Cervical Cancer: Overview and Risk Factors

A century ago, cervical cancer was one of the deadliest cancers. It is still the second most common cause of cancer death in third–world countries. However, there has been a 75 percent decrease in the incidence and mortality rate in the United States and other developed countries over the past 50 years. This is due to widespread Pap smear screening programs that identify cases in the early stages of disease.

Cervical cancer is closely tied to infection with cancer–causing forms of human papillomavirus (HPV), which is primarily acquired by sexual transmission.

Symptoms are often absent, even in advanced cases. When present, symptoms may include abnormal vaginal discharge or vaginal bleeding. Advanced disease may cause pain in the low back or legs and bowel or urinary symptoms, such as passage of blood and a sensation of pressure.

Risk Factors

• Human papillomavirus (HPV) infection: Most cases of cervical cancer involve HPV infection. However, not all cases of HPV infection cause cervical cancer. There are more than 100 types of HPV and only a few of these are known to cause cervical cancer.
• Age: Incidence increases with age. Cervical cancer is uncommon in women under 20. It is most common in women aged 45 to 49 years.
• Sexual factors: Factors that increase the risk for HPV infection and for cervical cancer include sexual intercourse at a young age, multiple sexual partners (or a partner with multiple partners), history of sexually transmitted diseases, a sexual relationship with a person who has exposure to HPV, and intercourse with an uncircumcised man.
• Smoking
• Use of birth control pills
• High number of children: Compared with women who have two or fewer babies, women with seven or more full–term pregnancies have a two– to four–fold increased risk for cervical cancer.