Cervical cancer: Encyclopedia II - Cervical cancer - Pathophysiology

Cervical cancer - Pathophysiology

The American Cancer Society provides the following list of risk factors for cervical cancer: human papillomavirus infection, smoking, HIV infection, chlamydia infection, dietary factors, oral contraceptives, multiple pregnancies, low socioeconomic status, use of the hormonal drug diethylstilbestrol (DES) and a family history of cervical cancer.

The presence of strains 16, 18 and 31 of human papillomavirus (HPV) is the prime risk factor for cervical cancer, and Walboomers et al. (1999) reported that the presence of HPV is a necessary condition for the development of cervical cancer. 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. The E6 gene introduced by the virus inhibits the p53 gene, the central cellular switch for apoptosis (the process by which damaged cells kill themselves). The mitosis rate accelerates, and the cell accumulates more DNA damage that makes it capable of invading other tissues.

Genital warts are caused by different HPV types, and are not related to cervical cancer.

The medically accepted paradigm, officially endorsed by the American Cancer Society and other organisations, is that a patient must have been infected with HPV to develop cervical cancer, and is hence viewed as a sexually transmitted disease. Not all women infected with HPV also develop cervical cancer. Use of condoms will not always prevent transmission. Likewise, HPV can be transmitted by skin-to-skin-contact with infected areas. HPV is thought to grow preferentially in the epithelium of the glans penis, and scrupulous washing and cleaning of this area may be preventative. The position on circumcision is controversial: some researchers argue that routine neonatal circumcision is an acceptable way of preventing various diseases (which include cervical carcinoma); others maintain that the benefits do not outweigh the risks.

Adapted from the Wikipedia article "Pathophysiology", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki