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Gynecologic Cancers Risk Factors

A risk factor is anything that changes your chance of getting a disease such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for many cancers. But having a risk factor, or even several, does not mean that you will get the disease.

Michigan Medicine doctor Diane Harper talks about human papillomavirus or HPV. Dr. Harper is a family medicine physician scientist and the physician director of the Rogel Cancer Center’s community outreach program. She is internationally recognized as a clinical research expert in HPV associated diseases, their prevention, early detection and treatment for the prevention of cancer.

Cervical Cancer Risk Factors

The most important risk factor for cervical cancer is infection by the human papilloma virus (HPV)

Human papilloma virus infection is a sexually transmitted infection that can cause warts in the genital area. According to the National Cancer Institute, research show that HPV-caused changes in the cervical cells happen slowly and often go away on their own, especially in younger women.

HPV is a group of more than 150 related viruses, some of which cause a type of growth called a papilloma, which are more commonly known as warts. Some types of HPV are called high-risk types because they are strongly linked to cancers, including cancer of the cervix, vulva, and vagina in women, penile cancer in men, and cancers of the anus, mouth, and throat in both men and women. The high-risk types include HPV 16, HPV 18, HPV 31, HPV 33, and HPV 45, as well as some others. There might be no visible signs of infection with a high-risk HPV until pre-cancerous changes or cancer develops.

Other risk factors for cervical cancer:

    Smoking: Women who smoke are about twice as likely as non-smokers to get cervical cancer. Smoking also makes the immune system less effective in fighting HPV infections.

    Immunosuppression: Human immunodeficiency virus (HIV), the virus that causes AIDS, damages the body's immune system and places women at higher risk for HPV infections.

    Chlamydia infection: Chlamydia is a relatively common kind of bacteria that can infect the reproductive system. It is spread by sexual contact. Some studies have seen a higher risk of cervical cancer in women whose blood test results show evidence of past or current chlamydia infection (compared with women who have normal test results).

    Diet: Women whose diets don’t include enough fruits and vegetables may be at increased risk for cervical cancer. Overweight women are more likely to develop adenocarcinoma of the cervix.

    Oral contraceptive (birth control pills): There is evidence that taking oral contraceptives for a long time increases the risk of cervical cancer.

    Intrauterine device use: A recent study found that women who had ever used an intrauterine device (IUD) had a lower risk of cervical cancer. The effect on risk was seen even in women who had an IUD for less than a year, and the protective effect remained after the IUDs were removed.

    Family history of cervical cancer: Cervical cancer may run in some families. If your mother or sister had cervical cancer, your chances of developing the disease are 2 to 3 times higher than if no one in the family had it.

Ovarian Cancer Risk Factors

    Age: The risk of developing ovarian cancer gets higher with age. Ovarian cancer is rare in women younger than 40. Most ovarian cancers develop after menopause. Half of all ovarian cancers are found in women over the age of 63.

    Obesity: Based on many research studies, obese women (those with a body mass index of at least 30) have a higher risk of developing ovarian cancer.

    Fertility drugs: Some studies found that using the fertility drug clomiphene citrate (Clomid®) for longer than one year may increase the risk for developing ovarian tumors. The risk seemed to be highest in women who did not get pregnant while on this drug. If you are taking fertility drugs, you should discuss the potential risks with your doctor. However, women who are infertile may be at higher risk (compared to fertile women) even if they don't use fertility drugs.

    Estrogen therapy and hormone therapy: Recent studies suggest women using estrogens after menopause have an increased risk of developing ovarian cancer. The risk seems to be higher in women taking estrogen alone (without progesterone) for many years (at least 5 or 10). The increased risk is less certain for women taking both estrogen and progesterone.

    Family history of ovarian cancer, breast cancer, or colorectal cancer: Ovarian cancer can run in families. Your ovarian cancer risk is increased if your mother, sister, or daughter has (or has had) ovarian cancer. The risk also gets higher the more relatives you have with ovarian cancer. Increased risk for ovarian cancer does not have to come from your mother's side of the family -- it can also come from your father's side. Up to 10% of ovarian cancers result from an inherited tendency to develop the disease. Genetic counseling, genetic testing, and strategies for preventing ovarian cancer in women with an increased familial risk.

    Personal history of breast cancer: If you have had breast cancer, you may also have an increased risk of developing ovarian cancer. There are several reasons for this. Some of the reproductive risk factors for ovarian cancer may also affect breast cancer risk. The risk of ovarian cancer after breast cancer is highest in those women with a family history of breast cancer. A strong family history of breast cancer may be caused by an inherited mutation in the BRCA1 or BRCA2 genes. These mutations can also cause ovarian cancer.

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