Causes and Risk Factors of Cervical Cancer

Table of Contents
View All
Table of Contents

By far, the most common cause of cervical cancer is human papillomavirus (HPV) infection. Certain health conditions can even increase your chance of developing the disease if you have HPV—and, sometimes, even if you don't. But genetics, smoking, and other factors can also play a role in cervical cancer's development, and several lifestyle choices can raise your risk (in many cases because of the fact that they increase the likelihood that you'll be infected with HPV in the first place).

cervical cancer causes and risk factors
Verywell 

Common Causes

There are few known causes of cervical cancer, with HPV being the strongest one.

It is important to note that while HPV is the most common cause of cervical cancer, most women who have HPV do not develop cervical cancer.

Awareness of the other causes is very important, because the additive effect of more than one being at play may have a significant impact on your chances of developing the disease.

This photo contains content that some people may find graphic or disturbing.

genital warts on penis
Genital warts.

DermNet / CC BY-NC-ND

  • HPV: HPV is a sexually transmitted virus that can manifest with visible genital warts, but generally does not result in any symptoms. HPV can cause microscopic, precancerous changes in the cervix that can eventually progress to more advanced cervical cancer. Having HPV does not necessarily mean that you will get cervical cancer, but if you are at risk of having the infection, you should see a doctor for accurate diagnosis and be treated because it is impossible to know with certainty whether or not the disease would otherwise be in your future. If the test result is negative, there are methods to prevent HPV. If you do have HPV there are ways to cope.
  • Smoking: According to the American Cancer Society, smoking increases your chances of developing cervical cancer if you have HPV. Smoking introduces harmful chemicals that lead to cancer. While they tend to be most concentrated in the lungs, they can also travel throughout the body and cause or contribute to the development of other types of cancer as well, including cervical cancer. 
  • Diethylstilbestrol (DES): DES is a medication that was used until the early 1970s to prevent miscarriages in women who were at high risk of losing a pregnancy. Use of this medication stopped when the associated risk of vaginal and cervical cancer was observed. Daughters of women who took DES during pregnancy are at risk of developing clear cell carcinoma of the vagina or cervix. Women who are at risk due to this exposure are now generally over the age of 45. 
  • Immune deficiency: Your immune system protects you, not only against infections but also against cancer. Women who have an immune system deficiency, whether due to HIV infection, medications that suppress the immune system, or an illness, are more susceptible to developing cervical cancer. This risk is much higher for women who have HPV infection but rarely can occur even without it. 

Genetics

There is a familial tendency to developing cervical cancer, and some families have genetic changes that could be responsible, at least partially, for some of the hereditary risks of cervical cancer. 

You are at a higher risk of developing cervical cancer if you have women in your family with the disease.

Some families who have higher rates of cervical cancer also have certain genetic changes. Specifically, abnormalities HLA-DRB1*13-2, HLA-DRB1*3(17), and HLA-B*07 genes have been identified in association with a familial incidence of cervical cancer. This means that irregularities in these genes, which can be detected with tests, are more common among women who have several family members with cervical cancer. 

Because not every woman who has HPV will develop cervical cancer, it is possible that having a genetic abnormality could make you more likely to have cervical cancer if you already have HPV. These genes do not independently cause cervical cancer in the absence of HPV. 

The presence of genes that predispose someone to cancer in general can increase the risk of developing cervical cancer as well. For example, abnormalities in the genes that code for interleukin 6 (IL -6), a protein that helps the immune system function, can play a role. But again, they generally only have this effect on cervical cancer risk if a woman already has been infected with HPV.

Lifestyle Risk Factors

A number of lifestyle risk factors are associated with cervical cancer. Based on the evidence gathered so far, it seems that these risk factors do not cause cervical cancer, but they are instead signs that you could be at risk:

  • Having multiple sexual partners: Having multiple sexual partners increases the chances of exposure to the virus because it is spread from one person to another, only through sexual contact. Women who have sex with men or who have sex with women are at risk of getting HPV. 
  • Beginning sexual activity at a young age: Women who become sexually active during the teen years are more likely to develop cervical cancer. This could be due to the fact that the condition takes years to develop, or to a lack of condom use among teenagers. 
  • Using oral contraceptives: Women who use oral contraceptives for many years have a higher risk of cervical cancer than women who do not, and the risk declines about 10 years after oral contraceptive use is discontinued. This may be due to the fact that women who use oral contraceptives are more likely to be sexually active and less likely to use condoms, and therefore are at higher risk of being exposed to HPV. 
  • Low socioeconomic status: Low socioeconomic status is associated with a higher chance of developing cervical cancer. In general, lower socioeconomic status is associated with less regular health care, and this could result in the disease advancing to late stages before it is treatable. 

​A Word About Tampons

Despite misinformation about tampons, it has never been proven that tampons play any role in cervical cancer. But there are other potential health complications of tampon use. Toxic shock syndrome related to tampon use is an uncommon but very serious disorder caused by the toxins released by bacteria.

Toxic shock syndrome occurs most commonly when tampons have been left in place for a long period of time.

Precautions against toxic shock syndrome include changing your tampon every four to eight hours and using a pad instead of a tampon when your bleeding is light..

Frequently Asked Questions

  • What causes cervical cancer?

