Introduction
Cancers are pathologies originating from abnormal growth and development of cells. The abnormal cells can invade and spread to other organs and parts of the body. There are various types of cancers and are classified according to their mode of spread and can be classified as either benign or malignant tumours. Benign are cancerous cells that rarely spread, rarely fatal unless when they occur close to vital organs. Malignant tumours are more lethal and have a high rate of metastasis and can be rated as more dangerous than benign tumours. The boundaries formed by benign tumours are well-circumscribed and encapsulated, while the borders created by malignant tumours are irregular and circumscribed. Benign tumours are also usually small while malignant are generally larger and irregular. The shape of benign tumours is either spherical or oval while malignant are typically irregular in form. Among the few predisposing factors that lead to cancers includes gender. Some of the cancers are only limited to specific genders and among the cancers affecting women will consist of breast and cervical cancer. The genetic makeup of individuals also plays a vital role in the emergence of cancers. Mutations in the genes and chromosomes increase the chances of developing a disease that can be evident in a family history due to the inheritance of certain traits from the parents.
Malignant cancers in women have various variation depending on the parts of the body and other organs in a female. Among the cancers that attack women arise due to the presence of the female reproductive system in females. Such cancers include ovarian and uterine cancers, breast cancers, vagina and fallopian tube cancers. Amon the other cancers affecting women will consist of; skin, colorectal and lung cancers. Cancers are caused by either lifestyle behaviours or by other triggers that women are exposed to in their day to day activities. With the modern lifestyle and increase in technology, a lot of carcinogenic compounds have been developed, which will later cause the development of these cancers. Also, the use of certain drugs, such as steroids tends to cause malignancies in women.
Skin cancers are mainly genetic but can also be triggered by the use of certain cosmetics and other beauty products which have contributed significantly to an increase in the prevalence and incidences of cancers in the previous years. Many products available in the markets but lack a clear explanation on the possible outcomes of using such products have accelerated the rate of the growing population of the women getting cancers. Lung cancer which has been a more significant cause of death among women has proved to be fatal than breast cancer. Among the known causes of lung cancer include the following; Smoking, exposure to asbestos, and having a family history with lung cancer. The leading cause of lung cancer is attributed to tobacco smoking. People who are non-smokers staying with tobacco smoking have an increased 24% risk of acquiring lung cancer compared to other nonsmokers. Another cause is exposure to asbestos. Asbestos is widely used in thermal and acoustic insulators. When these materials break loose and are allowed to leak into the atmosphere, they can be inhaled into the lungs. The chances of acquiring an asbestos-related lung cancer are further elevated by cigarette smoking.
Heredity is also another factor that significantly increases the chances of acquiring lung cancers in women. Presence of mutated characteristics within an individual automatically predisposes them to cancer if the mutant gene is dominant. Also, an individual can be a carrier hence carrying and transferring the genes and traits to the offspring. Gene mutations are brought about by very many factors. Compounds such as radiations, some drugs and viral infections have a potential risk of causing gene mutations. Exposure to carcinogenic materials can also affect the development of the fetus. A lot of care should be to pregnant mothers as any slight mistake could harm fetal development. Such errors could be accommodated by the fetal and later passed to the offspring, and this will predispose them to certain malignant cancers. It is essential for a health professional to always inquire about the family history in cancer patients to get a clear view of the possible causes of such anomalies. Cervix is a lower part of the uterus which is also referred to as the cervix uteri. The inner part, endocervix connects with the body of the uterus while the outer, exocervix connects with the birth canal. Cells covering the cervical epithelia are called glandular and squamous cells.
