Cervical cancer is a type of cancer that starts in the cervix. The cervix is a hollow cylinder that connects the lower part of a woman’s uterus to her vagina. Most cervical cancers begin in cells on the surface of the cervix.
Cervical cancer was once a leading cause of death among American women. That has changed since screening tests became widely available.
Symptoms of cervical cancer
Many women with cervical cancer don’t realize they have the disease early on, because it usually doesn’t cause symptoms until the late stages. When symptoms do appear, they’re easily mistaken for common conditions like menstrual periods and urinary tract infections (UTIs).
Typical cervical cancer symptoms are:
• unusual bleeding, such as in between periods, after sex, or after menopause
• vaginal discharge that looks or smells different than usual
• pain in the pelvis
• needing to urinate more often
• pain during urination
If you notice any of these symptoms, see your doctor for an exam. Find out how your doctor will diagnose cervical cancer.
Cervical cancer causes
Most cervical cancer cases are caused by the sexually transmitted human papillomavirus (HPV). This is the same virus that causes genital warts.
There are about 100 different strains of HPV. Only certain types cause cervical cancer. The two types that most commonly cause cancer are HPV-16 and HPV-18.
Being infected with a cancer-causing strain of HPV doesn’t mean you’ll get cervical cancer. Your immune system eliminates the vast majority of HPV infections, often within two years.
HPV can also cause other cancers in women and men. These include:
• vulvar cancer
• vaginal cancer
• penile cancer
• anal cancer
• rectal cancer
• throat cancer
HPV is a very common infection. Find out what percentage of sexually active adults will get it at some point in their lifetime.
Cervical cancer treatment
Cervical cancer is very treatable if you catch it early. The four main treatments are:
• radiation therapy
• targeted therapy
Sometimes these treatments are combined to make them more effective.
The purpose of surgery is to remove as much of the cancer as possible. Sometimes the doctor can remove just the area of the cervix that contains cancer cells. For cancer that’s more widespread, surgery may involve removing the cervix and other organs in the pelvis.
Radiation kills cancer cells using high-energy X-ray beams. It can be delivered through a machine outside the body. It can also be delivered from inside the body using a metal tube placed in the uterus or vagina.
Chemotherapy uses drugs to kill cancer cells throughout the body. Doctors give this treatment in cycles. You’ll get chemo for a period of time. You’ll then stop the treatment to give your body time to recover.
Bevacizumab (Avastin) is a newer drug that works in a different way from chemotherapy and radiation. It blocks the growth of new blood vessels that help the cancer grow and survive. This drug is often given together with chemotherapy.
If your doctor discovers precancerous cells in your cervix they can be treated. See what methods stop these cells from turning into cancer.
Cervical cancer stages
After you’ve been diagnosed, your doctor will assign your cancer a stage. The stage tells whether the cancer has spread, and if so, how far it’s spread. Staging your cancer can help your doctor find the right treatment for you.
Cervical cancer has four stages:
• Stage 1: The cancer is small. It may have spread to the lymph nodes. It hasn’t spread to other parts of your body.
• Stage 2: The cancer is larger. It may have spread outside of the uterus and cervix or to the lymph nodes. It still hasn’t reached other parts of your body.
• Stage 3: The cancer has spread to the lower part of the vagina or to the pelvis. It may be blocking the ureters, the tubes that carry urine from the kidneys to the bladder. It hasn’t spread to other parts of your body.
• Stage 4: The cancer may have spread outside of the pelvis to organs like your lungs, bones, or liver.
Cervical cancer test
A Pap smear is a test doctors use to diagnose cervical cancer. To perform this test, your doctor collects a sample of cells from the surface of your cervix. These cells are then sent to a lab to be tested for precancerous or cancerous changes.
If these changes are found, your doctor may suggest a colposcopy, a procedure for examining your cervix. During this test, your doctor might take a biopsy, which is a sample of cervical cells.
