CANCER OF THE CERVIX UTERI: REVIEW OF CAUSAL FACTORS WITH AN HYPOTHESIS AS TO ITS ORIGIN.

From a review of the published literature it appears that circumcision and racial characteristics have little influence on the incidence of cervical cancer while early marriage or early coitus and first pregnancy are highly associated with it. The disease always affects the cervical epithelium overlaying the cervical glands; this epithelium is probably regenerate squamous epithelium produced as a result of the process of metaplasia from preexisting columnar epithelium formed by indifferentiated stromal cells as a consequence of a fall in pH. Evidence from histological examination shows that the conversion from columnar to squamous epithelium occurs in situ and that there is no actual ingrowth or overgrowth of regenerating basal cells. These cells are actively phagocytic showing a specific propensity to phage spermatozoa post coitum; the phaged spermatozoa may influence the production of ribose nucleic acid which is in turn phaged by all cells within the metaplastic patch. In such cells a cytoplasm with at least 2 ribosomal populations would result one concerned with keratin synthesis and one concerned with rapid multiplication leading to hyperplasia.