What is it?
- Cervical cancer occurs on the cervix. The cervix is located at the top of the birth canal (vagina) and the lower part of the womb (uterus).
- Most cervical cancer is caused by certain types of human papillomavirus (HPV). HPV is a virus that is spread during sexual contact.
- The HPV vaccine protects against the types of HPV that most often cause cervical cancer.
What is cancer?
Cancer occurs when cells in the body grow out of control. Cancers are named for the part of the body where they start.
What is cervical cancer?
When cancer starts on the cervix, it is called cervical cancer. The cervix is the lower part of the uterus (womb) and is located at the top of the vagina (birth canal).
See more on the anatomy of the female reproductive system.
Cells do not suddenly change into cancer. They start as pre-cancerous cells that, if not treated, may develop into cancer over time. Pre-cancerous means that the cells are not normal.
What are the symptoms of cervical cancer?
Cervical cancer almost never has noticeable symptoms until it is at advanced stages. Symptoms may include:
- Heavy periods.
- Pain during sex.
- Discharge from vagina.
- Unexpected bleeding from the vagina, such as between periods or after sex.
There are many reasons other than cancer that can cause these symptoms, so it is important to check with a healthcare provider about any concerns.
What are the risk factors for cervical cancer?
A risk factor is the chance that something will harm or otherwise affect a person’s health. Most cervical cancer is caused by certain types of human papillomavirus (HPV). HPV is a virus that is spread during sexual contact. There are about 40 different strains (types) of HPV that can infect the genital area. About a dozen of these can cause cancer.
The most reliable way to avoid transmission of STDs is to abstain from oral, vaginal, and anal sex or to be in a long-term, mutually monogamous relationship with a partner known to be uninfected.
There are two types or strains of HPV:
- Low-risk strains: Low-risk strains of HPV can cause warts on the genitals. Warts can be itchy, embarrassing, and unpleasant, but these strains are considered low risk because they do not cause cancer.
- High-risk strains: High-risk strains do not cause warts but can, rarely, cause cancer. This is why they are called high-risk strains.
Most adults will have an HPV infection at some time during their lives. HPV infections almost always clear up on their own without treatment. A person with a high-risk strain of HPV that does not clear up on its own over many years could eventually get cancer.
A vaccine (shot) is available to prevent most high-risk HPV infections. It is best if the vaccine is received in childhood or early adolescence before a young woman begins having sex. It is also recommended for women up to age 26 who did not get the recommended doses when they were younger. Ask your healthcare provider about the HPV vaccine.
Are there tests for cervical cancer?
Two tests are often done to check for cervical cancer or pre-cancer:
- Pap test: Also called “cervical cytology,” this test is performed during a pelvic exam. A healthcare provider takes cells from the cervix, the lower part of the uterus (womb), to check for pre-cancerous and cancerous cells.
- HPV test: This tests the cells from the cervix for high-risk HPV infection.
HPV infection can cause Pap tests to be not normal. The HPV test can help tell if an abnormal Pap test could be due to high-risk HPV infection, which could mean the woman has a greater chance of developing pre-cancerous cells and needs closer monitoring.
A woman should get her first Pap test at age 21. After the first normal test, she should have a Pap test every three years. If a woman’s Pap test is abnormal, her healthcare provider will recommend follow-up.
Women who are 30–65 years old may have an HPV test done with the Pap test (known as co-testing). If both the Pap test and the HPV test are normal, most women should have another co-test in five years. Women older than 65 may be able to stop testing if a healthcare provider identifies them as low risk. A woman should talk to her healthcare provider about which type of testing is best for her and follow the guidance for when retests are due.
When a Pap or HPV test result is not normal, it usually does not necessarily mean that the woman has cancer. Test results may be abnormal because of several reasons:
- There is a cervical HPV infection present and this causes an abnormal Pap test result. HPV infection can resolve over time without any treatment, and many times any abnormal cells detected then return to normal without any treatment.
- There are some abnormal cells detected due to infection, inflammation from sex or using a diaphragm, and even changes associated with your period. These factors can cause an abnormal Pap test, but do not mean there are cancerous or pre-cancerous cells present.
- There are cancerous or pre-cancerous cells present and further testing may be needed.
- There is an error at the lab in looking at the cells from the Pap test.
It is important to find, carefully watch, and sometimes treat pre-cancers. If needed, treatment can prevent pre-cancer from becoming cancer. Your healthcare provider may suggest having the test again or getting other tests. Additional tests may include:
- Colposcopy: A healthcare provider uses an instrument with a light and microscope, called a colposcope, to examine the cervix for cells that are not normal. If there are abnormal cells, the healthcare provider will probably suggest a biopsy.
- Biopsy: A healthcare provider takes a small piece of tissue from the cervix, and it is sent to a lab for study.
- Other tests for high-risk HPV strains: Sometimes healthcare providers use additional HPV tests to help decide what the best next step is.
It is important to follow up with your healthcare provider about any tests or treatment that are recommended.
How are cervical cancer and pre-cancer treated?
A gynecologist (doctor for women’s reproductive health) or oncologist (cancer doctor) can help you choose the right treatment:
- Pre-cancer is usually treated by removing the cells that are not normal. This is usually done through a short procedure in the healthcare provider’s office or the health center.
- Cervical cancer is treated with surgery, radiation therapy, and/or chemotherapy. Sometimes more than one type of treatment is used.
Because it is possible that cervical cancer and its treatment can affect your ability to have children, talk with your healthcare provider about what you can do if you hope to have children in the future.
Did you know? (cervical cancer)
Content last reviewed on February 4, 2019