Cervical cancer affects the cervix, which is the narrow, cylindrical section of tissue that serves as the gateway between the vagina and the uterus.
Glandular cells cover the endocervix, the interior of the cervical canal. Flat, scale-like squamous cells form a protective barrier over the exocervix, the portion of the cervix that opens into the vagina. Most cervical cancers begin in the cells at the transformation zone, the point in the cervix where glandular and squamous cells meet.
According to the American Cancer Society, almost all cervical cancers are either squamous cell carcinoma or adenocarcinoma. On rare occasions, melanoma, sarcoma, and lymphoma may also be found in the cervix.Typically, there are no symptoms for early-stage cervical cancer. Most women experience symptoms only after the cancer invades nearby tissue. The most common symptoms are:
Longer or heavier than usual menstrual periods
Bleeding after vaginal intercourse
Postmenopausal bleeding
Vaginal discharge that may contain blood between periods or after menopause
Pain during vaginal intercourse, even without bleeding or discharge
The biggest risk factor for cervical cancer is infection with human papillomavirus (HPV), a group of some 150 related viruses that can cause genital warts, or papillomas. HPV is believed to be responsible for about 91 percent of cervical cancers.HPV can infect cells in several areas of the body, including the skin and the lining of the genitals, anus, mouth, and throat. Like other sexually transmitted diseases, HPV can be spread from person to person through skin-to-skin contact and vaginal, anal, or oral sex.Other cervical cancer risk factors may include:
Multiple full-term pregnancies
Smoking cigarettes
Long-term use of oral contraceptives
A suppressed immune system due to factors like HIV, chemotherapy, or chronic use of corticosteroids
First sexual encounter at a young age (younger than 18)
Many sexual partners
A previous cervical cancer diagnosis
Exposure to diethylstilbestrol (DES), a synthetic estrogen prescribed to pregnant women between 1940 and 1971 to prevent miscarriages and avoid other pregnancy problems
Early detection is key to protecting yourself from cervical cancer. Thanks to simple screening tests and minimally invasive procedures, it’s often possible to catch abnormal cells before they develop into cancerous ones.
Routine Screening
According to the American Cancer Society, people with a cervix should be screened for cervical cancer every 3 to 5 years between the ages of 25 and 65.The preferred method for screening is an HPV test performed by your healthcare provider every 5 years. During a routine gynecological visit, they’ll collect a sample of cervical cells by gently brushing your cervix with a specialized tool. This test can be done alongside a Pap smear, which involves inspecting cells for abnormalities.It’s also possible to collect a cervical sample yourself every 3 years by using a test kit approved by the U.S. Food and Drug Association (FDA). This test isn’t available over the counter, though, so you’ll still need to have your doctor or a telehealth provider order it. Keep in mind, if a self-collected HPV test shows anything abnormal, you’ll need to see a doctor for follow-up.
People at higher risk, such as those with previous abnormal test results, should consult their doctor for the best screening plan for their situation.
Colposcopy and Cervical Biopsy
If the Pap smear detects any abnormalities, your doctor will likely order more testing, such as a colposcopy, to look for cells that might be cancerous. During a colposcopy, your doctor uses a magnification tool called a colposcope to closely examine the cervix, vagina, and vulva.
A cervical biopsy may be taken to screen for cancerous changes. There are several types of biopsies your doctor may perform, depending on your case. The types include:
Punch Biopsy During this procedure, your doctor uses a sharp tool to remove a core of tissue.
Endocervical Curettage Your doctor will use a small instrument to scrape tissue from the cervix.
Electrical Wire Loop Your doctor will use a low-voltage electrified wire to remove a small sample from the cervix.
Cone Biopsy In this more extensive procedure, your doctor will remove a cone-shaped piece of tissue from the cervix
When detected at an early stage, cervical cancer is typically curable. The five-year survival rate for stage 1 cervical cancer is above 90 percent. The development of screening methods, HPV vaccination, and improved access to screening has led to a steep decline in both the incidence of cervical cancer and deaths from the disease over the past half century.
Cervical cancer treatment is based on the kind of cancer, the patient’s age and health history, how far the cancer has spread (stage), response to any previous treatments, and whether a patient wishes to have children.
Treatment options include:
Surgery Surgery for cervical cancer may be recommended to remove precancerous tissue. Surgery may be minimal or more extensive, depending on whether the cancer has spread.
Radiation Radiation may be used for cervical cancer when it has spread beyond the cervix, says the American Cancer Society.
Chemotherapy Concurrent chemoradiation combines chemotherapy with radiation therapy to boost the efficacy of radiation.
Routine screening, including Pap smears and HPV testing, is an important way to prevent cervical cancer.
HPV vaccination, like the Gardasil 9 or Cervarix vaccines, can help protect against the types of HPV that cause most cases of cervical cancers. But achieving widespread HPV vaccination rates continues to be a problem.
As of 2022, less than 40 percent of U.S. children ages 9 to 17 were up to date on the HPV vaccine, which is ideally administered at age 11 or 12. Geography and access to care also plays a role. Research shows children with private health insurance were more than twice as likely to be vaccinated than those with no coverage.The American Cancer Society lists several side effects of external beam radiation therapy for cervical cancer:
Fatigue
Upset stomach
Diarrhea or loose stools (if radiation is given to the pelvis or abdomen)
Nausea and vomiting
Skin changes (from mild redness to peeling or flaking)
Bladder irritation and dysfunction, blood in the urine
Vaginal pain
Menstrual changes
Low blood counts
When chemotherapy is combined with radiation, blood counts may be lower and fatigue and nausea tend to be worse. These side effects typically improve in the weeks after treatment is stopped. Long-term side effects include vaginal scar tissue, dryness, rectal bleeding, urinary problems, and weakened bones.
The American Cancer Society estimates about 13,360 new cases of invasive cervical cancer will be diagnosed and about 4,320 women will die from cervical cancer in the United States in 2025.
More Black and Hispanic women get HPV-associated cervical cancer than white women, possibly because of decreased access to Pap testing or follow-up treatment.
However, resources like AMIGAS, a bilingual outreach program, and organizations like the Black Women’s Health Imperative are working to create positive change.
Cervical cancer is most commonly caused by certain types of human papillomavirus (HPV), which are preventable through vaccination.
Early detection through routine screening like Pap smears and HPV tests is crucial because cervical cancer often does not present symptoms until it reaches an advanced stage.
There are effective treatment options for cervical cancer, including surgery, radiation, and chemotherapy, and the success rate is high when detected early.
If you experience symptoms like abnormal bleeding or pain during intercourse, it’s important to seek medical advice promptly to rule out serious conditions like cervical cancer.
