VIII.

PATHOPHYSIOLOGY Modifiable Risk factors: HPV Early age of first intercourse (<20 y/o) Second-hand tobacco smoker Immunosuppression, low socioeconomic status Poor access or use of health care Multiple sexual partners (husband) History of STIs smoking tobacco having many children (>5) Using birth control pills for a long time DES (diethylstilbestrol) Non - modifiable Risk factors: Genetics Age Gender

DNA damage in the cervical cell (Cervical Dysplasia) DNA reparation by DNA repair genes Failure of DNA repair DNA repaired

Cellular genes mutation

Activation of growth promoting oncogenes

Activation of Apoptosis Controlling genes

Activation of suppressing anti - oncogenes

Activation of growth promoting oncogenes

Activation of Apoptosis Controlling genes

Activation of suppressing anti - oncogenes

Unregulated Growth and Differentiation

Benign

Malignant

Cervical Cancer Formation

Bowel or bladder pressure

Bladder irritation

Rectal discharge Metastasis

Abdominal pain

Metastasis Blood vessel or lymph nodes

Presen

Swollen lymph nodes

Liver

Lungs

Bone

Pelvic organs

Vaginal mucosa

Damage and loss of function

Death

Abnormal vaginal bleeding after intercourse

Metrorrhagia

Postmenopausal bleeding

Polymenorrhea

Abnormal vaginal bleeding after intercourse

Metrorrhagia

Postmenopausal bleeding

Polymenorrhea

Shock

Death