Which of the following is a high-risk factor for cervical cancer?

• A. Immunocompromised
• B. In-utero DES exposure
• C. Prior abnormal results
• D. Prior normal screening

Answer: (C)

A history of abnormal cervical cytology signals existing cervical epithelial changes that can persist or progress, especially if a high-risk HPV infection is ongoing. When someone has had prior abnormal results, it means there were dysplastic changes or HPV-related alterations in the cervix, which places them at higher risk for future progression to cervical intraepithelial neoplasia and eventually cancer. This history serves as a strong predictor of ongoing risk because it reflects prior disease activity that may recur or worsen if not adequately monitored and treated.

Immunocompromised status also raises risk because immune surveillance against HPV is diminished, allowing persistent infection and faster progression. In-utero DES exposure increases risk for certain gynecologic cancers, including rare cervical/vaginal neoplasms. Prior normal screening, on the other hand, is associated with lower risk, not higher.