Cervical Screening

Ideas about causes

There are several risk factors for developing abnormal cervical cells, which if left untreated will develop in to cancer.

Human Papilloma Virus (HPV) causes 99.7% of cervical cancers*. HPV is a very common infection and anybody who has ever been sexually active can have HPV. In most cases it clears up by itself without the need for treatment.

There are many types of HPV. The types of HPV that can cause warts, genital warts and verrucas are known as ‘low risk’ strains and do not usually cause cell changes that may develop into cancer. Some types of HPV can cause changes in the cells of the cervix or the lining of the mouth and throat. They are known as high risk HPVs. The changed cells have an increased risk of becoming cancerous.

The body’s immune system will usually clear HPV up, without the need for treatment. Since there are no symptoms for HPV, most people don’t even know they have contracted the virus. The virus can remain suppressed in some people for long periods of time. In some women the virus persists, placing them at greater risk of developing cervical abnormalities (CIN) which may need treatment.

Most women who have the virus do not develop cervical cancer. Most women who have HPV do not develop cervical cancer. However, a small number of women do develop abnormal cells that may become cancerous. This is why cervical screening and HPV vaccination is important in helping to prevent cancer (see CIN3 - HPV).

Other risk factors include smoking, and some studies suggest long term use of the contraceptive pill (over ten years) can slightly increase the risk.

Many of the women we interviewed were aware of some of the risk factors associated with abnormal cervical cells but many found it difficult to accept them as causes in their case as they were not present in their own lifestyle.

She felt she was just unlucky to develop abnormal cervical cells.

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Age at interview: 48

Sex: Female

Age at diagnosis: 48

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No I am, well I suppose I have been aware that possibly smoking could be a contributing factor. Purely because when one goes for the test it's always one of the questions "Do you smoke?" "No," a bit smug. But no I haven't really, I just thought it was bad luck really if these things happen. You know assuming one is reasonably fit and healthy, tries to eat properly and doesn't smoke, I thought it would just be bad luck.

Several women were aware of HPV and said they found it difficult when they had learnt that their abnormal cervical cells could be associated with a virus like HPV which could have lain dormant for many years.

Describes her feelings about the connection between abnormal cervical cells and HPV.

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Age at interview: 28

Sex: Female

Age at diagnosis: 26

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Yes it's an embarrassing thing again to think that you've caught it that way because people think of that, look down at that and think oh gosh you know that's been sexually transmitted you know you must be with all these people which is not the case. But obviously I'd had sex with a guy before my partner years and years ago and then when I eventually decided to go and have the pap smear which was years later it was there, so I presumed it was the partner that I was with and that it had been sitting there that long, it was just lucky that I went for the pap smear when I did.

Many stressed that if HPV was a cause for their abnormal cervical cells, they didn't know how they could have contracted it because they'd had very few sexual partners. A few did feel that their sexual history could have led to them being vulnerable to contracting HPV.

Whenever people are diagnosed with something they tend to have their own ideas about the causes. A few women thought that their abnormal cervical cells could be linked to their family history of cervical or gynaecological cancers. There is no medical evidence to support this link. Others thought that using certain types of contraception, such as the pill, may have been a factor in causing them to develop abnormal cervical cells. Recent research suggests that amongst women who have taken the pill for at least 5 years, the risk is almost doubled. But this is still a small risk, and it is important to know that taking the pill can help to protect you against womb and ovarian cancers. (Cancer Research UK 2015).

Some women were aware of the link between smoking and abnormal cervical cells but many said they had never smoked. One woman explains how her abnormal cervical cells disappeared after she gave up smoking.

Her abnormal cells disappeared after she gave up smoking.

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Age at interview: 35

Sex: Female

Age at diagnosis: 28

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So she, yes so she had this camera and she had a look and I was fully expecting the worst and she said there's nothing there, it had completely gone away. And she showed me that my cervix was completely pink and there was no white patches, nothing and I was quite surprised that between that time and the last time I had a pap smear it had completely gone after it had been there for years and years and years. And she did say that it was possibly, you know she couldn't say for sure, possibly because I'd given up smoking like 4 months before and she said the virus can go away by itself but smoking inhibits it from going away and so I felt very virtuous and felt that you know there is a very good reason for me giving up smoking and not starting again and I felt quite pleased with myself. I mean I just couldn't believe it. I can't believe it's just gone away because I expected the worst really and it was, it was a big relief.

* Walboomers JMM et al. (1999) Human papilloma virus is a necessary cause of invasive cancer worldwide. Journal of Pathology, 189 (1), 12–19

Last reviewed October 2015.

Last updated October 2015.