Knowledge of the Warning Signs and Risk Factors for Cervical Cancer among Women Attending a Tertiary Hospital

Volume 2, Issue 2,  Article Number: 252005 (2025)

Usha Dadhich1,* ORCID logo | Nemi Chand Jat1  

1S. N. Institute of Nursing Sciences, Nirwan University Jaipur, Jaipur – 303305, Rajasthan (India)

*Corresponding Author: ushadadhich14@gmail.com

Received: 15 November 2024 | Revised: 22 November 2025

Accepted: 26 November 2025 | Published Online: 01 December 2025

DOI: https://doi.org/10.5281/zenodo.17760351

© 2025 The Authors, under a Creative Commons license, Published by Scholarly Publication

Abstract

Cervical cancer is a major cause of death from cancer among women globally. It has a pattern of development similar to that of a sexually transmitted disease and is associated with the greater risk from the number of partners and the earlier start of sexual activity. Different incidence patterns exist worldwide due to the establishment of screening programmes in some countries and not in others. Although cervical cancer rates and death rates have generally decreased over time, recent changes in lifestyle and sexual behaviour appear to be leading to an increase in the overall risk of developing cervical cancer. Smoking and the human papilloma virus (HPV) 16/18 are now important contributors to the idea of several factors, progressive cervix uteri carcinogenesis. Thus, screening programs, HPV vaccination, and societal preventative and control measures are advised. Using a cell morphological from observation to molecular analysis, cervical cancer screening techniques have changed over time. Both liquid-based cytology and high-risk HPV genotyping are popular strategies that are commonly recommended and used worldwide. Quick, inexpensive, accurate, and practical techniques will eventually become extra prevalent. By combining big data technology and picture identification, artificial intelligence also shows pledge for the detection of carcinoma of the cervical region. In the meantime, China has achieved considerable progress in the prevention and management of cervical cancer, which could act as a template for other resource-constrained poor countries. In conclusion, even though cervical cancer poses a threat to women’s health, it may be the first cancer that humans are able to eradicate with a thorough Preventive and regulating plan.

Keywords

Risk factors, Epidemiology, Cervical cancer screening, HPV, HIV

References

  1. zur Hausen, H. (1989). Papillomaviruses in anogenital cancer as a model to understand the role of viruses in human cancers. Cancer Research, 49, 4677-4681.

[View Article]        [Google Scholar]

  1. Walboomers, J. M., Jacobs, M. V., Manos, M. M., Bosch, F. X., Kummer, J. A., Shah, K. V., … & Muñoz, N. (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. Journal of pathology, 189, 12-19.

[View Article]       [Google Scholar]

  1. Aranda, S., Berkley, S., Cowal, S., Dybul, M., Evans, T., Iversen, K., … & Tsu, V. D. (2017). Ending cervical cancer: A call to action. International Journal of Gynecology & Obstetrics, 138, 4-6.

[View Article]       [Google Scholar]

  1. Garland, S. M., Giuliano, A., Brotherton, J. M. L., Moscicki, A. B., Stanley, M., Kaufmann, A. M., … & de Sanjose, S. (2018). IPVS statement moving towards elimination of cervical cancer as a public health problem. Papillomavirus Research, 5, 87.

[View Article]       [Google Scholar]

  1. Gultekin, M., Ramirez, P. T., Broutet, N., & Hutubessy, R. (2020). World Health Organization call for action to eliminate cervical cancer globally. International Journal of Gynecological Cancer, 30, 426-427.

[View Article]       [Google Scholar]

  1. Herrero, R. (2018). Elimination of cervical cancer in Latin America. Salud publica de Mexico, 60, 621-623.

[View Article]       [Google Scholar]

  1. Eckert, L. (2024). Enough: Because we can stop cervical cancer. Cambridge University Press.

[Google Scholar]

  1. Mattiuzzi, C., & Lippi, G. (2020). Cancer statistics: a comparison between world health organization (WHO) and global burden of disease (GBD). European journal of public health, 30, 1026-1027.

[View Article]       [Google Scholar]

  1. Song, B., Ding, C., Chen, W., Sun, H., Zhang, M., & Chen, W. (2017). Incidence and mortality of cervical cancer in China, 2013. Chinese journal of cancer research, 29, 471.

