A 42-year-old woman, gravida 2, para 2, comes for a routine examination. She has type 2 diabetes mellitus well controlled with glyburide. She has a history of vulvar condylomata acuminata successfully treated with laser ablation 12 years ago. She does not smoke. She drinks a six-pack of beer nightly. She is sexually active and uses a diaphragm with spermicide for contraception. Her mother had breast cancer at the age of 65 years. The patient is 157 cm (5 ft 2 in) tall and weighs 100 kg (220 lb); BMI is 40 kg/m2. Physical examination shows no other abnormalities. Pelvic examination shows a 2-cm ulcer on the cervix. A biopsy specimen of the cervical lesion shows invasive squamous cell carcinoma. Which of the following is the most significant predisposing factor for this patient’s cervical cancer?
(A) Alcohol use
(B) Diaphragm and spermicide use
(D) Human papillomavirus infection
(G) Type 2 diabetes mellitus
Correct answer : (D) Human papillomavirus infection
Human papilloma virus infection is the most important risk factor for development of cervical cancer.