The incidence of cervical cancer in South Africa is high when compared to women in western countries and appears at a younger age. The disease may affect as many as one in 34 South African women. The disease often is at a very advanced stage when diagnosed.

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By studying large numbers of women all over the world, researchers have identified certain risk factors that increase the chance that cells in the cervix will become abnormal or cancerous. They believe that, in many cases, cervical cancer develops when two or more risk factors act together.

Research has shown that women who began having sexual intercourse before age 18 and women who have had many sexual partners have an increased risk of developing cervical cancer. Women also are at increased risk if their partners began having sexual intercourse at a young age, have had many sexual partners, or were previously married to women who had cervical cancer. All these parameters point to the sexual transmission of carcinogenic agents of which the HPV is the most important one. Confirming this is the fact that women who live in a monogamous relationship, and nuns have an extremely low risk of developing cervical cancer.

There are over 100 different types of human papillomaviruses. Some of them (type 6 and 11), which are also sexually transmitted, cause genital warts (condylomata acuminata). Other HPV types (like 16 and 18) are called high-risk viruses because of their increased association with cervical cancer. Fortunately, most women who are infected with HPV do not develop cervical cancer. For this reason, scientists believe that other factors act together with HPVs. For example, other genital microbes also may play a role. Further research is needed to learn the exact role of viruses and other micro-organisms and how they act together with other factors in the development of cervical cancer.

Smoking increases the risk of cancer of the cervix. Cancer causing chemicals called carcinogens are taken up into the bloodstream and is then concentrated in cervical mucous. These carcinogens act together with other factors like HPV to cause genetic faults in epithelial cells of the cervix. The risk appears to increase with the number of cigarettes a woman smokes each day and with the number of years she has smoked.

Several reports suggest that women whose immune systems are weakened, are more likely than others to develop cervical cancer. For example, women who have the human immunodeficiency virus (HIV), which causes AIDS, are at increased risk. Also, organ transplant patients, who receive drugs that suppress the immune system to prevent rejection of the new organ, are more likely than others to develop pre-cancerous lesions and cancer.

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