[View Article]       [Google Scholar]

  1. Ferlay, J., Shin, H. R., Bray, F., Forman, D., Mathers, C., & Parkin, D. M. (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. International journal of cancer, 127, 2893-2917.

[View Article]       [Google Scholar]

  1. Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 68, 394-424.

[View Article]       [Google Scholar]

  1. Prabhu, M., & Eckert, L. O. (2016). Development of World Health Organization (WHO) recommendations for appropriate clinical trial endpoints for next-generation Human Papillomavirus (HPV) vaccines. Papillomavirus Research, 2, 185-189.

[View Article]       [Google Scholar]

  1. Ferlay, J., Colombet, M., Soerjomataram, I., Mathers, C., Parkin, D. M., Piñeros, M., … & Bray, F. (2019). Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. International journal of cancer, 144, 1941-1953.

[View Article]       [Google Scholar]

  1. Olorunfemi, G., Ndlovu, N., Masukume, G., Chikandiwa, A., Pisa, P. T., & Singh, E. (2018). Temporal trends in the epidemiology of cervical cancer in South Africa (1994–2012). International journal of cancer, 143, 2238-2249.

[View Article]       [Google Scholar]

  1. Small Jr, W., Bacon, M. A., Bajaj, A., Chuang, L. T., Fisher, B. J., Harkenrider, M. M., … & Gaffney, D. K. (2017). Cervical cancer: a global health crisis. Cancer, 123, 2404-2412.

[View Article]       [Google Scholar]

  1. Chen, W., Zheng, R., Baade, P. D., Zhang, S., Zeng, H., Bray, F., … & He, J. (2016). Cancer statistics in China, 2015. CA: a cancer journal for clinicians, 66, 115-132.

[View Article]       [Google Scholar]

  1. Lei, T., Mao, W. M., Lei, T. H., Dai, L. Q., Fang, L., Chen, W. Q., & Zhang, S. W. (2011). Incidence and mortality trend of cervical cancer in 11 cancer registries of China. Chinese Journal of Cancer Research, 23, 10-14.

[View Article]       [Google Scholar]

  1. Zhao, F. H., Lewkowitz, A. K., Hu, S. Y., Chen, F., Li, L. Y., Zhang, Q. M., … & Franceschi, S. (2012). Prevalence of human papillomavirus and cervical intraepithelial neoplasia in China: a pooled analysis of 17 population‐based studies. International journal of cancer, 131, 2929-2938.

[View Article]       [Google Scholar]

  1. Wu, E. Q., Liu, B., Cui, J. F., Chen, W., Wang, J. B., Lu, L., … & Qiao, Y. L. (2013). Prevalence of type-specific human papillomavirus and pap results in Chinese women: a multi-center, population-based cross-sectional study. Cancer causes & control, 24, 795-803.

[View Article]       [Google Scholar]

  1. Chen, W., Zhang, X., Molijn, A., Jenkins, D., Shi, J. F., Quint, W., … & Smith, J. S. (2009). Human papillomavirus type-distribution in cervical cancer in China: the importance of HPV 16 and 18. Cancer Causes & Control, 20, 1705-1713.

[View Article]       [Google Scholar]

  1. Wang, Z., Wang, J., Fan, J., Zhao, W., Yang, X., Wu, L., … & Hao, M. (2017). Risk factors for cervical intraepithelial neoplasia and cervical cancer in Chinese women: large study in Jiexiu, Shanxi Province, China. Journal of cancer, 8, 924.

[View Article]       [Google Scholar]

  1. Cohen, P. A., Jhingran, A., Oaknin, A., & Denny, L. (2019). Cervical cancer. Lancet, 393, 169-182.

[View Article]       [Google Scholar]

  1. Yuan, Y., Cai, X., Shen, F., & Ma, F. (2021). HPV post-infection microenvironment and cervical cancer. Cancer Letters, 497, 243-254.

[View Article]       [Google Scholar]

  1. Ghebre, R. G., Grover, S., Xu, M. J., Chuang, L. T., & Simonds, H. (2017). Cervical cancer control in HIV-infected women: past, present and future. Gynecologic oncology reports, 21, 101-108.

[View Article]       [Google Scholar]

  1. Roura, E., Castellsague, X., Pawlita, M., Travier, N., Waterboer, T., Margall, N., … & Riboli, E. (2014). Smoking as a major risk factor for cervical cancer and pre‐cancer: results from the EPIC cohort. International journal of cancer, 135, 453-466.

