Cervical cancer
Cancer - cervix; Cervical cancer - HPV; Cervical cancer - dysplasiaCervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina.
Causes
Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the United States because of the widespread use of Pap tests.
Pap tests
The Pap test mainly checks for changes that may turn into cervical cancer. Cells scraped from the opening of the cervix are examined under a microsc...
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Pap smear
A Pap test is a simple, relatively inexpensive procedure that can easily detect cancerous or precancerous conditions.
Cervical cancer starts in the cells on the surface of the cervix. There are two types of cells on the surface of the cervix, squamous and columnar (gland cells). Most cervical cancers are from squamous cells.
Cervical cancer usually develops slowly. It starts as a precancerous condition called dysplasia. This condition can be detected by a Pap test and is nearly 100% treatable. It can take years for dysplasia to develop into cervical cancer. Most women who are diagnosed with cervical cancer today have not had regular Pap tests, or they have not followed up on abnormal Pap test results.
Dysplasia
Cervical dysplasia refers to abnormal changes in the cells on the surface of the cervix. The cervix is the lower part of the uterus (womb) that open...
Read Article Now Book Mark ArticleAlmost all cervical cancers are caused by human papillomavirus (HPV). HPV is a common virus that is spread through skin-to-skin contact and also by sexual intercourse. There are many different types (strains) of HPV. Some strains lead to cervical as well as other cancers. Other strains can cause genital warts. Others do not cause any problems at all.
Genital warts
Genital warts are soft growths on the skin and mucous membranes of the genitals. They may be found on the penis, vulva, urethra, vagina, cervix, and...
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Cervical cancer
The development of cervical cancer is gradual and begins as a pre-cancerous condition called dysplasia. It is usually a slow-growing cancer and if caught early can be successfully treated. Routine Pap smears can detect early changes in the cells of the cervix allowing cervical cancer to be diagnosed early.
A woman's sexual behavior can increase her risk for developing cervical cancer. Risky sexual practices include:
- Having sex at an early age
- Having multiple sexual partners
- Having a partner or many partners who take part in high-risk sexual activities
Other risk factors for cervical cancer include:
- Not getting the HPV vaccine
HPV vaccine
The human papillomavirus (HPV) vaccine protects against infection by certain strains of HPV. HPV can cause cervical cancer and genital warts. HPV ha...
Read Article Now Book Mark Article - Being economically disadvantaged
- Having a mother who took the drug diethylstilbestrol (DES) during pregnancy in the early 1960s to prevent miscarriage
- Having a weakened immune system
Symptoms
Most of the time, early cervical cancer has no symptoms. Symptoms that may occur include:
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Abnormal vaginal bleeding between periods, after intercourse, or after menopause
Abnormal vaginal bleeding between perio...
This article discusses vaginal bleeding that occurs between a woman's monthly menstrual periods. Such bleeding may be called "intermenstrual bleedin...
Read Article Now Book Mark Article - Vaginal discharge that does not stop, and may be pale, watery, pink, brown, bloody, or foul-smelling
- Periods that become heavier and last longer than usual
Cervical cancer may spread to the vagina, lymph nodes, bladder, intestines, lungs, bones, and liver. Often, there are no problems or symptoms until the cancer is advanced and has spread. Symptoms of advanced cervical cancer may include:
- Abdominal pain
- Back pain
- Bone pain or fractures
- Fatigue
- Leaking of urine or feces from the vagina
- Leg pain
- Loss of appetite
- Pelvic pain
- Single swollen leg
- Weight loss
Exams and Tests
Precancerous changes of the cervix and cervical cancer cannot be seen with the naked eye. Special tests and tools are needed to spot such conditions:
- A Pap test screens for precancers and cancer, but does not make a final diagnosis.
- Depending on your age, the human papillomavirus (HPV) DNA test may be done along with a Pap test to screen for cervical cancer. Or it may be used after a woman has had an abnormal Pap test result. It may also be used as the first test. Talk to your health care provider about which test or tests are right for you.
Human papillomavirus (HPV) DNA test
The HPV test is used to check for infection with HPV types associated with cervical cancer. Typically, the test looks for 14 different HPV types. H...
Read Article Now Book Mark Article - If abnormal changes are found, the cervix is usually examined under magnification. This procedure is called colposcopy. Pieces of tissue might be removed (biopsied) during this procedure. This tissue is then sent to a lab for examination.
Colposcopy
A colposcopy is a special way of looking at the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. Abno...
Read Article Now Book Mark Article - A procedure called a loop electrosurgical excision procedure (LEEP) may also be done. This uses an electrified metal loop to remove some tissue from the cervix. If this is not feasible, a larger procedure called a cone biopsy may be done. This is a procedure that removes a cone-shaped wedge from the front of the cervix.
Cone biopsy
A cone biopsy (conization) is surgery to remove a sample of abnormal tissue from the cervix. The cervix is the lower part of the uterus (womb) that ...
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Cervical biopsy
In a cervical punch biopsy, the cervix may be stained with iodine solution in order to see abnormalities better. These areas of tissue are then sampled and examined.
Cold cone biopsy
The cold cone biopsy is a surgical procedure requiring general anesthesia and is indicated by the presence of precancerous changes in the cervix.
If cervical cancer is diagnosed, the provider will order more tests. These help determine how far the cancer has spread. This is called cancer staging. Tests may include:
Cancer staging
Cancer staging is a way to describe how much cancer is in your body and where it is located. Staging helps determine where the original tumor is, ho...
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CT scan of the abdomen and pelvis
CT scan of the abdomen and pelvis
A computed tomography (CT) scan of the pelvis is an imaging method that uses x-rays to create cross-sectional pictures of the area between the hip bo...
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Cystoscopy
Cystoscopy
Cystoscopy is a surgical procedure. This is done to see the inside of the bladder and urethra using a thin, lighted tube.
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Intravenous pyelogram (IVP)
Intravenous pyelogram (IVP)
An intravenous pyelogram (IVP) is a special x-ray exam of the kidneys, bladder, and ureters (the tubes that carry urine from the kidneys to the bladd...
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MRI of the abdomen and pelvis
MRI of the abdomen and pelvis
A pelvis MRI (magnetic resonance imaging) scan is an imaging test that uses a machine with powerful magnets and radio waves to create pictures of the...
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PET scan
PET scan
A positron emission tomography (PET) scan is a type of imaging test. It uses a radioactive substance called a tracer to look for disease in the body...
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Treatment
Treatment of cervical cancer depends on:
- The stage of the cancer
- The size and shape of the tumor
- The woman's age and general health
- Her desire to have children in the future
Early cervical cancer can be cured by removing or destroying the precancerous or cancerous tissue. This is why Pap tests done at the recommended times are so important to prevent cervical cancer, or catch it at an early stage. There are surgical ways to cure cervical cancer without removing the uterus or seriously damaging the cervix, so that a woman can still have children in the future.
Types of surgery for cervical precancer, and on occasion, very small early cervical cancer include:
- LEEP -- uses electricity to remove abnormal tissue.
- Cryotherapy -- freezes abnormal cells.
- Laser therapy -- uses light to burn abnormal tissue.
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Hysterectomy may be done for women with precancer who have undergone multiple LEEP procedures, or who are not interested in further childbearing.
Hysterectomy
Hysterectomy is surgery to remove a woman's womb (uterus). The uterus is a hollow muscular organ that nourishes the developing baby during pregnancy...
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Treatment for more advanced cervical cancer may include:
- Radical hysterectomy, which removes the uterus and much of the surrounding tissues, including lymph nodes and the upper part of the vagina. This is more often performed on younger, healthier women with small tumors.
- Radiation therapy, along with low dose chemotherapy, is more often used for women with tumors too large for radical hysterectomy or women who are not good candidates for surgery.
- Pelvic exenteration, an extreme type of surgery in which all of the organs of the pelvis, including the bladder and rectum, are removed.
Radiation may also be used to treat cancer that has returned.
Radiation
Radiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.
Read Article Now Book Mark ArticleChemotherapy uses drugs to kill cancer. It may be given alone or with surgery or radiation.
Chemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
Read Article Now Book Mark ArticleSupport Groups
You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.
Cancer support group
The following organizations are good resources for information on cancer:American Cancer Society. Support and online communities. www. cancer. org/...
Read Article Now Book Mark ArticleOutlook (Prognosis)
How well the person does depends on many things, including:
- Type of cervical cancer
- Stage of cancer (how far it has spread)
- Age and general health
- If the cancer comes back after treatment
Precancerous conditions can be completely cured when followed up and treated properly. Most women are alive in 5 years (5-year survival rate) for cancer that has spread to the inside of the cervix walls but not outside the cervix area. The 5-year survival rate falls as the cancer spreads outside the walls of the cervix into other areas.
Possible Complications
Complications can include:
- Risk of the cancer coming back in women who have treatment to save the uterus
- Problems with sexual, bowel, and bladder function after surgery or radiation
When to Contact a Medical Professional
Contact your provider if you:
- Have not had regular Pap tests
- Have abnormal vaginal bleeding or discharge
Prevention
Cervical cancer can be prevented by doing the following:
- Get the HPV vaccine. The vaccine prevents most types of HPV infection that cause cervical cancer. Your provider can tell you if the vaccine is right for you.
HPV vaccine
The human papillomavirus (HPV) vaccine protects against infection by certain strains of HPV. HPV can cause cervical cancer and genital warts. HPV ha...
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Practice safer sex. Using condoms during sex reduces the risk for HPV and other sexually transmitted infections (STIs).
Practice safer sex
Safe sex means taking steps before and during sex that can prevent you from getting an infection, or from giving an infection to your partner. These...
Read Article Now Book Mark Article - Limit the number of sexual partners you have. Avoid partners who are active in high-risk sexual behaviors.
- Get Pap tests as often as your provider recommends. Pap tests can help detect early changes, which can be treated before they turn into cervical cancer.
- Get the HPV test if recommended by your provider. It can be used along with the Pap test to screen for cervical cancer in women 30 years and older, or for some screening protocols, starting at age 25.
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If you smoke, quit. Smoking increases your chance of getting cervical cancer.
If you smoke, quit
If you smoke, you should quit. But quitting can be hard. Most people who have quit smoking have tried at least once, and often several times, witho...
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References
Centers for Disease Control and Prevention website. Clinical overview of HPV. www.cdc.gov/hpv/hcp/clinical-overview/. Updated July 9, 2024. Accessed August 27, 2024.
National Cancer Institute website. Cervical cancer treatment (PDQ) - health professional version. www.cancer.gov/types/cervical/hp/cervical-treatment-pdq. Updated July 23, 2024. Accessed August 27, 2024.
Salcedo MP, Phoolcharoen N, Schmeler KM. Intraepithelial neoplasia of the lower genital tract (cervix, vagina, vulva): etiology, screening, diagnosis, management. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 29.
US Preventive Services Task Force website. Final recommendation statement. Cervical cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening. Last updated March 10, 2022. Accessed August 27, 2024.
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Pap smear
Animation
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Cervical cancer
Animation
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Cervical cancer - illustration
The development of cervical cancer is gradual and begins as a pre-cancerous condition called dysplasia. It is usually a slow-growing cancer and if caught early can be successfully treated. Routine Pap smears can detect early changes in the cells of the cervix allowing cervical cancer to be diagnosed early.
Cervical cancer
illustration
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Cervical neoplasia - illustration
Cervical intraepithelial neoplasia (CIN) is the presence of abnormal cells on the surface of the cervix. A Pap smear and colposcopy are two of the procedures performed to monitor the cells and appearance of the cervix.
Cervical neoplasia
illustration
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Pap smear - illustration
A Pap test is a simple, relatively inexpensive procedure that can easily detect cancerous or precancerous conditions.
Pap smear
illustration
-
Cervical biopsy - illustration
In a cervical punch biopsy, the cervix may be stained with iodine solution in order to see abnormalities better. These areas of tissue are then sampled and examined.
Cervical biopsy
illustration
-
Cold cone biopsy - illustration
The cold cone biopsy is a surgical procedure requiring general anesthesia and is indicated by the presence of precancerous changes in the cervix.
Cold cone biopsy
illustration
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Cervical cancer - illustration
Cervical cancer is the third most common type of cancer in women. Approximately 2% to 3% of all women over age 40 years will develop some form of cervical cancer.
Cervical cancer
illustration
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Pap smears and cervical cancer - illustration
An instrument called a speculum holds the walls of the vagina open so that the cervix may be viewed and a swab of cells obtained for analysis.
Pap smears and cervical cancer
illustration
-
Cervical cancer - illustration
The development of cervical cancer is gradual and begins as a pre-cancerous condition called dysplasia. It is usually a slow-growing cancer and if caught early can be successfully treated. Routine Pap smears can detect early changes in the cells of the cervix allowing cervical cancer to be diagnosed early.
Cervical cancer
illustration
-
Cervical neoplasia - illustration
Cervical intraepithelial neoplasia (CIN) is the presence of abnormal cells on the surface of the cervix. A Pap smear and colposcopy are two of the procedures performed to monitor the cells and appearance of the cervix.
Cervical neoplasia
illustration
-
Pap smear - illustration
A Pap test is a simple, relatively inexpensive procedure that can easily detect cancerous or precancerous conditions.
Pap smear
illustration
-
Cervical biopsy - illustration
In a cervical punch biopsy, the cervix may be stained with iodine solution in order to see abnormalities better. These areas of tissue are then sampled and examined.
Cervical biopsy
illustration
-
Cold cone biopsy - illustration
The cold cone biopsy is a surgical procedure requiring general anesthesia and is indicated by the presence of precancerous changes in the cervix.
Cold cone biopsy
illustration
-
Cervical cancer - illustration
Cervical cancer is the third most common type of cancer in women. Approximately 2% to 3% of all women over age 40 years will develop some form of cervical cancer.
Cervical cancer
illustration
-
Pap smears and cervical cancer - illustration
An instrument called a speculum holds the walls of the vagina open so that the cervix may be viewed and a swab of cells obtained for analysis.
Pap smears and cervical cancer
illustration
-
Cervical cancer - InDepth
(In-Depth)
Review Date: 1/9/2023
Reviewed By: Howard Goodman, MD, Gynecologic Oncology, Florida Cancer Specialists & Research Institute, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Internal review and update on 02/20/2024 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 08/27/2024.