From the Guidelines
Cervical inflammation observed during a Pap smear is most commonly caused by persistent human papillomavirus (HPV) infection, which is detected in 99% of cervical tumors, particularly the oncogenic subtypes such as HPV 16 and 18 1.
Causes of Cervical Inflammation
The causes of cervical inflammation can be diverse, including:
- Infections such as bacterial vaginosis, yeast infections, and sexually transmitted infections (STIs) like chlamydia, gonorrhea, and trichomoniasis
- Physical irritation from tampons or douching
- Allergic reactions to products like spermicides or latex condoms
- Hormonal changes during pregnancy or menopause
- Recent sexual activity However, the most significant cause of cervical inflammation is persistent HPV infection, which can lead to cervical cancer 1.
Diagnosis and Treatment
Cervical inflammation can be detected microscopically during Pap smear evaluation, appearing as redness, swelling, and increased white blood cells in the cervical tissue. Treatment depends on the specific cause of the inflammation. For example, bacterial infections may require antibiotics, while yeast infections may be treated with antifungals. HPV vaccination has been shown to be effective in preventing infection and disease associated with the vaccine HPV types, and can prevent > 70% of cervical cancers 1.
Prevention and Screening
Regular Pap smears and HPV testing can help detect cervical inflammation and prevent cervical cancer. The HPV test has been introduced as a screening tool and has demonstrated higher sensitivity for high-grade cervical intraepithelial neoplasia (CIN2+) than cytology in several studies 1. Early detection and treatment of cervical inflammation can help reduce the risk of cervical cancer and improve treatment outcomes.
From the Research
Causes of Cervical Inflammation
Cervical inflammation observed during a Pap smear can be caused by various factors, including:
- Infections such as human papillomavirus (HPV) 2, 3, 4
- Bacterial vaginosis (BV) 2, 5
- Chlamydia trachomatis 2, 3, 4
- Neisseria gonorrhoeae 2, 4
- Trichomoniasis 2, 5, 4
- Herpes simplex virus (HSV) 2, 4
- Cervicitis, which is an inflammation of the cervix, typically caused by Chlamydia trachomatis and Neisseria gonorrhoeae 5
Risk Factors
Certain risk factors can increase the likelihood of developing cervical inflammation, including:
- Age less than 18 years at first coitus 3
- HPV infection 3, 4
- Positive Pap smear 3
- Parity greater than 5, which is associated with Chlamydia trachomatis infection 3
- Co-infections of HR-HPV with C. trachomatis and N. gonorrhoeae, which can increase the risk of high-grade squamous intraepithelial cervical lesion 4
Diagnosis and Treatment
A pelvic exam should be performed for any woman presenting with vaginal discharge to confirm the diagnosis and rule out an upper tract infection 5. Treatment and partner therapy is recommended for sexually transmitted illnesses, such as trichomoniasis, chlamydia, and gonorrhea 5.