Gynecologic Oncologist Joan Cheng, M.D.
Who’s at Risk for Cervical Cancer?
Risk factors are anything that may increase your chances of having a disease. Cervical cancer is the third most common gynecologic cancer in the United States. The mean age at diagnosis of cervical cancer is 48 years. It is extremely rare for a woman younger than 20 years to be diagnosed with this cancer. Human papillomavirus (HPV) is key to the development of cervical cancer and can be detected in 99.7% of cases. Most of the risk factors for cervical cancer are associated with an increased risk of acquiring or having weakened immune response to infection with HPV. Knowing these risk factors can help you make choices that might lower your risk. These include:
HPV infection is extremely common but only a small number of infected women will develop cervical cancer. For most women, the infection is temporary and harmless. A woman becomes infected through intimate contact with a partner who has the infection. There are over 150 subtypes of HPV and approximately 15 subtypes are known to lead to cervical cancer if they don’t go away on their own. Over the recent years, the development of HPV testing and HPV vaccination are expected to help prevent women from getting cervical cancer.
Sex at young age or multiple sexual partners
Compared with women who has first intercourse at 21 years or older, women who begin intercourse younger than 18 years are twice as likely to get cervical cancer. Also, compared with women who have one partner, women with six or more partners are three times more likely to get cervical cancer. Having sex with a high risk sexual partner, such as a partner with multiple sexual partners or with known HPV infection, puts you at higher risk of getting HPV infection. The only sure way to protect yourself is to not have sex, or to have sex only with a partner you know doesn’t have HPV. Also, you can lower your risk by getting the HPV vaccine before becoming sexually active and getting regular Pap screening and/or HPV testing.
If you smoke, you are twice as likely to get cervical cancer as women who do not smoke. Chemicals in cigarettes get into your bloodstream and in the cervical mucus which make it more likely for HPV infection to persist rather than go away. Also smoking weakens the immune system, making you less able to fight HPV infections.
Weakened immune system or HIV infection
Women who have illnesses or take medications that weaken their immune system raises the risk of cervical cancer. Also women with human immunodeficiency virus (HIV) are more likely to have persistent HPV infection and therefore are at higher risk of getting cervical cancer.
Oral birth control
Long term use of oral birth control pills increases the risk of cervical cancer. The risk goes back down after you stop taking them.
Early age at first birth and 3 or more pregnancies
Women who are younger than 20 years old at first birth and who have 3 or more babies have an increased risk for cervical cancer. These are also likely due to exposure to HPV through sexual intercourse.
Not getting regular Pap tests
Pap tests screen for abnormalities of the cervix caused by HPV infection. If these abnormalities are diagnosed and properly treated, then progression to cancer can be prevented. Therefore, women who get regular Pap tests are less likely to get cervical cancer.
It is not clear whether genetics play a role in cervical cancer. There is ongoing research to identify genetic changes that may make women less likely to clear HPV infection on their own, hence making them more likely to develop cervical cancer.
Knowing these risk factors for cervical cancer give you the power to make wise and deliberate choices that will significantly impact your health. Remember to visit your gynecologist on a regular basis, get your Pap test and get your HPV vaccine.
Joan Cheng, M.D. is a Gynecologic Oncologist with Crescent City Physicians, Inc., a subsidiary of Touro infirmary. Dr. Cheng attended Tulane Medical School and completed her residency at University of New York at Stony Brook. She then served her fellowship at University of Southern California. Dr. Cheng chose the specialty of Gynecologic Oncology because it represents a subspecialty in medicine that has the perfect blend of complex surgery and medical oncology, both of which SHE find fascinating and gratifying. And as a mother, wife, daughter and sister, Dr. Cheng connects well with the women she cares for.