Cervical Cancer Causes

Cervical cancer is a significant global health concern, ranking as the fourth most common cancer among women worldwide. Despite its prevalence, cervical cancer is a highly preventable and treatable disease when detected early. With advancements in medical research and public health initiatives, there has been a substantial reduction in cervical cancer incidence and mortality rates in developed countries. However, it remains a major cause of cancer-related deaths in developing nations, where access to screening and treatment may be limited.

Understanding the causes, risk factors, and prevention strategies for cervical cancer is crucial for women to take proactive steps in protecting their health.

What is Cervical Cancer?

Cervical cancer is a type of cancer that originates in the cells of the cervix, which is the lower, narrow part of the uterus that connects to the vagina. The cervix acts as a gateway between the uterus and the vagina, playing a crucial role in menstruation, pregnancy, and childbirth.

Cervical cancer typically develops slowly over time, beginning with precancerous changes in the cervical cells called cervical intraepithelial neoplasia (CIN) or dysplasia. These abnormal changes are classified into three stages based on their severity: CIN1 (mild), CIN2 (moderate), and CIN3 (severe). If left untreated, CIN3 has the highest risk of progressing to invasive cervical cancer.

The two main types of cervical cancer are:

1. Squamous cell carcinoma: This type accounts for about 80-90% of all cervical cancers. It develops from the flat, thin cells called squamous cells that line the outer part of the cervix.
2. Adenocarcinoma: This type accounts for 10-20% of cervical cancers and arises from the glandular cells that line the inner part of the cervix. These cells produce mucus and other fluids.

In rare cases, cervical cancer can be a mix of both squamous cell carcinoma and adenocarcinoma, or it may develop from other types of cells in the cervix.

Cervical cancer is usually slow-growing and may not cause noticeable symptoms in its early stages. As the disease progresses, common symptoms may include abnormal vaginal bleeding, pelvic pain, and pain during sexual intercourse. Regular cervical cancer screenings, such as Pap smears and HPV tests, are essential for early detection and treatment of precancerous changes and cervical cancer.

What Causes Cervical Cancer?

The primary cause of cervical cancer is a persistent infection with certain types of human papillomavirus (HPV), a common sexually transmitted virus. HPV is a group of more than 150 related viruses, some of which can cause changes in the cells of the cervix that may lead to cancer over time.

HPV types are classified into two categories based on their risk of causing cervical cancer:

1. 1. High-risk HPV types: These include HPV 16, 18, 31, 33, 45, 52, and 58. HPV 16 and 18 are the most oncogenic and are responsible for approximately 70% of all cervical cancer cases worldwide. These high-risk HPV types can integrate their genetic material into the host cell’s DNA, disrupting normal cell function and leading to uncontrolled cell growth.
2. 2. Low-risk HPV types: These include HPV 6 and 11, which do not cause cervical cancer but can cause genital warts and other benign conditions.

HPV is highly prevalent, with an estimated 80% of sexually active women and men contracting the virus at some point in their lives. The virus is transmitted through skin-to-skin contact during sexual activity, including vaginal, anal, and oral sex. In most cases, the body’s immune system clears the HPV infection within a few months to a couple of years without causing long-term health issues.

However, the infection persists in some cases and causes long-term changes in the cervical cells. These changes occur gradually, starting with precancerous lesions called cervical intraepithelial neoplasia (CIN). CIN is classified into three stages based on the severity of the abnormal cell changes: CIN1 (mild), CIN2 (moderate), and CIN3 (severe). If left untreated, CIN3 has the highest risk of progressing to invasive cervical cancer over several years or decades.

Several other factors can increase the risk of developing cervical cancer, such as:

1. 1. Weakened immune system: Women with compromised immune systems due to HIV infection, organ transplantation, or other factors have a higher risk of persistent HPV infection and cervical cancer development.
2. 2. Smoking: Cigarette smoking exposes the body to numerous carcinogens that can damage cervical cells and increase the risk of cervical cancer. Studies have shown that women who smoke are about twice as likely to develop cervical cancer compared to non-smokers.
3. 3. Long-term use of hormonal contraceptives: Some research suggests that long-term use of oral contraceptives (birth control pills) for five years or more may slightly increase the risk of cervical cancer. However, this risk decreases after stopping the use of oral contraceptives.
4. 4. Family history: Women with a family history of cervical cancer, particularly in a first-degree relative (mother, sister, or daughter), may have a higher risk of developing the disease due to shared genetic factors or exposure to common environmental risk factors.
5. 5. Exposure to diethylstilbestrol (DES): Women whose mothers took DES, a synthetic estrogen used between 1940 and 1971 to prevent miscarriage, have an increased risk of developing a rare type of cervical and vaginal cancer called clear cell adenocarcinoma.
6. 6. Previous radiation therapy to the pelvic area: Women who have received radiation therapy to the pelvic area for the treatment of other cancers have a higher risk of developing cervical cancer.
7. 7. History of other types of cancer: Women with a history of vaginal or vulvar cancer have an increased risk of developing cervical cancer.

While these risk factors can contribute to the development of cervical cancer, it is crucial to remember that HPV infection is the underlying cause in nearly all cases. By understanding the causes and risk factors for cervical cancer, women can take proactive steps to reduce their risk through vaccination, regular screening, and lifestyle modifications, such as quitting smoking and practising safe sex.

The treatment of cervical cancer depends on several factors, including the stage of the cancer, the size of the tumour, the patient’s age and overall health, and personal preferences.

The main treatment options for cervical cancer include surgery, radiation therapy, chemotherapy, and targeted therapy. In recent years, proton therapy has emerged as a promising treatment modality for cervical cancer.

Proton therapy is an advanced form of radiation therapy that uses high-energy proton beams instead of traditional X-rays. Protons have unique physical properties that allow them to deposit most of their energy at a specific depth in the body, known as the Bragg peak. This enables proton therapy to deliver high doses of radiation to the tumour while minimising exposure to surrounding healthy tissues.

Conclusion

Cervical cancer is a serious health concern, but with proper education, prevention, and early detection, it can be effectively managed. By understanding the causes and risk factors, getting vaccinated against HPV, and undergoing regular cervical cancer screenings, women can take proactive steps to protect their health. If you experience any concerning symptoms, such as abnormal vaginal bleeding or pelvic pain, consult your healthcare provider promptly for evaluation and guidance.