A Review on Cervical Dysplasia: Etiology, Risk Factors, Diagnostic Biomarkers and Possible Nutritional Association

Abstract

Objectives: Cervical dysplasia which is the precursor or premalignant form of cervical cancer is prolonged; hence its diagnosis is essential for the early detection and inhibiting the development of cervical cancer. This review briefs the extensive studies conducted globally to gain knowledge about the development of cervical dysplasia along with the risk factors associated, role of human papilloma virus (HPV), potential diagnostic biomarkers and association with various micronutrient levels. Materials and method: All these data were collected through extensive literature review. Result: Based on the review, it can be stated that HPV virus (HPV 16 most commonly) is the most important etiological agent for the process of cervical carcinogenesis. However, HPV infection solely does not cause cervical cancer. There are various factors which act synergistically to develop cervical dysplasia and cancer. Smoking was found to be an important independent risk factor. There are studies which showed conflicting results regarding oral contraceptive intake association with cervical dysplasia. There are quite a few biomarkers like HPV DNA, p16INK4a, telomerase, and microRNA expression which have been identified as effective in diagnosing cervical dysplasia. Chromosome 3q mutation has been reported to be present in early dysplastic lesions; hence, it can be used in screening early lesions. Various micronutrient studies highlighted the facts that high plasma concentrations of several carotenoids and Vitamin C are inversely proportional to the degree of cervical dysplasia. Low red cell folate levels n plasma increases the risk of cervical dysplasia association. Low dietary intake of Vitamin A is also associated with increased risk of cervical dysplasia. Conclusion: Finally, it can be stated that more extensive studies relating to nutritional and serum markers level need to be conducted with larger cohorts so that an appropriate nutrition plan can be implemented for these patients.