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Cervical Cancer: Overview and Risk Factors

Cervical cancer occurs primarily in 2 varieties: squamous cell carcinoma (about 80% of cases) and adenocarcinoma (about 15%). Adenosquamous carcinoma makes up most of the remaining cases, and this type may have a poorer outcome. A rare cause of death when screening programs exist, cervical cancer accounts for about 1% of all cancer deaths in developed countries. Cervical cancer is age related; incidence is extremely low in women under 20, and peaks at 16.5/100,000/year in women aged 45 to 49.1

Symptoms are absent in many cases, but abnormal vaginal discharge or bleeding often occurs. Advanced disease may also cause pain in the low back and pelvis with radiation into the posterior legs, as well as bowel or urinary symptoms such as passage of blood and a sensation of pressure.

Risk Factors

Women in developing nations have much higher mortality (nearly 50%) than those in developed nations due to the scarcity of screening programs. Other risk factors include:

Human papillomavirus (HPV) infection. This virus has many subtypes and not all cause cancer, but most cervical cancers involve HPV.

Sexual factors. Early sexual intercourse; history of multiple sexual partners (or a partner with multiple partners); history of sexually transmitted disease; sexual relationship with a person who has exposure to HPV; and intercourse with an uncircumcised man. Uncircumcised men and their sexual partners have an elevated rate of HPV infection.2

  • Smoking.
  • History of genital squamous dysplasia.
  • High parity. Women with 7 or more full–term pregnancies have 2 to 4 times the risk for squamous cell cervical cancer than women who have 0 to 2 babies.3
  • Oral contraceptives. The proportion of adenocarcinoma increases with the duration of oral contraception.
  • Immunosuppression.

 

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Cervical Cancer: Diagnosis and Treatment >>