    Cervical cancer is believed to stem from multiple factors, including lifestyle, environment, and a genetic predisposition for the disease. With that said, around 90% of cervical cancer cases are linked to human papillomavirus (HPV), a group of sexually transmitted viruses. Some types of HPV can cause changes in cells that lead to cervical cancer, anal cancer, penile cancer, and other cancers.

  • What types of HPV cause cancer?

    There are over 200 types of HPV, but only a handful are linked to cervical cancer. Two high-risk types—HPV types 16 and 18—account for roughly 70% of cervical cancer cases, while HPV types 31 and 45 account for 10%. Other high-risk types include HPV types 33, 35, 39, 51, 52, 56, 58, 59, 68, 73, and 82.

  • How does HPV cause cancer?

    When exposed to HPV, the immune system can usually clear the infection on its own. However, in some cases, a high-risk HPV type will persist and “hijack” the genetic machinery of a cell—not only causing cells to multiply rapidly but also blocking the action of tumor suppressor proteins meant to prevent cells from turning cancerous. A combination of these and other events can lead to the development of cancer.

  • What are the symptoms of HPV?

    An HPV infection is often asymptomatic. In some people, HPV may cause genital warts that rarely turn cancerous. Most people with high-risk HPV types will have no signs of infection until it is already causing health problems. This is why OB/GYN check-ups, including regular Pap smears, are so important to the early detection of cervical cancer.

  • What causes cervical cancer other than HPV?

    Smoking is the lifestyle factor most closely linked to cervical cancer, increasing the risk of cervical intraepithelial hyperplasia (the abnormal growth of cells on the cervix that could lead to cancer). Multiple pregnancies might also increase the risk, as can the long-term use of oral contraceptives (which can increase the risk by more than two-fold).

  • What are the early signs and symptoms of cervical cancer?

    People with early-stage cervical cancer often have no symptoms. When symptoms do develop, they often include:

    • Abnormal vaginal bleeding, including bleeding after sex, between periods, or after menopause
    • Pain during sex
    • Unusual vaginal discharge, sometimes with blood
    • Pelvic pain or pressure
Was this page helpful?
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. World Health Organization. Human papillomavirus (HPV) and Cervical Cancer. Updated January 24, 2019.

  2. Eisenberg MC, Campredon LP, Brouwer AF, et al. Dynamics and Determinants of HPV Infection: The Michigan HPV and Oropharyngeal Cancer (M-HOC) Study. BMJ Open. 2018;8(10):e021618. doi:10.1136/bmjopen-2018-021618

  3. Institute of Medicine (US) Committee on Ethical and Legal Issues Relating to the Inclusion of Women in Clinical Studies; Mastroianni AC, Faden R, Federman D, editors. Women and Health Research: Ethical and Legal Issues of Including Women in Clinical Studies: Volume I. Washington (DC): National Academies Press (US); 1994. C, DES Case Study.

  4. Smola S, Trimble C, Stern PL. Human papillomavirus-driven immune deviation: challenge and novel opportunity for immunotherapyTher Adv Vaccines. 2017;5(3):69–82. doi:10.1177/2051013617717914

  5. Chen X, Jiang J, Shen H, Hu Z. Genetic susceptibility of cervical cancerJ Biomed Res. 2011;25(3):155–164. doi:10.1016/S1674-8301(11)60020-1

  6. Burd EM. Human papillomavirus and cervical cancerClin Microbiol Rev. 2003;16(1):1–17. doi:10.1128/cmr.16.1.1-17.2003

  7. Centers for Disease Control and Prevention. Basic information about HPV and Cancer. Updated August 22, 2018.

  8. Green J, Berrington de Gonzalez A, Smith JS, et al. Human papillomavirus infection and use of oral contraceptivesBr J Cancer. 2003;88(11):1713–1720. doi:10.1038/sj.bjc.6600971

  9. Al-Harbi NM, Judia SSB, Mishra KN, Shoukri MM, Alsbeih GA. Genetic predisposition to cervical cancer and the association with XRCC1 and TGFB1 polymorphismsInt J Gynecologic Cancer. 2017;27(9). doi:10.1097/IGC.0000000000001103

  10. Centers for Disease Control and Prevention. Cancers associated with human papillomavirus (HPV). Updated September 3, 2020.

  11. Luria L, Cardoza-Favarota G. Human papillomavirus. In: StatPearls [Internet]. Updated January 24, 2021.

  12. Ashrafi GH, Salman NA. Pathogenesis of human papillomavirus – immunological responses to HPV infection. In: Human Papillomavirus - Research in Global Perspective. InTech; 2016.

  13. Fang J-H, Yu X-M, Zhang S-H, Yang Y. Effect of smoking on high-grade cervical cancer in women on the basis of human papillomavirus infection studiesJ Can Res Ther. 2018;14(8):184. doi:10.4103/0973-1482.179190

  14. Lee Y, Roberts C, Dobbins T, et al. Incidence and outcomes of pregnancy‐associated cancer in Australia, 1994–2008: a population‐based linkage studyBJOG: Int J Obstetric Gynaecol. 2012;119(13):1572-82. doi:10.1111/j.1471-0528.2012.03475.x

  15. Asthana S, Busa V, Labani S. Oral contraceptives use and risk of cervical cancer—a systematic review & meta-analysisEur J Obstetric Gynecology Reproductive Biol. 2020;247:163-75. doi:10.1016/j.ejogrb.2020.02.014

  16. American Cancer Society. Signs and symptoms of cervical cancer. Updated January 3, 2020.

Additional Reading