A 35-Year-Old Nulliparous, Mildly Obese Woman Is Diagnosed with Cervical

A 35-year-old nulliparous, mildly obese woman is diagnosed with cervical intraepithelial neoplasia III.  She has been sexually active for 15 years and has had 4 lifetime partners.  She has been monogamous with her current partner for several months and takes oral contraceptives consistently.  The patient does not use condoms and douches regularly to "stay fresh."  Menarche occurred at age 9, and her menses recur every 28 days and last 6 days.  She had a plantar wart a few years ago but otherwise has no medical problems.  She drinks 1-2 glasses of wine every night but does not use tobacco or illicit drugs.  The patient's mother had breast cancer at age 42.  Which of the following is the most significant factor that predisposed this patient to cervical abnormalities?

A) Alcohol use
B) Early menarche
C) Family history of breast cancer
D) History of plantar wart
E) Lack of barrier contraception
F) Nulliparity
G) Obesity
H) Practice of douching

Correct Answer:

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