Causes and Risk Factors of Cervical Cancer

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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
Illustration by 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.

  • 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.

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