[View Article]       [Google Scholar]

  1. Crosbie, E. J., Einstein, M. H., Franceschi, S., & Kitchener, H. C. (2013). Human papillomavirus and cervical cancer. Lancet, 382, 889-899.

[View Article]       [Google Scholar]

  1. Bruni, L., Diaz, M., Castellsagué, M., Ferrer, E., Bosch, F. X., & de Sanjosé, S. (2010). Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. Journal of Infectious Diseases, 202, 1789-1799.

[View Article]       [Google Scholar]

  1. Mittal, S., & Banks, L. (2017). Molecular mechanisms underlying human papillomavirus E6 and E7 oncoprotein-induced cell transformation. Mutation Research/Reviews in Mutation Research, 772, 23-35.

[View Article]       [Google Scholar]

  1. Stelzle, D., Tanaka, L. F., Lee, K. K., Khalil, A. I., Baussano, I., Shah, A. S., … & Dalal, S. (2021). Estimates of the global burden of cervical cancer associated with HIV. Lancet global health, 9, e161-e169.

[View Article]       [Google Scholar]

  1. Adler, D. H., Wallace, M., Bennie, T., Mrubata, M., Abar, B., Meiring, T. L., … & Bekker, L. G. (2014). Cervical Dysplasia and High‐Risk Human Papillomavirus Infections among HIV‐Infected and HIV‐Uninfected Adolescent Females in South Africa. Infectious diseases in obstetrics and gynecology, 2014, 498048.

[View Article]       [Google Scholar]

  1. Cooper, D., Hoffman, M., Carrara, H., Rosenberg, L., Kelly, J., Stander, I., … & Shapiro, S. (2007). Determinants of sexual activity and its relation to cervical cancer risk among South African women. BMC Public Health, 7, 341.

[View Article]       [Google Scholar]

  1. Remschmidt, C., Kaufmann, A. M., Hagemann, I., Vartazarova, E., Wichmann, O., & Delere, Y. (2013). Risk factors for cervical human papillomavirus infection and high-grade intraepithelial lesion in women aged 20 to 31 years in Germany. International Journal of Gynecological Cancer, 23, 519-526.

[View Article]       [Google Scholar]

  1. Clements, A. E., Raker, C. A., Cooper, A. S., & Boardman, L. A. (2011). Prevalence and patient characteristics associated with CIN 3 in adolescents. American journal of obstetrics and gynecology, 204, 128.e1-128.e7.

[View Article]       [Google Scholar]

  1. Liu, Z. C., Liu, W. D., Liu, Y. H., Ye, X. H., & Chen, S. D. (2015). Multiple sexual partners as a potential independent risk factor for cervical cancer: a meta-analysis of epidemiological studies. Asian Pacific Journal of Cancer Prevention, 16, 3893-3900.

[View Article]       [Google Scholar]

  1. Louie, K. S., De Sanjose, S., Diaz, M., Castellsagué, X., Herrero, R., Meijer, C. J., … & Bosch, F. X. (2009). Early age at first sexual intercourse and early pregnancy are risk factors for cervical cancer in developing countries. British journal of cancer, 100, 1191-1197.

[View Article]       [Google Scholar]

  1. International Collaboration of Epidemiological Studies of Cervical Cancer. (2007). Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16 573 women with cervical cancer and 35 509 women without cervical cancer from 24 epidemiological studies. Lancet, 370, 1609-1621.

[View Article]       [Google Scholar]

  1. Muñoz, N., Franceschi, S., Bosetti, C., Moreno, V., Herrero, R., Smith, J. S., … & Bosch, F. X. (2002). Role of parity and human papillomavirus in cervical cancer: the IARC multicentric case-control study. Lancet, 359, 1093-1101.

[View Article]       [Google Scholar]

  1. Asthana, S., Busa, V., & Labani, S. (2020). Oral contraceptives use and risk of cervical cancer—A systematic review & meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 247, 163-175.

[View Article]       [Google Scholar]

  1. Harari, A., Chen, Z., & Burk, R. D. (2014). HPV genomics: past, present and future. Current problems in dermatology, 45, 1.

