The cervix is the lower section of the uterus. It has two parts: The endocervix (closest to the uterus) and the ectocervix (next to the vagina). Most cervical cancers start where these two parts meet.

View the Understanding Cervical Cancer online brochure.

Normal cervical cells develop precancerous changes gradually. There are two types of cervical cancer:

• squamous cell carcinoma
• adenocarcinoma

About 80% to 90% of cervical cancers are squamous cell carcinomas.

Risk Factors

Risk factors increase the odds of getting a disease but do not always mean a disease will occur. Cervical cancer risk factors include the following:

• Human papillomavirus (HPV) infection: This is the most significant risk factor. There are more than 100 types of the virus; about two thirds of all cervical cancers are caused by HPV 16 and 18.
• Sexual history: Behaviors that increase the risk of HPV infection (and thus cervical cancer risk) include sex at an early age, many sexual partners, and a partner who has had many sexual partners.
• HIV infection: HIV is the virus that causes AIDS. Because HIV damages the body’s immune system, it increases the risk for HPV infection.
• History of sexually transmitted disease (STD): Studies suggest that women who have had an STD are at greater risk for cervical cancer.
• Multiple pregnancies: Although the reasons are unclear, having many full-term pregnancies increases cervical cancer risk.
• Smoking: Cancer-causing chemicals from smoking affect more than just the lungs. Women who smoke double their cervical cancer risk.
• Diet: Diets low in fruits and vegetables may increase cervical cancer risk. Also, overweight women are more likely to develop cervical cancer.

Symptoms of Cervical Cancer

Cervical precancers and early cancers usually show no symptoms. When symptoms do occur—often if the cancer has invaded nearby tissue—these are common:

• Abnormal vaginal bleeding or discharge
• Pain or bleeding during or after intercourse
• Bleeding after douching or a pelvic exam

All of these symptoms can be caused by conditions other than cervical cancer. Therefore, regular Pap tests and pelvic exams are very important.

Early Detection and Prevention

Here are ways to prevent and detect cervical cancer:

• Get regular pelvic exams and Pap tests
• Know and report symptoms to your doctor
• Avoid controllable risk factors such as smoking
• Use condoms to protect against HIV and HPV

A vaccine is now available for women under age 26 that protects against some types of HPV infection. Ask your doctor for more information.

Diagnosis of Cervical Cancer

When diagnosing cervical cancer, a doctor performs a pelvic exam and Pap test. If the tests are abnormal or if the doctor suspects cervical cancer, these tests may be recommended:

• Colposcopy: This procedure allows doctors to see the surface of the cervix closely and clearly.
• Cervical biopsies: These procedures remove small amounts of tissue for analysis. They are usually done at the same time as a colposcopy.
• Cone biopsy: This procedure removes a cone-shaped piece of cervical tissue for analysis. It is also a way of treating precancers and early cancers.
• Endocervical curettage: This procedure uses a curette instrument to remove tissue from the endocervical canal (the area between the outer and inner part of the uterus). Tissue is then analyzed.

If cervical cancer is discovered, these imaging studies may be done to determine if the cancer has spread:

• Chest X-ray
• Computer tomography (CT) scans
• Magnetic resonance imaging (MRI) scans
• Positron emission tomography (PET) scans

If you are diagnosed with cervical cancer, consult a gynecologic oncologist. These specialists have advanced surgical and medical training in treating gynecologic cancers.

Staging and Treatment of Cervical Cancer

Staging determines the extent of a cancer and if it has spread. Cancers at varying stages have different prognoses and treatments. Treatments depend on stage, patient health, plans for childbearing, and other considerations. Methods include the following:

• Surgery
• Chemotherapy
• Radiation therapy

A patient may undergo all or a combination of these. The patient and her cancer health care team will determine the best treatment options.