The U.S. Preventive Services Task Force (USPSTF)Trusted Source recommends the following screening schedule for women by age:
• Ages 21 to 29: Get a Pap smear once every three years.
• Ages 30 to 65: Get a Pap smear once every three years, get a high-risk HPV (hrHPV) test every five years, or get a Pap smear plus hrHPV test every five years.
Do you need a Pap smear? Learn what to expect during a Pap test.
Cervical cancer risk factors
HPV is the biggest risk for cervical cancer. Other factors that can also increase your risk include:
• human immunodeficiency virus (HIV)
• a family history of cervical cancer
• a diet low in fruits and vegetables
• taking birth control pills
• having three full-term pregnancies
• being younger than 17 when you got pregnant for the first time
Even if you have one or more of these factors, you’re not destined to get cervical cancer. Learn what you can start doing right now to reduce your risk.
Cervical cancer prognosis
For cervical cancer that’s caught in the early stages, when it’s still confined to the cervix, the five-year survival rate is 92 percent.
Once the cancer has spread within the pelvic area, the five-year survival rate drops to 56 percent. If the cancer spreads to distant parts of the body, survival is just 17 percent.
Routine testing is important for improving the outlook of women with cervical cancer. When this cancer is caught early, it’s very treatable.
Cervical cancer surgery
Several different types of surgery treat cervical cancer. Which one your doctor recommends depends on how far the cancer has spread.
• Cryosurgery freezes cancer cells with a probe placed in the cervix.
• Laser surgery burns off abnormal cells with a laser beam.
• Conization removes a cone-shaped section of the cervix using a surgical knife, laser, or a thin wire heated by electricity.
• Hysterectomy removes the entire uterus and cervix. When the top of the vagina is also removed, it’s called a radical hysterectomy.
• Trachelectomy removes the cervix and the top of the vagina, but leaves the uterus in place so that a woman can have children in the future.
• Pelvic exenteration may remove the uterus, vagina, bladder, rectum, lymph nodes, and part of the colon, depending on where the cancer has spread.
Cervical cancer prevention
One of the easiest ways to prevent cervical cancer is by getting screened regularly with a Pap smear and/or hrHPV test. Screening picks up precancerous cells, so they can be treated before they turn into cancer.
HPV infection causes most cervical cancer cases. The infection is preventable with the vaccines Gardasil and Cervarix. Vaccination is most effective before a person becomes sexually active. Both boys and girls can be vaccinated against HPV.
Here are a few other ways you can reduce your risk of HPV and cervical cancer:
• limit the number of sexual partners you have
• always use a condom or other barrier method when you have vaginal, oral, or anal sex
An abnormal Pap smear result indicates you have precancerous cells in your cervix. Find out what to do if your test comes back positive.
Cervical cancer statistics
Here are some key statistics about cervical cancer.
The American Cancer Society estimates that in 2019, approximately 13,170 American women will be diagnosed with cervical cancer and 4,250 will die from the disease. Most cases will be diagnosed in women between the ages of 35 and 44.
Hispanic women are the most likely ethnic group to get cervical cancer in the United States. American Indians and Alaskan natives have the lowest rates.
The death rate from cervical cancer has dropped over the years. From 2002-2016, the number of deaths was 2.3 per 100,000 women per year. In part, this decline was due to improved screening.
Cervical cancer and pregnancy
It’s rare to get diagnosed with cervical cancer while you’re pregnant, but it can happen. Most cancers found during pregnancy are discovered at an early stage.
Treating cancer while you’re pregnant can be complicated. Your doctor can help you decide on a treatment based on the stage of your cancer and how far along you’re in your pregnancy.
If the cancer is at a very early stage, you may be able to wait to deliver before starting treatment. For a case of more advanced cancer where treatment requires a hysterectomy or radiation, you’ll need to decide whether to continue the pregnancy.
Doctors will try to deliver your baby as soon as it can survive outside the womb.