[View Article]       [Google Scholar]

  1. Conway, C., Chalkley, R., High, A., Maclennan, K., Berri, S., Chengot, P., … & Wood, H. M. (2012). Next-generation sequencing for simultaneous determination of human papillomavirus load, subtype, and associated genomic copy number changes in tumors. Journal of Molecular Diagnostics, 14, 104-111.

[View Article]       [Google Scholar]

  1. Resnick, R. M., Cornelissen, M. T., Wright, D. K., Eichinger, G. H., Fox, H. S., Schegget, J. T., & Manos, M. M. (1990). Detection and typing of human papillomavirus in archival cervical cancer specimens by DNA amplification with consensus primers. JNCI: Journal of the National Cancer Institute, 82, 1477-1484.

[View Article]       [Google Scholar]

  1. de Roda Husman, A. M., Walboomers, J. M., van den Brule, A. J., Meijer, C. J., & Snijders, P. J. (1995). The use of general primers GP5 and GP6 elongated at their 3′ ends with adjacent highly conserved sequences improves human papillomavirus detection by PCR. Journal of general virology, 76, 1057-1062.

[View Article]       [Google Scholar]

  1. Castle, P. E., Porras, C., Quint, W. G., Rodriguez, A. C., Schiffman, M., Gravitt, P. E., … & CVT Group. (2008). Comparison of two PCR-based human papillomavirus genotyping methods. Journal of clinical microbiology, 46, 3437-3445.

[View Article]       [Google Scholar]

  1. Arbyn, M., Verdoodt, F., Snijders, P. J., Verhoef, V. M., Suonio, E., Dillner, L., … & Anttila, A. (2014). Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis. Lancet oncology, 15, 172-183.

[View Article]       [Google Scholar]

  1. Snijders, P. J., van den Brule, A. J., Schrijnemakers, H. F., Snow, G., Meijer, C. J., & Walboomers, J. M. (1990). The use of general primers in the polymerase chain reaction permits the detection of a broad spectrum of human papillomavirus genotypes. Journal of General Virology, 71, 173-181.

[View Article]       [Google Scholar]

  1. Qu, W., Jiang, G., Cruz, Y., Chang, C. J., Ho, G. Y., Klein, R. S., & Burk, R. D. (1997). PCR detection of human papillomavirus: comparison between MY09/MY11 and GP5+/GP6+ primer systems. Journal of clinical microbiology, 35, 1304-1310.

[View Article]       [Google Scholar]

  1. Tjalma, W. A. A., & Depuydt, C. E. (2013). Cervical cancer screening: which HPV test should be used—L1 or E6/E7?. European Journal of Obstetrics & Gynecology and Reproductive Biology, 170, 45-46.

[View Article]       [Google Scholar]

  1. Kerr, D. A., Sweeney, B., Arpin III, R. N., Ring, M., Pitman, M. B., Wilbur, D. C., & Faquin, W. C. (2016). Automated extraction of formalin-fixed, paraffin-embedded tissue for high-risk human papillomavirus testing of head and neck squamous cell carcinomas using the Roche Cobas 4800 system. Archives of Pathology & Laboratory Medicine, 140, 844-848.

[View Article]       [Google Scholar]

  1. Poljak, M., Valenčak, A. O., Domjanič, G. G., Xu, L., & Arbyn, M. (2020). Commercially available molecular tests for human papillomaviruses: a global overview. Clinical Microbiology and Infection, 26, 1144-1150.

[View Article]       [Google Scholar]

  1. Clarke, M. A., Wentzensen, N., Mirabello, L., Ghosh, A., Wacholder, S., Harari, A., … & Burk, R. D. (2012). Human papillomavirus DNA methylation as a potential biomarker for cervical cancer. Cancer Epidemiology, biomarkers & prevention, 21, 2125-2137.

[View Article]       [Google Scholar]

  1. Gu, Y. Y., Zhou, G. N., Wang, Q., Ding, J. X., & Hua, K. Q. (2020). Evaluation of a methylation classifier for predicting pre-cancer lesion among women with abnormal results between HPV16/18 and cytology. Clinical epigenetics, 12, 57.

[View Article]       [Google Scholar]

Cite This Article

U. Dadhich and N. C. Jat, “Knowledge of the Warning Signs and Risk Factors for Cervical Cancer among Women Attending a Tertiary Hospital,” Radius: Journal of Science and Technology 2(2) (2025) 252005. https://doi.org/10.5281/zenodo.17760351

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