Cervical cancer is caused by abnormal cell growth in the tissues of your cervix. The most common cause of cervical cancer is human papillomavirus (HPV).
Routine Pap smears and the HPV vaccine can detect or prevent an HPV infection.
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What Is Cervical Cancer?
Cervical cancer is cancer caused by abnormal cell growth in the tissues of the cervix — the organ that connects your uterus and vagina.
Cervical cancer develops slowly. Usually, it begins with cervical dysplasia or cervical precancer, in which abnormal cells begin to appear in cervical tissue.
A human papillomavirus (HPV) infection, for which there's a vaccine, is the most common cause of cervical cancer.
What is cervical precancer?
Cervical precancer is the presence of cervical cells that look abnormal but aren't yet cancerous. Often the first sign of cancer that may develop years later, cervical precancer usually doesn't cause pain or other symptoms.
Cervical precancer is diagnosed far more often than invasive cervical cancer.
How common is cervical cancer?
Nearly 14,000 women will be diagnosed with invasive cervical cancer in 2024, and about 4,360 will die from cervical cancer, according to the American Cancer Society.
Cervical cancer is most frequently diagnosed between the ages of 35 and 44, with the average age being 50. It rarely develops in women younger than 20.
Many older women don't realize they're still at risk of developing cervical cancer as they age.
More than 20% of cervical cancers are found in women over 65. However, these cancers rarely occur in women who were getting regular tests to screen for cervical cancer before they were 65.
Cervical cancer risk factors
Anyone can develop cervical cancer, but certain factors may increase your risk.
They include:
- Being infected with or exposed to HPV.
- First having sex at a young age.
- Giving birth multiple times.
- Having a weakened immune system.
- Having irregular or suspicious Pap smears.
- Having many sexual partners.
- Smoking.
- Using oral contraceptives.
How common are HPV infections?
HPV infections are common — but not everybody with HPV will develop cervical cancer.
Most people who are sexually active will have an HPV infection at some point in their lives and never know. Most HPV infections go away on their own without causing problems because the body’s immune system fights them off.
But some high-risk HPV infection types last for many years, causing precancerous cells on a Pap test much later. These changes can progress into cervical cancer if not treated.
What are the types of cervical cancer?
The most common types of cervical cancer are:
- Adenocarcinoma — Cancer that develops in the glands that produce cervical mucus.
- Squamous cell carcinoma — Cancer that occurs in the squamous cells that line the bottom surface of the cervix. This is the most common type of cervical cancer.
What are the types of human papillomaviruses (HPVs)?
There are many types of sexually transmitted HPVs:
- High-risk HPV types — Can infect the cells of the cervix and cause cervical cancer. They also can infect other cells, causing anal, penile, vaginal, vulvar, and head and neck cancers.
- Low-risk HPV types — Can cause genital warts, which may grow on the internal or external genitals, but don't turn into cancer.
HPV infections are spread through skin-to-skin contact, including vaginal, anal, and oral sex. Although condoms can lower the risk of an HPV infection, they don't protect against them completely.
Complications of cervical cancer
Left undiagnosed or untreated, cervical dysplasia can progress to cervical cancer. In turn, cervical cancer can metastasize (spread) to other surrounding tissue and organs. The cancer can spread to the vagina and the surrounding muscles that support the bones of the pelvis.
How can I prevent cervical cancer?
According to the CDC, as many as 93% of cervical cancers could be prevented by screening and HPV vaccination. Regular Pap smears and the HPV vaccine can detect or prevent HPV infection.
Yet more than 8 million U.S. women ages 21 to 65 report that they haven't been screened for cervical cancer in the last five years. Seven out of 10 women who had not been screened had a primary care provider and health insurance.
Abnormal cervical cells are found during a pelvic exam with a Pap smear. The CDC recommends that you should get your first Pap test at around age 21 and then every three years if your results are normal.
Between the ages 30 and 65, you should talk to your provider about which of the following options are best for you:
- HPV test only — With a normal result, you can usually wait five years until your next screening.
- Pap smear and HPV test — With normal results on both tests, you can usually wait five years until your next screening.
