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Cervical Cancer

Medically reviewed by Drugs.com. Last updated on Oct 11, 2023.

What is Cervical Cancer?

Harvard Health Publishing

The cervix is a small, donut-shaped structure. It is located at the top of the vagina. It is the entrance to the uterus.

Cervical cancer begins in the outer layer of the cervix. This outer layer is called the cervical epithelium. Tiny changes begin in epithelial cells. Over time, cells may become cancerous and grow out of control.

Cervical Cancer

Cervical cancer usually grows slowly. It can remain in the cervical covering for up to 10 years. Once cervical cancer moves beyond this layer, it invades nearby tissue. This includes the uterus, vagina, bladder, and rectum.

Almost all cervical cancer is caused by infection with human papilloma virus (HPV). HPV can damage the cells that line the cervix. Sometimes the damage occurs in the genes of the cells, which may lead to cervical cancer.

HPV is a very common infection among sexually active women. But only a small number of women with HPV develop cervical cancer.

Smokers are more likely to develop cervical abnormalities if they are infected with HPV. Women infected with human immunodeficiency virus (HIV) are also at higher risk.

Symptoms

In its early stages, cervical cancer does not cause any symptoms. When cervical cancer does cause symptoms, a woman may experience:

These symptoms do not mean that you have cervical cancer. In fact, a woman may experience these symptoms for many reasons.

More advanced cervical cancer can cause:

Diagnosis

Diagnosis of cervical cancer usually begins with a pelvic exam. The doctor inspects your cervix and vagina. He or she performs a Pap test. During a Pap test the doctor obtains a sample of cells from the surface and canal of your cervix. The cells are sent to a laboratory for examination. The Pap test is a quick, painless procedure.

If the Pap test indicates abnormal or possibly cancerous cells, a gynecologist will do one or more of the following:

DNA testing can also identify the type of HPV. This is important because some types of HPV are more likely than others to cause cancer.

Your HPV DNA test may suggest a higher risk of developing cancer. If that is the case, your doctor may recommend further testing be done soon. Women who have a lower risk may be able to wait a few months before having a follow-up Pap smear.

Expected Duration

Cervical cancer grows slowly and can take years to invade nearby tissues. However, it will continue to grow until it is treated.

Prevention

Almost all cervical cancer is caused by infection with HPV. There are currently two available HPV vaccines that target the major cervical cancer-causing types of HPV. The vaccines do not protect against all types of HPV.

The Centers for Disease Control and Prevention (CDC) recommends that all females starting at ages 11 or 12 get the HPV vaccine. Older girls and young women up to age 26 also should be vaccinated. Girls as young as nine years old may receive the vaccine. The vaccine is given as a set of two or three shots over six months depending on the age when vaccination is started.

Detecting cervical cancer early dramatically increases your chances of a cure. That is why Pap tests are an important part of prevention.

Women at average risk of cervical cancer should begin regular screening with a Pap test at age 21. Pap smears should be done once every 3 years until age 30, as long as prior Pap smears have been normal. Most experts recommend against HPV screening for women who are under age 30 and have an average risk of cervical cancer.

Women age 30 and over have several options for screening if they have had normal Pap smears in the past:

Women that have an increased risk of cervical cancer need more frequent screening. Usually this means at least once per year. Risk factors that increase risk include:

Other steps to help prevent cervical cancer:

Treatment

The cancer's stage is determined by how far the cancer has spread. Treatment depends on the stage.

When recommending treatments for Stage 0 or Stage I cancer, your doctor will consider whether you want to have children. A pregnant woman diagnosed with Stage 0 or Stage I cervical cancer may be able to postpone treatment until after birth.

A woman with Stage 0 cancer who still wants to have children is usually treated with a surgical procedure to do one of the following:

For two years after these procedures, women should have frequent Pap tests to check for abnormal cells.

In women with Stage I cancer that plan to become pregnant, doctors may remove a cone-shaped piece of cervical tissue. For women who don't plan to become pregnant, the treatment for a minimally invasive Stage I cancer is usually a total hysterectomy. A total hysterectomy is the removal of the uterus and cervix.

Larger Stage I and Stage II cancers require a radical hysterectomy or radiation therapy plus chemotherapy. A radical hysterectomy is the removal of the uterus, cervix, ovaries, fallopian tubes and pelvic lymph nodes. The choice between surgery and radiation therapy partly depends on the woman's age and health. The doctor should also consider the patient's concerns about potential side effects or complications.

The usual treatment for Stage III and Stage IV is a combination of radiation and chemotherapy.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

View more treatment options

When to Call a Doctor

Report any of the following symptoms to your doctor:

Remember that these symptoms don't necessarily mean that you have cancer.

For women with advanced cervical cancer, significant vaginal bleeding requires immediate medical attention.

Prognosis

Survival depends on the stage at which the cancer is discovered and treated. Almost 100% of women with Stage 0 disease are cured. Women with Stage 1 and Stage 2 disease have a very good chance for cure. Cure rate is substantially lower if cervical cancer is discovered at a later stage.

Additional Info

National Cancer Institute (NCI) 
http://www.cancer.gov/

American Cancer Society (ACS) 
http://www.cancer.org/

Cancer Research Institute
http://www.cancerresearch.org/

 


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