Incidence
The age-standardised (European) annual incidence rate of cervical cancer is 13.2 per 100,000 females.Age-standardised mortality rate for the UK was 2.9 per 100,000 in 2008.
Risk factors
- Heterosexual women.
- Infection with human papilloma virus (HPV), predominantly types 16 and 18 (infection present in around 95% of cases).
- Women with multiple sexual partners, or partners of promiscuous males.
- Smoking.
- Lower social class.
- Immunosuppression ,eg HIV, and post-transplant.
- There is a slight increase in risk with use of a combined oral contraceptive.
- Non-attendance at the cervical screening programme.
Pathogenesis
Three types of primary tumour are generally seen:
- Bulky, ectocervical tumour, which fills the upper vagina.
- Invasive, bulky tumour that can enlarge to a size where it fills the lower pelvis.
- Destructive, invasive tumour that erodes tissue, causing ulceration and excavation with infected, necrotic cavities.