- Pap smear only — With a normal result, you can usually wait three years until your next Pap test.
If you're older than 65, you may no longer need screening if:
- You’ve had your cervix removed through total hysterectomy for noncancerous conditions, like fibroids.
- You’ve had normal screening results for several years and you’ve had no past cervical precancer.
Talk to your health care provider about getting up to date on your gynecological health exams and vaccinations.
How can I reduce my risks of cervical cancer?
Two important tests can help prevent cervical cancer or find it early, when it's most easily treatable. Both can be done in a doctor’s office.
The tests for cervical cancer are:
- HPV test — Looks for the human papillomavirus, which can cause cervical cell changes.
- Pap smear (also called Pap test) — Looks for precancerous changes in the cells of the cervix that could become cervical cancer without treatment.
The HPV vaccine also is important in preventing HPV infections and the cervical changes they can cause, some of which are spread through sex and can cause cancer, including cervical cancer.
Other things you can do to try to lower your risk of HPV and cervical cancer:
- Don't smoke.
- If you're 26 or younger, get an HPV vaccine if you haven't been vaccinated already.
- Use condoms during sex.
HPV infection can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that aren't covered. While the effect of condoms in preventing HPV infection is unknown, condom use has been associated with a lower rate of cervical cancer.
What Are the Signs and Symptoms of Cervical Cancer?
Cervical cancer symptoms include:
- Pain and/or spotting during intercourse.
- Pelvic pain.
- Unusual vaginal discharge.
- Vaginal bleeding.
When should I see a doctor about my cervical cancer symptoms?
Make an appointment to see your doctor if you have any symptoms for signs of cervical cancer.
How Do You Diagnose Cervical Cancer?
We use a variety of tests to diagnose and screen for cervical cancer, including:
- CT scans or PET-CT scans
- MRI
- Pelvic exam or biopsy
- Ultrasound
How Do You Treat Cervical Cancer?
Treatment options for cervical cancer
Surgery for cervical cancer
Surgery is often the recommended treatment for cervical cancer.
Your doctor may advise:
- Cone biopsy (conization) — Doctors remove a larger cone-shaped piece of tissue from the cervix using the loop electrosurgical excision procedure or the cold knife cone biopsy procedure.
- Hysterectomy — If abnormal cells are found inside the opening of the cervix, your doctor may remove your uterus, including the cervix.
Radiation for cervical cancer
Radiation therapy may be used following surgery to continue to shrink the tumor.
If your cancer is advanced or you're not a good candidate for surgery, your doctor may recommend primary treatment using:
- A combination of chemotherapy and radiation therapy.
- Only radiation therapy.
A combination of these treatments may cause changes in your genitals that may make intercourse difficult. Talk to your provider if you have any questions related to sexual activity following treatment for cervical cancer.
Treatment options for human papillomavirus (HPV)
There's no cure for HPV, but high-risk HPV cells found through an abnormal Pap smear can be examined further or treated with:
- Colposcopy — A procedure to examine the cervix for precancerous cells.
- Cryotherapy — A treatment to freeze and remove precancerous cells from the cervix.
- LEEP (loop electrosurgery excision procedure) — A procedure that uses an electrical current to remove precancerous cells from the cervix.
If you're diagnosed with cervical cancer, your treatment will depend on:
- Other medical conditions.
- The size of your tumor.
- The stage of your cancer.
- Your age.
- Your desire to have children.
Your provider and other specialists will work with you to consider your options and determine a course of action.
Cervical cancer survival rates
According to the National Cancer Institute:
- The five-year relative survival rate for all people with cervical cancer is 67%.
- When cervical cancer is diagnosed after it has spread to a distant part of the body, the five-year relative survival rate is 19%.
- When cervical cancer is diagnosed after it has spread to nearby tissues, organs, or regional lymph nodes, the five-year relative survival rate is 60%.
- When cervical cancer is diagnosed at an early stage, the five-year relative survival rate is 91%.
Why Choose UPMC for Cervical Cancer Care?
Through the UPMC Gynecologic Cancer Program, you have access to additional treatment options and services, including:
