Risk Factors, pathogenesis and histopathology in Cancer of Cervix

8.1. Risk Factors for Cancer of Cervix

The Risk Factors which involve in making a woman susceptible to develop Cancer of Cervix are as follows:

  1. Human Papilloma Virus Infection
  2. Smoking
  3. Immunosuppression
  4. Chlamydia infection
  5. Diet
  6. Oral Contraceptive Pills
  7. Multiple Full Term Pregnancies
  8. Pregnancy at Young age
  9. Poverty and low hygiene
  10. Diethylstilbestrol (DES)
  11. Family history of cervical cancer

8.2. Pathogenesis of Cancer of Cervix – The causes

Transmission of HPV occurs primarily by skin-to-skin contact. Basal cells of stratified squamous epithelium may be infected by HPV. Other cells types appear to be relatively resistant. It is assumed that the HPV replication cycle begins with entry of the virus into the cells of the basal layer of the epithelium.

It is likely that HPV infection of the basal layer requires mild abrasion or micro trauma of the epidermis.

Once inside the host cell, HPV DNA replicates progress to the surface of the epithelium. In the basal layer, viral replication is considered to be non-productive, and the virus establishes itself as a low-copy number episome by using the host DNA replication machinery to synthesize its DNA on average once per cell cycle. In the differentiated keratinocytes of the suprabasal layer of the epithelium, the virus switches to a rolling-circle mode of DNA replication, amplifies its DNA to high copy number, synthesizes capsid proteins, and causes viral assembly.

Recent studies and research propose the usage of the vaccination therapy for the prevention of the Cancer of Cervix. While sexually transmitted viruses have been found to be as cofactors, which along with the co-infection of the herpes viruses increasing the chances of formation of Cancer of Cervix, Cytomegalovirus, Human Herpes Virus (HHV) -6 and HHV – 7 have been also found to be the excitement causes of the Cancer of Cervix. Chlamydia Trachomatis has also been found as a super infection on high risk Human Papilloma Virus infections to result into Cancer of Cervix.

But behind all these viruses and their infections, lies the basic cause, the predisposition of which leads to the activation of the infections caused by the above mentioned viruses and bacteria – the Genetic Factor. As nearly as 27% of Genetic predisposition has been found to be the underlying causes, which aid to, decide upon the susceptibility of a woman towards the viruses and bacteria mentioned above to result into Cancer of Cervix. The effect of Family Environment towards a genetic cause to result into Cancer of Cervix was found to be up to 2% which was common in between the sisters and not in between Mother and Daughter.

Another cause for Cancer of Cervix is the low immunity of a woman. The inner linings of the Cervix and the surrounding areas remain a house of the viruses and bacteria which can live

in the environment of the Vagina and the Cervix and can cause harm every now and then when the resistances offered by the Immunity cells in the areas are low in their ability, infections arise.

Many a times, the immunity is able to resist the further development of the infections of the secondary causative organisms by expressions of various signs and symptoms, which or without the aid of medicinal support, get relieved, cured, suppressed or palliated. According to the level of treatment done for the infection, it can arise again in the presence of favorable conditions for the cervical infections to cultivate.

If the infection gets promoted repeatedly, the risk of alteration in the genes of the cervical cells gets high and thus these altered genes can become the focus of the root of the Cancer of Cervix.

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