Cervical Cancer

Ideas about causes of cervical cancer

The main risk for getting cervical cancer is persistent infection with some types of human pailloma virus known as High Risk HPV. This is a sexually transmitted virus but is extremely common. Anyone who has ever had sex is likely to have been infected. However, most people will clear up the virus with their own immune system within 2 years.

The risk of getting HPV increases with the number of sexual partners and with starting to have sex at an early age. The risk of having a persistent infection is related to a weakened immune system. Smoking can impair the immune system of the cervix and as such is a risk factor for cervical cancer. Infection with HIV also reduces immunity and increases the risk of cervical cancer. Women who have had an organ transplant have to take drugs to suppress their immune system so that they do not reject the donor organ and this also increases the risk of cervical cancer. It is important that all women go for regular cervical screening to help protect against cervical cancer.

Many of the women we interviewed were aware of some of the risk factors associated with cervical cancer and said these risk factors were not present in their own lifestyle. Many believed it could happen to anybody and felt that they were just unlucky.

A few felt that some of the risk factors may have been present in their own lifestyle, such as HPV, smoking and long term use of the contraceptive pill. Some questioned whether they had developed HPV many years ago and were unaware of it. Others questioned whether their husbands or partners could have given them HPV. A few were not aware that HPV or smoking can be a risk factor for cervical cancer. Since there are no symptoms for HPV, most people don’t even know they have contracted the virus.

Recent medical evidence suggests that some types of HPV, which is a sexually transmitted virus, are a major risk factor for cervical cancer. HPV is thought to cause 99.7% of cervical cancers*1.

There are more than 100 different types of HPV, many of which are harmless. The types of HPV that can cause warts, genital warts and verrucas are known as ‘low risk’ strains and do not usually cause cell changes or develop into cancer.

​"However, some types of HPV can cause abnormal changes to the cells of the cervix, which can eventually lead to cervical cancer” (NHS Choices website 2017). These types of HPV can cause changes in the cells of the cervix or the lining of the mouth and throat. They are known as high risk HPVs. The changed cells have an increased risk of becoming cancerous.

It is thought that 15 strains of high-risk HPV’s are responsible for causing cervical cancers *2 and “two strains of the HPV virus (HPV 16 and HPV 18) are known to be responsible for 70% of all cases of cervical cancer. (NHS Choices website 2017)

Nearly all sexually-active men and women get HPV at some point in their lives - 80% (four out of five) of the world’s population will contract some type of the virus once*3. HPV is transmitted primarily by genital-to-genital sexual contact, anal sex and, occasionally, oral sex. It can also be transmitted from same-sex partner to same-sex partner. Infection with HPV does not imply either infidelity or promiscuity as even people who have sex with only one person in their lifetime can get it.

Most women who have the virus do not develop cervical cancer. However, a small number of women do develop abnormal cells that may become cancerous. This is why cervical screening and HPV vaccination is important in helping to prevent cancer.

Since April 2011, the NHS Cervical Screening Programme has been introducing a new testing system called the ‘HPV triage’ so if a woman has a screening result that shows abnormal cell changes the sample is automatically tested for the HPV virus.

• If HPV is found (an ‘HPV positive’ result), you are invited to go for colposcopy, which is a closer look at the cervix to see if any treatment is needed.
• If no HPV is found, you can go back to regular screening every 3-5 years depending on your age (NHS Cervical Screening Programme April 2015)

Some women found that it was difficult to deal with having a cancer which had sexual connotations associated with it.

Some women were aware of the link between smoking and cervical cancer but many said they had never smoked. One woman explains how she was not aware that smoking was a risk factor for cervical cancer when she was diagnosed ten years ago. Most of the women who did smoke, gave up when they were told they had cervical cancer.

A few women mentioned that stress and diet may have been a cause. Others talked about their family history of cancer. There is no medical evidence that cervical cancer is related to family history.

A few women mentioned that there needed to be more publicity and awareness of HPV and its link with cervical cancer, so that young women would have a better understanding about why they should attend regularly for cervical screening, be vaccinated against HPV and why they should use condoms to protect themselves during sexual intercourse (for more information see Cervical abnormalities' CIN3 and CGIN - HPV).

“Studies have already shown that the vaccine protects against HPV infection for around 10 years, although experts expect protection to be for much longer.” (NHS Choices August 2014) 

Women need to be vaccinated before they come into contact with the virus. As the virus is transmitted by skin-to-skin contact, usually by sexual activity, this age will vary. The HPV vaccination programme started in the UK in September 2008 with all 12- to 13-year-old and 17- to 18-year-old girls being offered the vaccine.
*1   (Walboomers JMM et al. (1999) Human papillomavirus is a necessary cause of invasive cancer worldwide. Journal of Pathology, 189 (1), 12–19.)
*2   Li N et al., 2011. Human papillomavirus type distribution in 30,848 invasive cervical cancers worldwide: variation by geographical region, histological type and year of publication. International Journal of Cancer 128, 927–935.
*  Koutsky L. 1997. Epidemiology of genital human papillomavirus infection. The American Journal of Medicine, 102 (5A), 3-8
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Last reviewed July 2017.
Last updated July 2017.


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