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While high-risk HPV is the cause of 99.7% of all cervical cancers, there are other factors that increase your risk of developing the disease. These risk factors can be broken down into three different groups:
- Not attending cervical screening (smear test)
- Factors that increase your exposure to the virus
- Factors that make your body more vulnerable to infections or less able to fight them off (by affecting your body’s immune response)
This means that without screening, about one in 60 women will develop cervical cancer. Attending cervical screening can prevent around seven out of ten (70%) cases of cervical cancer , by catching and treating abnormalities before they have a chance to develop into cancer. This means that with screening, about one in 200 women will develop cervical cancer. So not attending cervical screening when invited increases your risk of developing cervical cancer.
Any sexual or intimate contact with a partner of either gender could expose you to high-risk HPV. However, the below factors may give you more exposure to the virus:
- Being sexually active from a younger age
- Having children at a younger age
- Giving birth to many children
- Having a higher number of sexual partners
- Long term use of the contraceptive pill (more than 10 years) can slightly increase the risk of developing cervical cancer but the benefits of the pill outweigh the risks for most women .
It is important to remember that cervical cancer is not caused by promiscuity or infidelity. The above risk factors simply increase your chances of coming into contact with a high-risk type of HPV at some point. However, many women who have only had one sexual partner in their lifetime contract high-risk HPV and may go on to develop cervical abnormalities, also called cervical intraepithelial neoplasia (CIN), which can lead to cervical cancer.
The factors that make your body more vulnerable to infection or affect your immune response include:
- Smoking (as with most cancers)
- Having a weakened immune system (including being affected by a condition that affects your immune system; eg. HIV, Lupus or organ transplantation).
If you have a weakened immune system you should be screened annually to help to minimise your increased risk. This is usually done outside of the regular NHS National Screening Programme so please check with your health care professional if you are worried about this or would like further information on screening outside of the national programme.
Smoking is a major risk factor for developing both squamous cellular (the skin on the outer surface of the cervix) abnormalities (known as dyskaryosis) and squamous cell cervical cancer. The increased risk is thought to be caused by a combination of the following factors:
- Smoking can weaken the immune system around the cells of the cervix, which makes it harder to both prevent and clear high-risk HPV infections. These persistent high-risk HPV infections could then develop into abnormalities in the cells of the cervix
- The chemicals found in cigarettes and tobacco can damage the DNA of the cervical cells, which may contribute to the development of abnormalities and cancer .
On average, women who smoke are twice as likely to develop cervical cancer as those who don’t smoke . The increase in the risk is linked to:
- The duration of the woman’s smoking habit (the number of years she has been a smoker)
- The intensity of the woman’s smoking (the number of cigarettes she smokes a day).
The longer a woman has been smoking for and the higher the intensity of her smoking, the more her risk is of developing cervical abnormalities and cervical cancer .
Diethylstilbestrol (DES) is a man-made (synthetic) form of oestrogen, a female hormone. Doctors prescribed it from 1938 until 1971 to help some pregnant women who had had miscarriages or premature deliveries in their past. If your mother was given DES while she was pregnant with you, you also have an increased risk of developing cervical abnormalities and, if left untreated, cervical cancer. Your health care professionals will be able to advise you further about these risks.
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- Cancer Research UK, 2014. Cervical cancer risks and causes: The pill. http://www.cancerresearchuk.org/about-cancer/type/cervical-cancer/about/.... Accessed: 19.07.2016.
- Roura E et al, 2014. Smoking as a major risk factor for cervical cancer and pre-cancer: Results from the EPIC cohort. International Journal of Cancer 135, 453–466.
- NHS Choices, 2015. Cervical cancer – causes. http://www.nhs.uk/Conditions/Cancer-of-the-cervix/Pages/Causes.aspx. Accessed: 19.07.2016.