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Cervical Cancer

Cervical cancer is a kind of cancer that begins in the cervix, the lower end of the uterus, joining the vagina.

Many cervical cancer cases are caused by different strains of human papillomavirus (HPV). After exposure to HPV, the immune system usually stops the virus from causing damage. However, the virus lives for many years in a small fraction of people exposed, contributing to the transformation of some cervical cells into cancerous cells.

Undergoing screening tests and getting a vaccination against HPV infection can help lower the risks of cervical cancer.

The initial treatment for cervical cancer entails removing the cancer through surgery. Other options may include medications to destroy the cancerous cells, such as chemotherapy and targeted therapy. Radiation therapy is another alternative, which uses strong energy beams to kill the cells. In some cases, radiation is used together with low-dose chemotherapy.

By Able Health I Medically reviewed by Dr. Alireza Estedlal

Page last reviewed: February 2024 I Next review due: February 2026

What is cervical cancer?

Cervical cancer refers to the abnormal cell growth in the cervix that, if not treated, can invade the surrounding tissues and spread to different body parts. Squamous cell carcinoma and adenocarcinoma are the two primary types of cervical cancer. About 80 to 90 percent of all cases are squamous cell carcinoma, whereas adenocarcinoma constitutes the remaining 10 to 20 percent.

Cervical cancer is among the most prevalent types of cancers affecting women globally. In 2018, the World Health Organization (WHO) estimated up to 570,000 new cases and about 311,000 deaths from cervical cancer. The rates of occurrence and mortality differ across various regions, with bigger rates recorded in low and middle-income nations with limited access to screening tests and treatment.

Types of cervical cancer

Cervical cancer is classified depending on the kind of cell in which it originates. The major types of cervical cancer include:

  • Squamous cell carcinoma, which starts in the squamous cells, thin, flat cells lining the cervix's outer region. This type constitutes the majority of cervical cancer cases.
  • Adenocarcinoma, which originates from the column-shaped glandular cells lining the cervical canal.

Occasionally, both types of cells are responsible for cervix cancer. The cancer can also develop in other cells in the cervix in rare cases.

Signs and Symptoms of Cervical Cancer

During the early stages, cervical cancer may not cause any symptoms. But as it progresses, it might trigger signs and symptoms like:

  • Heavy menstrual bleeding that lasts longer than usual
  • Vaginal bleeding between periods, after intercourse, or after menopause
  • Vaginal discharge that appears watery or bloody and may be heavier with a foul smell
  • Pelvic pain or pain during intercourse

Cervical cancer screening: Why early detection is important

  • Cervical cancer incidence: In the UK, 1 out of 142 women will get cervical cancer at some point in life.
  • Age of diagnosis: Most cervical cancer cases are detected in women between 30 and 45 years.
  • Survival rate: 92% is the 5-year rate of survival for cervical cancer during its early stages.
  • Screening programme: The NHS provides cervical screening every 3 to 5 years for women aged between 25 and 64 years.
  • Screening effectiveness: Mostly cervical screening can help prevent about 75% of the cases.
  • Screening barriers: Unawareness, fear, embarrassment, or some cultural beliefs can stop women from going for cervical screening.

Generally, early detection of cervical cancer significantly increases the possibility of the treatment being successful and a high survival rate. Routine screening tests can thus aid in the discovery of abnormal cervix changes before developing into cancer. Screening also ensures diagnosis of the condition at its early stage when it is still curable.

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Types of cervical cancer screening tests

The two types of cervical cancer screening tests include:

  • Pap smear: Also known as a Pap test, this exam collects cervix cells for microscopic examination to look for any abnormality.
  • HPV test: This test is used to check the presence of high-risk strains of HPV, the leading cause of cervical cancer.

The ideal age to begin cervical cancer screening differs based on one's location and guidelines. But generally, specialists recommend starting screening at about 21 years old, irrespective of sexual activity. In addition, screening regularity varies and can range from 3 to 5 years for women between 21 and 65 years with normal outcomes.

What Are The Causes of Cervical Cancer?

Cervical cancers occur due to DNA alterations of the healthy cells in the cervix. DNA is responsible for instructing the cell activities, and any changes direct the cells to multiply rapidly. These cells will thrive as the healthy ones naturally die as part of the life cycle, resulting in an increased number of abnormal cells, which may aggregate into a mass known as a tumor. They might invade, damage healthy tissues, and spread to other body parts over time.

HPV, a common virus transmitted through sexual contact, is the underlying cause of many cervical cancers. In most individuals, the virus doesn't cause any problems and often disappears on its own. However, for others, the virus might alter cells, leading to cervical cancer.

What are the risk factors?

