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What causes cervical cancer?
The most significant cause of cervical cancer is persistent HPV infection (Marth et al. 2017). HPV is very common and most sexually active people come into contact with the virus during their lifetime. In most people, the virus causes no harm and resolves without treatment. Although most types of HPV are harmless, some can cause genital warts and some can cause changes that may develop into cancers, including cervical cancer. HPV is detected in 99% of cervical tumours, particularly subtypes HPV 16 and HPV 18, which are believed to cause 70% of cervical cancer cases.
Long-term infection with a high-risk HPV is the most common cause of cervical cancer
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Several other risk factors for developing cervical cancer have also been identified. It is important to remember that having a risk factor increases the risk of cancer developing but it does not mean that you will definitely get cancer. Likewise, not having a risk factor does not mean that you definitely won’t get cancer.
FACTORS THAT INCREASE RISK
Persistent infection with a high-risk HPV
HIV and AIDS
Presence of other sexually transmitted infections alongside
HPV
Smoking
Use of the contraceptive pill
Having children
Family history
Previous cancer of the vagina, vulva, kidney or urinary tract
FACTORS THAT DECREASE RISK
Safer sex using barrier methods to reduce the risk of HPV infection
HPV vaccination to prevent HPV infection
Cervical screening to detect precancerous abnormal cell changes in the cervix
There are various risk factors associated with developing cervical cancer although each factor may not apply to every woman who develops the disease.
HPV vaccination
Three HPV vaccines are currently available, and all three provide protection against HPV 16 and HPV 18 (Marth et al. 2017). Reports from countries with established HPV vaccination programmes have shown that HPV vaccination decreases the incidence of high-grade cervical abnormalities and reduces the prevalence of the HPV types targeted by the vaccines. The effect of HPV vaccination on the incidence of cancer is not yet known but it is expected to prevent more than 70% of cervical cancers (Marth et al. 2017).
Screening
Cervical screening involves taking a sample of cells from the cervix to check for markers of cervical cancer. Until recently, the Papanicolaou (Pap) test, in which cervical samples were checked for the presence of abnormalities, was the standard method for cervical cancer screening (Marth et al. 2017). The Pap test has reduced the incidence of cervical cancer by 60%–90% and the death rate by 90%. More recently, an HPV DNA screening test has been introduced, which has better sensitivity for high grade CIN than the Pap test and has been shown to provide 60%–70% greater protection against invasive cancer compared with the Pap test.
