Cervical dysplasia risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [7]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [8]

Overview

The most potent risk factor in the development of cervical dysplasia is Human papillomavirus (HPV) infection. Other risk factors include smoking, increased number of sexual partners, and young age at time of first sexual intercourse.

Risk Factors

• Human papillomavirus (HPV) infection:

• The most important risk factor in the development of cervical dysplasia is infection with a high-risk strain of human papillomavirus.
• More than 60 types of HPV are acknowledged to exist (some sources indicate more than 200 subtypes). Of these, 15 are classified as high-risk types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82), 3 as probable high-risk (26, 53, and 66), and 12 as low-risk (6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81, and CP6108), but even those may cause cancer. Types 16 and 18 are generally acknowledged to cause about 70% of the cancer cases. Although most HPV infections clear up on their own, the infections could increase to major abnormalities or cervical cancer.
• The presence of strains 16, 18 and 31 is the prime risk factor for cervical dysplasia, and Walboomers et al. (1999) reported that the presence of HPV is a necessary condition for the development of cervical dysplasia. A virus cancer link with HPV has been found to trigger alterations in the cells of the cervix, leading to the development of cervical intraepithelial neoplasia and cancer.

• Other risk factors for cervical cancer include the following:

• Smoking: Among women who are infected with HPV, smoking cigarettes slightly increases the risk of cervical dysplasia.

• HIV infection: Infection with HIV (the virus that causes AIDS) or taking drugs that suppress the immune system increases the risk of cervical dysplasia.

• Increased number of sexual partners: Women who have had many sexual partners have a higher risk of developing cervical dysplasia . Also, a woman who has had sex with a man who has had many sexual partners may be at higher risk of developing cervical cancer. In both cases, the risk of developing cervical cancer is higher because these women have a higher risk of HPV infection.

• Young age at time of first sexual intercourse: Having unprotected sex, especially at a young age, makes HPV infection more likely.

• Hormonal contraception: Using birth control pills for a long time (5 or more years) may slightly increase the risk of cervical dysplasia among women with HPV infection. However, the risk decreases quickly when women stop using birth control pills.

• High parity: Studies suggest that giving birth to many children (5 or more) may slightly increase the risk of cervical cancer among women with HPV infection.