Risk factors associated with cervical cancer include:

  • Tobacco smoking: Smoking elevates the risks of developing cervical cancer. HPV infections usually last longer and don't easily go away in people who smoke.
  • High number of sex partners: The risk of acquiring HPV and, consequently, cervical cancer increase with the number of your sex partners and the number of partners your partner has had.
  • Early sexual activity: Engaging in sexual activity at an early age raise the risk of getting HPV.
  • Sexually transmitted infections (STIs): Having STIs like chlamydia, herpes, syphilis, gonorrhea, or HIV/AIDS increases the risk of developing HPV, which could cause cervical cancer.
  • Weakened immune system: Having HPV or another medical problem that weakens the immune system increases the risks of cervical cancer.
  • Exposure to diethylstilbestrol (DES): If your mother took DES medication when pregnant to avoid miscarriage, you are at risk of getting cervical cancer. The drug was used back in the 1950s and has been connected to clear cell adenocarcinoma.

What is The Connection between Cervical Cancer and HPV?

Human papillomavirus is a large number of viruses that can infect the skin as well as the mucous membranes in different body parts. Over 100 types of HPV exist, and the high-risk kinds can lead to cervical cancer. The virus is mostly passed through sexual contact involving vaginal, anal, or oral sex.

When the high-risk HPV types infect cervix cells, they can alter the DNA of these cells, causing abnormal cell multiplication and the onset of cervical cancer with time. It's, however, essential to know that not every HPV infection result in cervical cancer. Many cases of HPV resolve on their own and don't cause any damage. Even so, constant infection with high-risk kinds raises the risk of the condition.

HPV testing is essential in preventing cervical cancer and ensuring early detection. The presence of high-risk HPV types in cells of the cervix can also be discovered before any abnormal alterations are noticeable.

Usually, HPV testing is done along with a Pap smear or as the main screening technique for women aged 30 and above.


How is cervical cancer diagnosed?

If your healthcare provider suspect cervical cancer, the diagnostic process will possibly begin with a comprehensive examination of the cervix. A colposcope, a special magnifying tool, is used to look for cancerous signs.

While performing a colposcopic exam, the practitioner can remove a small cervical cell sample for more analysis in the lab. Obtaining the sample may include the following:

  • Punch biopsy: Sharp equipment is used to pinch out a tiny sample of the cervix tissue.
  • Endocervical curettage: This involves using a curet, a small spoon-like tool, or a tiny brush to scrape off a tissue sample from the cervix.

If the outcomes raise more concerns, additional diagnostic tests may be required:

  • Electrical wire loop: Also called loop electrosurgical excision procedure (LEEP), this test utilizes a thin, low-voltage electrified wire to remove a small tissue sample. This is usually performed in the medical practitioner’s office, and medicine is administered to numb the region and minimize discomfort.
  • Cone biopsy: Also known as conisation, this test enables the medical provider to remove deeper cervical cell layers for examination. This procedure is normally performed in a hospital, and medications to make you sleep may be administered so you are unaware of what is happening.


What are the treatment options for cervical cancer?

Factors like the stage, other underlying medical conditions, and personal preferences can determine the suitable treatment for cervical cancer. Typical treatment options are surgery, chemotherapy, radiotherapy, or a combination of these procedures.


For small cervical cancers that have not spread past the cervix, surgery is usually the primary treatment option. The kind of operation suitable for you will depend on the cancer stage, size, and if you wish to conceive and have children in the future.

These surgical options may include:

  • Cone biopsy: A cone biopsy may be done to take out the whole cancer. The surgery is suitable for very small cervical cancers and involves cutting out a cone-shaped section of the cervix tissue. It leaves the cervix area unaltered, making it a good option for those planning to get pregnant.
  • Trachelectomy: This is a surgery to remove the cervix. A radical trachelectomy procedure can be used to treat a small cervical cancer by removing the cervix and some nearby tissues. The uterus is usually not touched in this operation, making it possible to get pregnant.
  • Hysterectomy: This is a surgery to remove both the cervix and uterus. A radical hysterectomy can be used to treat many cervical cancers that have not grown past the cervix. It involves removal of the uterus, cervix, section of the vagina, and surrounding lymph nodes. Although a hysterectomy can typically cure cervical cancer and prevent a recurrence, removing the womb makes it impossible to get pregnant.

For microinvasive cervical cancers (those that haven't spread further), minimally invasive hysterectomy might be a treatment option. The operation involve creating tiny holes in the abdomen instead of a large incision. Individuals who undergo this surgical procedure recover quickly and remain in the hospital for a short period.

Nonetheless, some research claims that minimally invasive hysterectomy could be less effective compared to traditional hysterectomy. It is, therefore, important to talk with the doctor about the advantages and risks of this treatment if you are considering it.

Radiation therapy

Radiation therapy employs very strong beams such as X-rays or protons to destroy the cancerous cells. The therapy is usually combined with chemotherapy and used as the main treatment option for cervical cancers that have spread beyond the cervix. In addition, it may be used following surgery to reduce the risks of recurrence.

