Predisposing factor for developing cervical cancer is?

Appeared in: ISRO- 2016

Explanation

Multiparity, or having had multiple full-term pregnancies, is a significant risk factor for cervical cancer.
The risk increases with the number of pregnancies; women with one or two full-term pregnancies have a twofold risk, while those with seven or more have a fourfold risk compared to nulliparous women.
The proposed mechanisms include physical trauma to the cervix during childbirth, hormonal changes during pregnancy that may affect the cervical transformation zone, and potential immune suppression during pregnancy, which can increase susceptibility to persistent HPV infection.

Option A: Nulliparity (never having given birth) is not a risk factor for cervical cancer. In fact, the risk of cervical cancer increases with the number of births.
Option C: While early age at first full-term pregnancy is a risk factor, age 22 is not typically considered early enough to significantly increase risk. The risk is more pronounced for pregnancies before the age of 20.
Option D: Use of oral contraceptives is a risk factor, but it is primarily associated with long-term use (typically more than 5 years). The question does not specify the duration of use, making it a less definitive risk factor than multiparity.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Risk factors for cervical cancer as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in educating patients about modifiable risk factors and the importance of cervical cancer screening (Pap tests, HPV testing) and HPV vaccination.
During patient history taking, it is essential to assess for risk factors like parity, smoking history, and sexual history to identify individuals who may need more targeted counseling or adherence support for screening.
What if? If the 45-year-old multiparous woman was also a long-term smoker, her risk for cervical cancer would be compounded, as smoking is an independent risk factor that impairs the clearance of HPV infection.

How to Approach the Question

This is a clinical recall question that requires knowledge of risk factors for a specific disease.
First, identify the disease in the stem: 'cervical cancer'.
Next, evaluate each option based on established epidemiological risk factors for this cancer.
Option A (nullipara) is a risk for endometrial/ovarian cancer, not cervical. Eliminate it.
Option B (multipara) is a known, significant risk factor. Keep it as a strong candidate.
Option C (first child at 22) is not considered 'early pregnancy' (less than 20 years), which is the actual risk factor. Eliminate it.

Concept Tested & Keywords

QKxfLrdisJyqIAcXD-sPkt

E6 Gynecology Williams pp. 240-293, 212-256

Practise the full ISRO- 2016

Attempt every question from this paper in a timed mock, then review the full solution for each one.