Yasmin Williams - HEALTH-WISETODAY, WE continue our discussion on cervical cancer. Last time we discussed diagnosing the precursor of cervical cancer intraepithelial lesions of the cervix using the Pap test and colposcopy.
Today, we discuss other risk factors for cervical cancer:-
1. Human papilloma virus infection (HPV). There are over 80 types of HPV. The common plantar wart and verrucous genital warts are caused by this virus. HPV infection of the cervix is very common and a small percentage of women infected with untreated HPV will develop cervical cancer. Infection with HPV types 16 and 18 are commonly associated with the precursor of cervical cancer - intraepithelial neoplasia and invasive cancer.
Although there are many factors involved in the development of cervical cancer, cervical infection with the human papilloma virus appears to be the primary risk factor for cervical cancer. Currently, there is a test Hybrid Capture (HC11) that identifies the presence of the cancer-causing types of the Human Papilloma Virus. This test may be useful as a screening tool in particular circumstances.
Since HPV is so critical to the development of cervical cancer, immunisation against the main cancer forming types of HPV may be an important primary prevention strategy in the fight against cervical cancer. Such a vaccine is currently being developed and tested.
A woman's sexual history is also important is assessing risk for cervical cancer.
2. Sexual history
women who begin having sexual intercourse before they are 16 years
women who have had many sexual partners
women who have partners who have/had many partners are at a greater risk of HPV infection and cervical cancer.
3. Smoking
Studies have shown an association between smoking in women and cervical intraepithelial neoplasia ( precursor of cancer) and cervical cancer. High levels of nicotine and cotinine presumably from inhaled cigarette smoke have been found in the mucous in the cervix of smokers even when the levels in their blood was low. Based on the existing research, we cannot say at this time that smoking causes cervical cancer. At this time, we can say that there is an association between cervical cancer and smoking and therefore smoking appears to be a risk factor.
4. Diet
Similarly, there have been studies that indicate that diets that are low in beta carotene/vitamin A are associated with a high risk of cervical cancer. There have also been studies that suggest that adequate intake of vitamin C, E, folate and selenium may be associated with lower risks for cervical cancer.
The jury is still out on the role of diet as there have also been studies that do not confirm the findings just noted.
5. Human Immunodeficiency Virus (HIV)
HPV is found more often in HIV-infected women possibly because they are more susceptible to the HPV infection. Abnormal cell changes are said to progress more rapidly to malignancy (that is, become cancer). HIV-infected women should therefore be targeted with Pap smears at appropriate intervals.
The take home message this week is that, for cervical cancer prevention:-
a) Have sexual activity later in life
b) Limit sexual partners
c) Prevent sexually transmitted infections
d) Have a healthy diet
e) Do not smoke cigarettes
In summary, the focus must be on a healthy lifestyle with safe sex.
Dr. Yasmin Williams is a Family Doctor
and Public Health Specialist.