Radiation therapy can be administered in different ways:

  • External beam radiation therapy: Involves directing the radiation beam to the affected part of the body.
  • Brachytherapy: Done by placing a device containing radioactive elements inside the vagina for just a few minutes.
  • Combining both external and internal radiation.

Radiation therapy may trigger menopause in women who haven't started yet. You should, therefore, discuss options to preserve your eggs with your doctor before undergoing the treatment.


Chemotherapy utilizes powerful medications to destroy cancer cells. To treat cervical cancers that have grown past the cervix, the healthcare provider usually combines low doses of chemotherapy with radiation therapy. This helps enhance radiation effectiveness.

Higher chemotherapy doses may be used to assist in managing symptoms in severely advanced cases. The surgeon can also recommend chemotherapy before surgery to shrink the cancer.

Targeted therapy

Targeted therapy uses drugs that target and specifically attack chemicals in the cancerous cells. This treatment can kill the cancer cells by blocking the chemicals. Typically, targeted therapy is combined with chemotherapy and may be an alternative for advanced cases of cervical cancers.


Immunotherapy uses medication to help the immune system destroy the cancerous cells. The immune system attacks microorganisms and other foreign cells to fight diseases in the body. However, the cancer cells hide from the immune system in order to survive. Immunotherapy thus work by helping the immune system cells locate and eradicate the cancerous cells.

In most cases, immunotherapy is recommended when the cervical cancer has progressed and other treatment options are not effective.

Palliative care

Palliative care is specialized medical care focused on helping patients with serious diseases like cancer feel better by relieving pain or other symptoms. Doctors, nurses, and other specialists work together to provide palliative care. The aim of this team is to enhance the overall quality of life for you and your family.

In addition, palliative care experts often work with patients, their families, and the healthcare team to provide comfort. They also give more support to those who are undergoing cancer treatment.

Sometimes, palliative care is given alongside aggressive cancer treatments like chemotherapy, radiation therapy, or surgery. Integrating palliative care with such treatments can help cancer patients feel better and even live long, fulfilling lives.

What are The Significance of Nutrition and Exercise during Cervical Cancer Recovery?

Adopting a healthy lifestyle through regular exercise and proper nutrition is essential for your general well-being and can significantly aid cervical cancer recovery. The right nutrition gives the body the necessary nutrients to promote healing, sustain energy levels, and strengthen the immune system.

Cervical cancer treatment can cause various side effects, which can affect appetite and the ability to consume particular foods. Therefore, working with your practitioner or professional dietitian is crucial to creating a customized diet plan that considers your needs and any other nutritional concerns.

A properly balanced diet plan should comprise fruits, vegetables, lean proteins, whole grains, and healthy fats. In addition, drinking enough water and avoiding or limiting sugary drinks, processed foods, and too much alcohol is important.

Routine exercise during treatment and recovery from cervical cancer can help enhance physical strength, minimize fatigue, manage stress, and boost overall well-being. Before you begin your exercise program, you should discuss it with your doctor to ensure its safe and suitable for your situation.

Exercise plans may differ based on the treatment procedure and general health. Activities like walking, yoga, swimming, and mild strength training may be helpful. Also, listening to your body and adjusting the intensity and workout duration depending on how you feel is essential.

How Does Cervical Cancer Affect Fertility and Sexual Health?

Cervical cancer, as well as the treatments, can significantly affect a woman's fertility and overall sexual health. Based on the cancer stage and treatment method, there might be fertility preservation alternatives for those who plan to get pregnant in the future.

Radiation therapy and surgical treatments for cervical cancer can damage or remove reproductive organs or alter hormones, affecting fertility. Discussing the available fertility preservation options with your doctor before undergoing treatment is thus important.

In addition, cervical cancer and treatments can impact sexual health, leading to physical changes, pain and discomfort during intercourse, changes in libido, and vaginal dryness. Also, emotional and psychological factors, including body image worries or recurrence anxiety, can affect one's sexual well-being.

Having open communication with the doctor is important to address such concerns and find effective management strategies. Specialized clinics, reproductive health experts, and cancer support groups can help with resources for sexual health assistance and fertility preservation.

Coping With Cervical Cancer: Psychological and Emotional Assistance

Being diagnosed with cervical cancer can have an intense emotional effect on you and your family. Experiencing a series of emotions like anxiety, fear, anger, sadness, and confusion is usually normal. Nonetheless, managing and coping with such feelings is crucial to the treatment and healing process.

People navigating cervical cancer challenges can significantly benefit from emotional and psychological support. Assistance can be received from different resources such as support groups, doctors, mental health specialists, family members, and friends. It is also essential to speak openly regarding your feelings and worries and ask for help when necessary.

Furthermore, hospitals, community centers, or cancer support organizations can provide resources for psychological and emotional assistance. These resources include support groups, counseling services, online forums, and helplines. Generally, connecting with people who have gone through similar experiences can be comforting, validating, and encouraging.