Did you know that cervical cancer is the 4th most commonly diagnosed cancer in women, worldwide? In 2020, WHO found around 6,04,000 new cases of cervical cancer, 90% of which belonged to low and middle-income countries. In this blog, we’ll be discussing the risk factors and causes of cervical cancer, with a hope to spread awareness.

Let us start with a quick insight on cervical cancer first:

What Is Cervical Cancer?

It is the cancer that affects the cells present in the cervix, the lowermost part of the uterus that opens up to vagina. The cervix consists of 2 main parts:

• Ectocervix- The outermost part of the cervix made up of flat-thin cells known as squamous cells.
• Endocervix- This part of the cervix connects vagina to the uterus and is layered with column-shaped cells called glandular cells that further make mucus.

If the abnormal growth isn’t addressed on time, then it can transform into cancer cells, and eventually spread deep into the cervix and its surroundings.

The main types of cervical cancers consists of following -

1. Squamous cell carcinoma- Affects the squamous cells in the ectocervix.

2. Adenocarcinoma- Targets the endocervical glandular cells.

3. Adenosquamous carcinoma- Characteristics include both squamous cell carcinoma and adenocarcinoma in a few rare cases, hence called adenosquamous carcinoma or mixed carcinoma.

Cervical Cancer And HPV

Human Papillomavirus (HPV) is one of the main causes of cervical cancer worldwide. Over 9 out of 10 cases of cervical cancer happen to occur due to high-risk types of HPV. There are over 40 types of HPV which are known as “genital HPV”. They spread through skin-to-skin contact of the genital areas, especially during oral, anal, or vaginal sex. Out of these 40 different types, over 70% of HPV-related cervical cancers occur due to high-risk HPV types HPV-16 and HPV-18.

The majority of HPV cases are asymptomatic so most women don’t experience any symptoms or warning signs at the onset of the infection. The absence of symptoms leads to an undetected infection. Undetected and untreated high-risk HPV infections may cause the growth of abnormal cancer cells. Regular HPV testing is the best way for a sexually active individual to stay on top of the situation.

That said, some of the low-risk HPV infections do show symptoms of genital warts (small bumps or growths on or around the genital region). In addition, symptoms of cervical cancer caused by genital HPV include vaginal bleeding or pain after intercourse and pelvic pain.

Cervical Cancer Symptoms

An early stage cervical cancer usually has no signs or symptoms. Therefore, women often discover cancer when it has already progressed. The symptoms of stage 1 cancer could go unnoticed as they only include bleeding in-between periods and discomfort at pelvic region.

Whereas, symptoms of stage 2 cancer could be more specific like — abnormal uterine bleeding, unusual vaginal bleeding after intercourse, bleeding even after menopause, bloody vaginal discharge, or pelvic pain.

At stage 3 & 4, as the cancer advances, following symptoms become apparent — Inflammation of legs, back aches, painful urination, unusual weight loss, fatigue or weakness, vaginal fistula (an unsual connection between vagina and some other organ like bladder, recutm etc), breathing difficulties, bloody spit, etc.

Now that you have a fair understanding of cancer symptoms, let’s discuss the causes of cervical cancer.

Risk Factors And Causes Of Cervical Cancer

Whenever a healthy cell goes through unwanted mutations/changes due to an unspecified factor then it leads to a mass, i.e.,cancer. The reason why these cells behave this way is still unknown. However, the role of HPV in the majority of cervical malignancies remains constant.

HPV is a sexually transmitted infection caused by a group of 200+ human papillomaviruses. Some HPV genotypes (high risk) may result in cervical cancer whereas others (low risk) may only cause skin or genital warts. Most low risk HPV infections wane away on their own. But if the infection persists, it may further develop into cervical cancer.

Apart from a HPV infection, other factors that can increase the risks of cervical cancer includes -

1. HIV Infection

As HIV infection lowers immunity, the risk of contracting HPV, including the high-risk genotype, increases. Moreover, if a person with HPV has lowered immunity then their chances of developing pre-cancerous cells also spikes.

2. Smoking

Research shows that smoking promotes the chances of developing cervical cancer. Smoking weakens our body’s immune system cells that are important to fight HPV virus. Moreover, cigarettes have tobacco which is a carcinogen (chemicals that induce cancer), that promotes the chances of developing cervical cancer.

3. Prolonged Use Of Birth Control Pills

According to research, the longer a woman takes birth control pills, the more likely she is to get cervical cancer. However, at any point in life, if she stops taking birth control pills, the risk drops back to normal. Anyhow, it’s always advisable to discuss the duration and risks of taking these pills.

4. Sexual Past Or History

When a person has several sexual partners, their chances of contracting HPV increases. Women who become sexually active at a young age are more likely to get an HPV infection. As a result, in both circumstances, the elevated risks of HPV could result in the development of cervical cancer.

5. Chlamydia Infection

Chlamydia is a sexually transmitted bacterial infection (caused by bacteria Chlamydia trachomatis), which often shows no symptoms. It spreads through sexual contact (oral, anal or vaginal sex). According to several studies, women who have evidence of previous or ongoing chlamydia infection may face an increased risk of developing cervical cancer. The studies also suggest that the Chlamydia-causing bacteria might even promote the growth and persistence of HPV in the cervix, elevating the chances of developing cervical cancer.

