Cervical Cancer Causes and Risk Factors

Cervical cancer is cancer that starts in the cells of the cervix — the lower, narrow end of the uterus. Most abnormal cells found in this region are often precancerous but could become cancer if not removed early. Understanding the causes and risks associated with cervical cancer can help you be more proactive when it comes to getting screened. Treatment is more effective when abnormal cells are detected early. 

Causes of Cervical Cancer

The number one cause of cervical cancer is infection by the human papillomavirus (HPV). HPV is not a single virus but a group of more than 200 related viruses. Some of these viruses can be transmitted through sexual activity, including vaginal, anal, or oral sex. Sexually transmitted HPVs fall into two groups: low risk and high risk. Several types of HPV are considered high risk; however, HPV16 and HPV18 are the two types primarily responsible for HPV-related cancers. 

Infection with HPV is fairly common in sexually active people and often goes unnoticed. This is because HPV doesn’t always produce symptoms. Many times, an HPV infection will clear on its own. But for some, it can become a chronic infection that could one day cause cervical cancer. You can learn more about HPV and its relation to cervical cancer by visiting our blog post, HPV and Cervical Cancer: What’s the Connection? 

While HPV is a primary cause of cervical cancer, it’s not the only one. While some risk factors can’t be controlled, others can. Being aware of your risk factors and talking about them with your physician may help you make more informed lifestyle and healthcare choices.

Cervical Cancer Risk Factors You Can Control

• Sexual activity. People who become sexually active before age 18 and those who have had multiple sexual partners increase their exposure to HPV infection. 
• Smoking. Women who use tobacco are twice as likely to develop cervical cancer than nonsmokers. Women who don't smoke should avoid inhaling secondhand smoke as it can also increase risk. Additionally, tobacco may weaken the immune system against fighting HPV infections and can lead to other cancers.
• Using oral contraceptives long-term. Women who take oral contraceptives (OCs) for a long time could be at an increased risk of developing cervical cancer. Talk to your physician or gynecologist about the benefits of using oral contraceptives and if they outweigh the potential risks.
• Birthing multiple children. Women who have had seven or more full-term pregnancies have an increased risk of getting cancer of the cervix.  

Cervical Cancer Risk Factors You Cannot Control

• Age. Cervical cancer rarely develops in women under the age of 20, however, the risk goes up between the late teens and mid-30s. After your mid-30’s it is important to get regular cervical cancer screenings as you remain at risk. These screenings include a Pap test and/or an HPV test.
• Having a weakened immune system. Immune system deficiencies may leave you at a higher risk of HPV infection and cervical cancer. Corticosteroid medications, organ transplants, and treatments for other types of cancer can cause immune suppression. Certain diseases, such as AIDS or lymphoma, may also cause a weakened immune system. 
• Diethylstilbestrol (DES) exposure. Exposure to the drug diethylstilbestrol (DES) while in the mother's womb can increase the risk of developing rare types of cervical cancer. DES was a drug given to women from about 1940 to 1970 to prevent miscarriage. 

Ways to Reduce Your Risk of Cervical Cancer

Based on your age, health, and personal risk for cervical cancer, there are preventative measures you can take to help lower your risk of developing it. These include:

• Getting screened regularly. Having routine screenings with Pap tests to find any precancerous cells and treat them is an effective way to prevent cervical cancer. A Pap test takes a sample of cervical cells to be observed under a microscope and detect any changes or abnormalities in the cells. This test is typically done in a doctor's office during an annual pelvic exam.  
• Getting tested for HPV. During the same visit as your Pap test, the gynecologist can also perform an HPV test. Keep in mind that positive test results don’t mean you’ll develop cervical cancer. However, your gynecologist may want to monitor you more closely compared to patients who test negative for HPV.
• Getting vaccinated against HPV. You might consider getting the HPV vaccine series to help reduce your cervical cancer risk. 
• Using a condom during sex. In addition to helping prevent sexually transmitted diseases (STDs), condoms can also help decrease the risk of an HPV infection. 
• Quit smoking. Precancerous cells are more likely to develop in those who smoke. If you struggle to quit smoking, ask your doctor about smoking cessation programs that could help you quit. 

The more you do to help lower your risk of developing cervical cancer, the better. Making positive lifestyle changes can help reduce the risk of other types of cancer as well. 

Remember, detecting cervical cancer early means treatment outcomes are highly successful. The best way to stay on top of this is to keep up with regular screenings that include a Pap test and HPV test. Do your best not to skip screenings, especially if you are considered at high risk of developing any type of gynecologic cancer. And remember, for women with insurance, your annual screening exam should be at no cost to you.

If you experience any concerning changes, including abnormal bleeding, pain during sexual intercourse, or increased vaginal discharge, bring it to the attention of your doctor. Your doctor is the best person to thoroughly examine your symptoms, which may include running Pap or HPV tests. Information from these tests can determine the cause of the problem and if it is a cervical cancer diagnosis. When asked questions about your personal activities, it is best to be honest so your doctor has the information they need for a personalized screening and/or treatment plan.

Learn more about how gynecologists diagnose cervical cancer, the stages of cervical cancer, and the cervical cancer treatment options that are available through a cancer center.