Cervical cancer as an important public health concern related to a virus infection
Among of the gynecological cancer types, CC must be the most detectable cancer due to access to the anatomical target. Unfortunately, this cancer type is the fourth most frequent cancer in the female population worldwide.
More than 85% of cases occur in developing countries in which this malignancy is a public health concern due to its high mortality rates, provoked at least by late detection and lack of coverage for screening procedures [8]. Prior to the appearance of CC, women develop a precancer period that spans approximately two decades. During this extensive period, cervical epithelium cells present morphological and molecular changes that could not be typical of a healthy state neither of cancer; they are in transition state, as in the “limbo”. Thus, these abnormal or precancer cells are known as squamous intraepithelial lesions (SIL) classified as low grade (LSIL) if they only affect the first third of the cervical epithelium, or high grade (HSIL) if they affect more than 50% of cervical epithelium layer [9].Like other cancers, CC is a multifactorial disease, although there are different risk factors that could be controlled to prevent the development and progression of precursor lesions to invasive cancer. Among these risk factors are the onset of active sexual during the teen period, multiple sexual partners, overuse and uncontrolled of hormonal contraceptives, drug abuse, inadequate and overuse of antibiotic regimens, lack of protection during sexual intercourse and absence of routine gynecological inspections, among others; however, the main etiological factor associated with this type of cancer is the persistent HPV infection considered as sexually transmitted infection [10, 11].
The HPV is an infectious agent that is transmitted through sexual contact and affects the anus-genital and oropharyngeal tracts. This involves the transmission of one or more viral genotypes that infect the epithelia, which ones are classified as low risk (LR-HPV) and high risk (HR-HPV) according to their carcinogenic potential. Persistent infection by any of the HR-HPV genotypes is the cause of the vast majority of SIL [12]. It should be noted that the process of cellular transformation of normal cells to precancerous cells and invasive carcinoma involves a long period of time, as already mentioned, which makes the prevention of this neoplasm 100% feasible through the SIL screening.
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