A school health nurse is educating a group of adolescent girls about risk factors of cervical cancer. Which of the following is the most common risk factor?

1. A

   Multiple sexual partners

2. B

   Smoking

3. C

   Late menarche

4. D

   Sedentary life style

Appeared in: BHU NO - 12 April 2024

Explanation

• Nearly all cases of cervical cancer (99.7%) are caused by persistent infection with high-risk types of the Human Papillomavirus (HPV).
• HPV is a sexually transmitted infection. The risk of acquiring HPV increases with the number of sexual partners.
• Therefore, having multiple sexual partners is the most common and significant risk factor for developing cervical cancer because it directly increases the chance of exposure to HPV.
• An early age of first intercourse (before age 20) is also a significant risk factor for the same reason.

Why Other Options Were Wrong

• Option B: Smoking is a significant co-factor but not the primary risk. It impairs the immune system's ability to clear HPV infections and contains carcinogens that can damage cervical cell DNA, but HPV infection itself is the principal cause.
• Option C: Late menarche is not a risk factor for cervical cancer. Some studies suggest early menarche might be a minor risk factor, but the link is not as strong or direct as with HPV.
• Option D: A sedentary lifestyle is a general risk factor for various health issues, including some types of cancer, but it is not a direct or primary risk factor for cervical cancer. The link is not specific or causal like HPV infection.

Related Visual

Clinical Relevance

• Nursing practice connection: Knowing Risk factors for cervical cancer helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
• A school health nurse's primary role in this context is education and primary prevention. Counseling adolescent girls on HPV vaccination is a critical intervention.
• Nurses must be able to explain sensitive topics like sexual health in an accessible and non-judgmental way, emphasizing risk reduction strategies like vaccination and safe sex practices.
• It is important to clarify that while multiple partners increase risk, HPV can be contracted even with one partner, reinforcing the importance of vaccination for all.

How to Approach the Question

• First, identify the core of the question: it asks for the 'most common' risk factor for cervical cancer.
• Recall the primary cause of cervical cancer. Your knowledge base should point to Human Papillomavirus (HPV).
• Evaluate each option based on its relationship to HPV. Ask yourself, 'Which of these factors most directly leads to HPV infection?'
• Multiple sexual partners directly increase the chance of exposure to a sexually transmitted infection like HPV.
• Smoking is a co-factor that helps the virus cause cancer, but it's not the initial cause.
• Late menarche and a sedentary lifestyle have no direct causal link to HPV infection or cervical cancer.

Concept Tested & Keywords

• Concept Tested: Risk factors for cervical cancer
• Stem keywords: cervical cancer, risk factors, adolescent girls
• Lead-in keywords: most common
• Clinical cues: The question targets an adolescent population, highlighting the importance of primary prevention education.
• Negative lead-in flag: false

Question ID

Q-Vik96uVDFLf_VGuAAqkW

Copy ID

Reference Book

E6 Gynecology Williams p. 240-293