Clinical meaning
Cervical cancer develops from abnormal cell changes in the cervix, most commonly in the transformation zone where squamous and columnar epithelium meet. Persistent infection with high-risk human papillomavirus (HPV) types, especially HPV 16 and 18, is the primary cause. The virus integrates into host cell DNA and produces oncoproteins E6 and E7 that inactivate tumor suppressor proteins, allowing uncontrolled cell growth. Cervical cancer progresses through precancerous stages (cervical intraepithelial neoplasia CIN 1, 2, 3) before becoming invasive, making screening and early detection critical for prevention.
Exam relevance
Risk factors: - Persistent high-risk HPV infection (types 16 and 18 cause approximately 70% of cases) - Lack of HPV vaccination - Smoking (doubles the risk of cervical cancer) - Immunosuppression (HIV, organ transplant recipients) - Multiple sexual partners or early onset of sexual activity - History of sexually transmitted infections (chlamydia, herpes) - Prolonged oral contraceptive use (greater than 5 years) - Lack of regular Pap screening