6. Multiple Childbirth

When a woman has 3 or more full-term pregnancies, her chances of contracting HPV (due to increased sexual activity) rises. Changes in female hormones and reduced immunity in pregnant women can also increase vulnerability towards HPV infection.

7. Low Socioeconomic Status

Pap tests and HPV tests for cervical cancer screening can help detect precancerous conditions developing in the cervix. If detected at an early stage, they can be monitored and treated, and thereby prevent cervical cancer. Numerous women with low income background have limited access to sufficient healthcare services, which leads to inadequate screening and treatment of cervical pre-cancers.

Additionally, other factors that could lead to cervical cancer include:

• Early or young age pregnancy (at the age of/ below 20 years)
• Poor quality of life
• Low nutrient diet
• Exposure to hormonal drug, diethylstilbestrol — DES

4 Ways To Prevent Cervical Cancer

Cervical Cancer can easily be prevented if you take holistic preventative measures and become aware of the HPV infection from a young age. A multidisciplinary approach used to prevent cervical cancer includes elements like sufficient primary education in the community, awareness about risk factors, immunization through vaccines, regular screening, and access to treatment.

1. Quit Smoking

Staying away from risk factors like smoking can be a great start on the journey to prevent cervical cancer. The by-products of tobacco are evident in the cervical mucus of smoking women. They are twice as likely to get cervical cancer in comparison to women who don’t smoke.

2. Avoid Long-Term Use Of Oral Contraceptives

Evidence suggests that amongst women infected by HPV those consuming birth control pills for long durations increase the risk of cervical cancer. Women who take oral contraceptives for over 10 years have 4 times higher chances of developing this cancer. However, if you stop taking these pills before reaching the 10-year threshold, the risk decreases significantly.

3. Regular Screening

Once you turn 30, taking the HPV-DNA Test on a regular basis is the most effective strategy to prevent cervical cancer. This method is preferred over a pap smear (a test where your doctor collects cells from your cervix and examines them under the microscope in their lab for signs of cervical cancer). That’s because while the pap smear includes a visual inspection of your cells it might not always be adequate to provide solid answers about high-risk HPV infections. The HPV-DNA Test provides objective results leaving no scope for uncertainty or confusion.

WHO has proposed a preventative strategy to eliminate cervical cancer across the globe. This plan calls for over 70% of women around the world to be screened with an HPV-DNA test by the age of 35 and then again before they turn 45 years old.

HPV DNA Tests can even be conducted from the comfort and convenience of your home with LifeCell self-collection test kits. You can collect the vaginal swab with the help of detailed instructions and get confirmatory results within 2 days. “LifeCell’s HPV Test — Female” screens for 24 high-risk genotypes that could result in cervical cancer using PCR technology. You get the results via a comprehensive report and in case the tests identify high-risk HPV infection you can avail the right treatment at an early stage in consultation with your clinician.

4. HPV Vaccination

Currently, there are four vaccines that act as a precaution against HPV 16 and 18 infections. High-grade precancerous lesions, aggressive malignancy, and infections with HPV are all prevented by HPV vaccines, according to clinical studies and post-marketing surveillance.

The most effective timing for HPV vaccinations is before you are exposed to the virus through any kind of sexual activity. As a result, the WHO suggests immunizing girls between the ages of 9 and 14 to prevent cervical cancer.

Cervical cancer screening is not replaced by HPV vaccination as the vaccine cannot protect against all HPV types. So the cervical screening regimen remains the same for vaccinated women as well. Punctual screening will help detect and treat cervical pre-cancer and cancer and lower the incidence and mortality rates from the disease.

Ending Note!

Cancer is a life-threatening disease that robs one of their happiness, health and sometimes life. By being aware of risk factors and causes of cervical cancer, one can stop its progression at an early stage. HPV, on the other hand, could also be avoided if an individual consciously makes decisions such as abstaining from unprotected sex and undergoing regular HPV tests.

If you wish to know more about HPV, then you can check this article- Your Guide To HPV Infection And Vaccine.

Furthermore, maintaining overall sexual health with routine HPV tests aid in the early discovery and treatment of infection. To aid you in this endeavor, LifeCell offers a simple at-home self-collection HPV test that can help you understand your sexual health. This test looks for 24 high-risk HPVs, three of which are major high-risk HPVs (HPV-16, HPV-18, and HPV-45), with the remaining 21 being other high-risk HPVs. If these HPVs go undetected, they can develop into cervical cancer.

We hope we’ve been able to answer a few questions on your mind regarding cervical cancer and its risk factors. If you or someone in your family has recently been diagnosed with HPV, you should see a doctor as soon as possible. Early detection and treatment of HPV could prevent the virus from spreading and progressing into cervical cancer.

The foremost and best way to beat the prevalence of cervical cancer is by getting regularly tested for HPV!

The squamous cells at the border where ectocervix & endocervix meet is where most cervical cancers start from.

Cervical cancer takes a lot of time to develop due to which most women suffering from it are often unaware of abnormal cell growth in their cervix. This phenomenon is known as dysplasia.

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