Epidemiology of Cervical Cancer in Europe
Cervical cancer is one of the most common diseases in women in European regions, and this accounts for about 3.8% of the total (Holl et al. 2015; 2861). General cases of cervical cancers are reportedly to be low in developed countries. In high-income countries, the facts are rare and this due to a long history in screening services in such countries (Castellsague, Mena and Alemany, 2017; 30). However, cervical cancer remains to be of great public health importance in Europe. In 2008, cervical cancer was diagnosed in about 61000 women, and this accounted for 28000 deaths (Hillemanns, Soergel, Hertel and Jentschke, 2016;504). With the discovery of Human papillomavirus (HPV) as an essential cause of cervical cancer That has facilitated the development of some prophylactic vaccines against the HPV. The International Agency for Research on Cancer (IARC) has acknowledged the existence of twelve HPV types that can cause cancer in humans. The twelve types of HPV include HPV 16/18/31/33/35/39/45/51/52/56/58/59 (Hillemanns et al. 2016; 503). It takes several years before HPV infections progress to cancer (Castellsague et al. 2017; 30). However, the mortality and morbidity have been falling from the 1980s across the region from 6.35 deaths per 100000 populations to 4.47 deaths per 100000 in 2009. However, a lot of burden despite the varying mortality rates among countries lies in eastern Europe. The incidence of cervical cancer in Europe is at 10.6 per 100000. (Hartwig et al. 2015; 95). The incidence rates differ between western, central and eastern and central Europe. It is significantly lower in west Europe due to more advanced screening activities and well-established prevention programs as compared to east and central Europe. (Hartwig et al. 2015; 95)
Etiopathogenesis Cervical Cancer
The cause and development of cervical cancers follow a well-defined process of development. It is well acknowledged that the Human Papilloma Virus is a principal causative agent of cervical cancer. It takes nearly several decades before an infection develops into cancer. HPV-16 and HPV-18 play a significant role in the development of cervical cancer. (Brickman and Palefsky, 2015; 390). However, some research tends to suggest that HPV in itself is not able to cause cervical cancer, but it is multifactorial causation. HPV is found in almost in all patients with cervical cancer to nearly 100%, though it has not been seen with every patient found with cervical cancer. (Sharma et al. 2015; 9). Other factors contributing to the development of cervical cancer is the use of oral contraceptives, nutrition, cigarette smoking, HSV-2 and vaginal douching. (Sharma et al. 2015; 11). After a prolonged standing infection with HPV is what will eventually cause the development of cervical cancer.
Women should be screened for precancerous changes in the changes from as early as 20 years of age, but the most affected women are within the age bracket of 50-60 years (Sharma et al. 2015;11). Cervical cancer is also referred to as a sexually transmitted disease due to transmission of HPV through sexual intercourse. The carcinogenic virus is unaffected by barrier contraceptives which leads to infection of the unstable metaplastic cervical epithelium. Averagely only a small percentage of HPV infections will result in the development of CIN grade 2 or 3 lesions which are rated as inactive forms of cervical cancer (Sharma et al. 2015; 12). The evolution from infection up to the time precursor forms develop is supposed to take three years.
A tiny percentage of CIN grade 3 (20%) will eventually progress to invasive cervical cancer within a range of 5 years. Roughly 40% of the CIN grade 3 will advance to cervical cancer within a range of 30 years. Due to only a small proportion of HPV infections progressing to cancers, then other factors must be included to potentiate the carcinogenesis. Among the few factors that potentiate the carcinogenesis process will consist of; Environmental factors, lack of access to routine screening and checkup, the type and duration of viral infection and the host's condition that compromises its immunity. Also, some gynaecological factors contribute to increasing the risk of HPV infection (Sharma et al. 2015; 13). They include early age sexual intercourse and even an increased number of sexual partners.
Main Factors
HPV Infection or Other Type. Cancer-Causes
HPV is a prevalent viral infection affecting the female reproductive system. Both men and women are affected at some point in their life, and others might be repeatedly infected with HPV. The threshold time for getting infected is as soon as one becomes sexually active. HPV is sexually transmitted; however, penetrative sex is not necessary. (Small et al. 2017; 2407). Skin to skin contact of genital organs is enough to cause transmission. There are many subspecies of HPV which do not create an infection. The HPV infection clears typically up after two years by itself without any intervention. Only a small percentage of certain types HPV persists and progress and develops into cervical cancer. (Small et al. 2017; 2412). The most common causative agent for cervical cancer is HPV. Nearly all cases of cervical cancer are because of HPV infection. Some of the HPV types that do not cause cancer which includes type 6 and 11 mainly cause other infections which provide for genital warts and respiratory papillomatosis (Gawdzik, Chmaj-Wierzchowska, Jurczyk, Sporny and Opala, 2015; 7).
However, some of this infection rarely leads to death but are significant in disease causation and can significantly affect sexual life. The infection with other species of HPV are known to cause other types of cancers on different parts of the body, and this includes the cancer of the penis, oropharynx, vulva and anus (Gawdzik et al. 2015; 7). The following cancers are also preventable using the primary prevention strategies as that of cervical cancer. Even though the invasion of HPV infection might clear on their own, some may persist for a certain period and end up causing some precancerous lesions. These lesions will later develop into invasive forms of cervical cancer. It usually takes 20-30 years to develop in women with healthy body immunity but is likely to take 10-25 years in immunosuppressed patients such as those having HIV.
Among the other types of cancers caused by HPV includes throat cancer. This type of cancer is acquired through oral sex. It is obtained through the introduction of the virus to the mouth from an infected patient. The HPV virus rapidly invades the throat and the back of the tongue and accelerates to form oropharyngeal cancer (Gawdzik et al. 2015; 8). Anal cancer is mainly caused by genetic mutations which lead to abnormal growth of cells around the anal region. However, anal cancer is also jointly attributed to HPV infection. The evidence of HPV causing anal cancer was due to the presence of HPV in nearly all anal cancer patients.
Sexual Intercourse
HPV is a sexually transmitted vi...
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