What is the risk factor of cervical cancer?

NORCET 2 -2021 (Shift-2)

Obstetrics & Gynaecology

Easy

Appeared in: NORCET 2 -2021 (Shift-2)

Explanation

Persistent infection with high-risk Human Papillomavirus (HPV) is the primary etiological agent for cervical cancer.
Over 99% of all cervical cancer cases are associated with an oncogenic HPV subtype, making it the most significant risk factor.
HPV oncoproteins, E6 and E7, disrupt normal cell cycle control by degrading tumor suppressor proteins like p53 and Rb, leading to malignant transformation.

Option B: While long-term use of Oral Contraceptive Pills (OCPs) is a recognized risk factor, it is not the primary cause. The risk associated with OCPs is less significant than that of HPV infection.
Option C: Nulliparity (never having given birth) is not a risk factor for cervical cancer. In fact, high parity (having many children) is the risk factor. Nulliparous women are the lower-risk comparison group.
Option D: This option is incorrect because 'Nullipara' is not a risk factor for cervical cancer. For 'All of the above' to be correct, all individual options must be correct.

Visual 1: Diagram: Pathophysiology of HPV infection. A visual flowchart showing how the HPV virus integrates into cervical cells and how the E6 and E7 oncoproteins lead to the degradation of p53 and Rb tumor suppressors, resulting in dysplasia and eventually cancer.
Visual 2: Infographic: Pyramid of Cervical Cancer Risks. An infographic illustrating the hierarchy of risk factors, with HPV infection at the wide base as the primary cause, and other factors like smoking, OCP use, and high parity as smaller, contributing layers on top.

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.
Understanding that HPV is the primary cause of cervical cancer underscores the critical importance of HPV vaccination for prevention. Nurses play a key role in educating patients and parents about vaccine safety and efficacy.
Regular cervical cancer screening (Pap tests and/or HPV testing) is essential for early detection of pre-cancerous changes caused by HPV, allowing for timely treatment and prevention of invasive cancer.
Patient counseling should include all modifiable risk factors. A nurse should advise patients on smoking cessation and discuss the risks/benefits of long-term OCP use in the context of their overall health and HPV status.

How to Approach the Question

First, read the question carefully to identify the core concept being tested: risk factors for cervical cancer.
Next, evaluate each option independently based on your knowledge. Recall the primary cause versus contributing factors.
Option A (HPV) is the well-established primary cause. Option B (OCP) is a known, but secondary, risk factor. Option C (Nullipara) is incorrect; high parity is the risk factor.
Since Option C is incorrect, Option D ('All of above') must also be incorrect.
When a question asks for 'the' risk factor and provides multiple correct options, choose the one that is the most significant or primary cause. In this case, HPV is responsible for nearly all cervical cancers, making it the best answer.

Concept Tested & Keywords

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