Introduction

Cervical cancer is the third most common type of cancer in women worldwide. In 2014 alone, the American Cancer Society estimates that 12,360 new cases will be diagnosed, and 4,020 women will die from cervical cancer. Most cases of cervical cancer are found in women between the ages of 20-50. Rarely, it develops in women younger than 20, however 20% of cases are found in women over 65. Cervical cancer is thankfully a slow process, normally taking 5 years to mature from the first stage into full-blown cancer. Many people will not know that they have cancer in that first 5 years.

Like any form of cancer, there isn’t one sign that someone will get cervical cancer 100%. However, there are risk factors that increase the likelihood of someone developing cervical cancer. The most influential of all the risk factors is Human Papilloma Virus (HPV). Certain types of HPV are referred to as high-risk types because they are strongly linked to cancers; in fact more than 99% are caused by these high-risk HPV viruses. High-risk strains 16 and 18 cause 70% of all cervical cancers. Along with HPV, smoking, Human Immunodeficiency Virus (HIV), oral contraceptives, and pregnancy at a young age are also risk factors. Having more than one of these factors greatly increases your chance of developing cancer of the cervix. 

The cervix is the thin, lower portion of the uterus and is conjoined to the top of the vagina. There are 2 main types of cells that cover the cervix, stratified squamous cells, which are on the exocervix, and mucus-secreting columnar epithelium, which are on the endocervix. The transformation zone is where these two types of cells meet and is where most cervical cancers start.

HPV encodes for the production of the viral oncoprotein known as E6. This turns off some of the tumor suppressor genes. The high-risk HPV E6 proteins can associate with the p53 tumor suppressor protein by binding to it through transcriptional modulation. This interaction promotes the degradation of p53 in vitro, which presumably accounts for the very low levels of p53 in cervical carcinoma cell lines. Normally, the p53 gene would initiate apoptosis of a cell with the mutant DNA.  Below you can see the effects when the high risk HPV is present.

This is the gross appearance of stage I cervical squamous cell carcinoma