Almost all cervical cancers are caused by the human papillomavirus (HPV), which is a common virus that can be passed from one person to another during sexual intercourse. There are many types of HPV. Some HPV types can cause changes on a woman’s cervix that can lead to cervical cancer over time, while the other types can cause genital or skin warts.
HPV is so common that most people get it at some time in their lives. HPV usually causes no symptoms so you can’t tell that you have it. For most women, HPV will go away on its own, however, if it does not, there is a chance that over time it may cause cervical cancer.
Other factors that can increase women’s risk of cervical cancer include;
Sexual history: Several factors related to your sexual history can increase the risk of cervical cancer. The risk is most likely affected by increasing the chances of exposure to HPV. For example; Having many sexual partners: The greater your number of sexual partners one has and the greater your partner’s number of sexual partners, the higher your chance of acquiring HPV.
Early sexual activity: Having sex at an early age increases your risk of HPV. Research shows this increased risk is because the cervix changes during puberty. These changes make the cervical area more vulnerable to damage.
Having one partner who is considered high risk (someone with HPV infection or who has many sexual partners)
Other sexually transmitted infections (STI’s): Having other STI’s such as chlamydia, gonorrhoea, syphilis and HIV/AIDS increases your risk of HPV.
The human immunodeficiency virus (HIV) weakens the immune system. A weakened immune system increases the risk of getting other infections, including HPV. Having a weakened immune system also increases the chances that an HPV infection won’t go away. HIV increases the risk that pre-cancerous changes to the cells in the cervix can develop into cervical cancer.
Women who are HIV positive have a higher risk for cervical cancer, and pre-cancerous cells change to cervical cancer faster in HIV-positive women than in HIV-negative women.
Chlamydia trachomatis is a type of bacteria that is spread by sexual contact and can infect a woman’s genital tract. Women with both HPV and chlamydia infections have a higher risk for cervical cancer. Research shows that long-term inflammation caused by chlamydia makes it harder for the body to clear the HPV infection, especially with repeated chlamydia infections.
Herpes simplex virus type 2 is also called human herpesvirus 2 or HHV-2. Infection with this virus may also be linked with a higher risk of developing cervical cancer in women with HPV.
Smoking: Smoking increases the chance of an HPV infection not going away on its own. If an HPV infection doesn’t go away, it can lead to the development of squamous intra-epithelial lesion, which is a pre-cancerous condition of the cervix, and cervical cancer.
Giving birth many times: Parity is the number of times a woman has given birth. Multiparity, or giving birth more than once, has been linked with a higher risk for cervical cancer in women with an HPV infection. The more children a woman gives birth to, the greater her risk for cervical cancer. But there isn’t a specific number of births that increases the risk.
We don’t yet fully understand how giving birth increases the risk for cervical cancer. It may be because of changes in hormones during pregnancy, or the trauma to the cervix during birth. Some research has suggested that women who have caesarean sections do not have a higher risk of developing cervical cancer
Oral contraceptives: Oral contraceptives are commonly called the pill. Taking oral contraceptives over a long time may increase the risk of an HPV infection developing into cervical cancer. This risk does not appear to be related to having an HPV infection. Women who take oral contraceptives for more than 5 years appear to have the highest risk for cervical cancer. This risk goes down over time after you stop taking oral contraceptives. After 10 years of not taking them, your risk for cervical cancer is no longer high.
Diethylstilbestrol (DES): This is a form of estrogen which was used between 1940 and 1971 to treat women with certain problems during pregnancy, such as miscarriages. It has not been approved for use in pregnant women since the 1970s.
Daughters of women who took DES during their pregnancy have a higher than average risk of developing a rare type of cervical cancer called clear cell carcinoma. Some studies also suggest that daughters of women who took DES may have a higher risk of developing pre-cancerous changes of the cervix and squamous cell carcinoma (SCC) of the cervix.
The author is; Lilian Nuwabaine Luyima; BSc Nurse & MSN-Midwife & Women’s’ Health Specialist working with Aga Khan University as the CPD Coordinator & Heroes in Health Award Winner-Midwife of the year 2021