnancies have an increased risk of developing cervical cancer.
  • Being younger than 17 at your first full term pregnancy – Women who were younger than 17 years when they had their first full-term pregnancy are almost 2 times more likely to get cervical cancer later in life than women who waited to get pregnant until they were 25 years or older.
  • Socio-economic status – A lower socio-economic status is also a risk factor for cervical cancer. Many low-income women do not have ready access to adequate health care services, including pap tests. This means they may not get screened or treated for cervical pre-cancers.
  • Diethylstilbestrol – DES is a hormonal drug that was given to some women to prevent miscarriage between 1940 and 1971. Women whose mothers took DES (when pregnant with them) develop clear-cell adenocarcinoma of the vagina or cervix more often than would normally be expected.
  • Having a family history of cervical cancer – Cervical cancer may run in some families. If your mother or sister had cervical cancer, your chances of developing the disease are 2 to 3 times higher than if no one in the family had it.

[6] Information taken from the American Cancer Society, for more information go here.

Cervical cancer and its relation to HPV as a risk factor

Human papillomavirus is a group of more than 150 related viruses. It is the most common viral infection of the reproductive tract. Most sexually active women and men will have a HPV infection at some point in their lives and some may become repeatedly infected. Acquiring the infection typically occurs shortly after becoming sexually active. Penetrative sex is not the only method of transmission; skin-to-skin genital contact can transmit HPV as well [7].

While many types of HPV do not cause problems and clear up within two years, a small portion of HPV infections can become precancerous and progress to cancer. Two types of HPV in particular, 16 and 18, are known as high-risk types of HPV infection. They cause nearly seventy per cent of all precancerous cervical lesions and cervical cancers. Other types of high-risk HPVs can also cause cervical cancer, including HPV types 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59 [8]. Cervical cancer remains by far the most common HPV-related disease, with nearly all cases being attributable to HPV infections [9]. HPV infection can also cause anal, vaginal, vulvar, penile and some oral cavity and oropharyngeal cancers [10].

What can I do to reduce my risk of cervical cancer?

  • Go for regular Pap tests
  • Go for follow-up testing if your Pap test result is abnormal.
  • Consider HPV immunization. It is approved for women up to 45 years of age. Women are encouraged to speak to their healthcare provider about getting immunized.
  • It is ideal to have the vaccination before becoming sexually active and possibly exposed to the HPV virus. However, women who are already sexually active can also receive the vaccine. The vaccine prevents most but not all
  • cervical cancers. Therefore, even if you are vaccinated against HPV, you still need regular Pap tests.
  • Be aware that the risks of HPV infection include starting sexual activity at an early age, having multiple sexual partners and having a partner with a number of previous intimate contacts.
  • Use a condom. Condoms do not fully protect you from HPV infection, but they may reduce the risk. Condoms are effective protection against other sexually transmitted infections.
  • Be tobacco-free and avoid second hand smoke. Tobacco use can weaken the immune system, which makes it difficult for your body to fight off an infection.
  • Eat well; follow Canada’s Food Guide. Exercise regularly, manage stress and get enough rest to stay healthy.

[15] Information taken from CancerCare Ontario

[5] “What Is Cervical Cancer?” Canadian Cancer Society. Canadian Cancer Society, 2015. Web. 05 Aug. 2015.
[6] “What Are the Risk Factors for Cervical Cancer?” American Cancer Society. American Cancer Society, 2015. Web. 06 Aug. 2015.
[7] “Human Papillomavirus (HPV) and Cervical Cancer.” World Health Organization. World Health Organization, Mar. 2015. Web. 06 Aug. 2015.
[8] “Human Papillomavirus (HPV).” Canadian Cancer Society. Canadian Cancer Society, 2015. Web. 06 Aug. 2015.
[9] “Human Papillomavirus (HPV) and Cervical Cancer.” World Health Organization. World Health Organization, Mar. 2015. Web. 06 Aug. 2015.
[10] “Human Papillomavirus (HPV).” Canadian Cancer Society. Canadian Cancer Society, 2015. Web. 06 Aug. 2015.
[15] “Cervical Cancer Screening – Frequently Asked Questions.” Resources for the Public. CancerCare Ontario. Web. 5 Jan. 2016.