Cervical Cancer

Cervical cancer is found in the cervix, which is the narrow, lower part of the uterus where it connects to the upper end of the vagina. Ovarian cancer, by contrast, often originates in the fallopian tubes or the ovaries, which are reproductive organs located on each side of the uterus in the pelvis.

HPV associated cancers

The majority of cervical cancers are associated with HPV infections and are described based on how the cancer cells look microscopically:

• Squamous cell carcinoma develops in the cells of the ectocervix, or the surface of the cervix, and comprise 9 out of 10 cervical cancer diagnoses.
• Adenocarcinomas, which develop from glandular cells of the endocervix, or cervical canal, are less common.
• Adenosquamous carcinomas, sometimes called mixed carcinomas, are cervical cancers with squamous cell and adenocarcinoma features.

Non-HPV cancers

Rare tumor types that are not associated with HPV infection can arise in the cervix. These include:

• Neuroendocrine carcinomas (NECC) can arise from multiple sites, including the cervix.
• Small cell carcinoma is a very rare subtype of neuroendocrine cancer that can also arise from the cervix.
• It is possible (although very rare) for cancers that occur in other parts of the body — such as melanoma, sarcoma, or lymphoma — to develop in the cervix.

Symptoms associated with cervical cancer include:

• Abnormal vaginal bleeding, particularly bleeding after intercourse, bleeding or spotting between periods. Less commonly, people may also experience heavy or irregular periods or post-menopausal bleeding.
• Unusual vaginal discharge, which may contain blood.
• Pelvic pain or pain during sexual intercourse.
• Leg swelling.
• Problems with urination or bowel movements.
• Blood in the urine.

If you are experiencing any of these symptoms, see a healthcare professional and tell them about your concerns.

Cervical cancer is the only gynecologic cancer with effective prevention and screening tools.

• Human papillomavirus (HPV) infection is associated with almost all cervical cancers. HPV is commonly transmitted during sexual contact or sexual intercourse. Strains of the virus that are associated with cervical cancer have been identified and are specifically targeted by the HPV vaccines. The HPV vaccine can prevent cervical cancer that stems from HPV infections, and is recommended by the CDC.
• Smoking can increase the risk that an HPV infection may lead to cancerous changes in the cervix.
• A weakened immune system. Because most cervical cancer is caused by a viral infection, conditions or medications that suppress immune function can increase a person’s risk of developing HPV infection and cervical cancer. These include infections like HIV, or medications such as chronic steroid use or the use of immunosuppressive medications after an organ transplant.

If a biopsy confirms the presence of cervical cancer, further tests may be ordered to learn the extent of the cancer’s spread, or stage.

• A pelvic exam may be performed under anesthesia to evaluate the tissue adjacent to the cervix for evidence of tumor spread.
• Cystoscopy is a thin camera that can be placed in the bladder through the urethra to look for any evidence that the cancer has invaded the bladder wall.
• Proctoscopy involves an inspection of the rectum, using a lighted tube, to look for tumor involvement of the rectum.

Imaging tests may also help determine if, or how far, cervical cancer has spread:

• Chest x-ray or CT scan (computed tomography) can show if cervical cancer has spread to the lungs.
• CT scan or MRI (magnetic resonance imaging) can look for evidence of tumor involvement beyond the cervix.
• PET scan (positron emission tomography) uses a labeled sugar substance to identify possible tumor involvement of tissues such as lymph nodes. This substance collects mainly in cancer cells, and shows up in imaging. PET scans are sometimes performed at the same time as CT scans.
• Intravenous pyelogram or IVP, is an x-ray of the urinary system to evaluate for hydronephrosis, or swelling of the kidneys resulting from compression of a pelvic tumor.

Treatment of cervical cancer is determined primarily by the stage at diagnosis. The clinical stage is based on whether metastatic spread is detected using imaging tests, biopsies, and physical exams. The pathologic stage includes information obtained from surgery, including whether tumor cells are present in lymph nodes or other sites.

View the American Cancer Society’s detailed information on cervical cancer stages.

Treatment for cervical cancer largely depends on the stage. In the early stages, cervical cancer may be treated with surgery. Sometimes people additionally receive radiation or chemotherapy after surgery. In advanced stages, surgery is not recommended. Instead, most people are treated with a combination of radiation and chemotherapy. Recent studies have now demonstrated that immune therapy can also improve outcomes for people with metastatic or recurrent cervical cancer. Read more about cervical cancer treatments.

A recurrence refers to cancer that has come back after treatment. If cervical cancer recurs, a doctor will assess the location of the recurrent disease and make recommendations for treatment. In determining next steps, patients should discuss their goals for care and treatment.
Some patients may be able to participate in a clinical trial that evaluates up-and-coming treatments for cervical cancer recurrence.

The average 5-year survival rate for cervical cancer varies based on the stage at diagnosis. For early-stage disease, the 5-year overall survival may be as high as 91%. In people with regional spread to other sites in the pelvis or lymph nodes, the average 5-year survival is 60%. For people with distant spread, it is 19%.

As with every cancer diagnosis, it is important to remember that statistics are a set of trends based on observations of large groups of people and are not an individual prognosis. If you have been diagnosed with cervical cancer, talk to your medical team about your specific circumstances.

According to the American Cancer Society, in 2024, 13,820 women will find out they have invasive cervical cancer, and 4,360 women will die from cervical cancer.

For detailed information about cervical cancer, visit the American Cancer Society.

OCRA has several support programs available for those with cervical cancer, as well as their loved ones. OCRA’s Woman to Woman Peer Mentor Program matches trained survivor Mentors with gynecologic cancer patients. Woman to Woman is offered at sites across the country and is also available through our virtual national mentoring program. Request a peer Mentor through OCRA’s Woman to Woman Peer Mentor Program.

Those with cervical cancer and all gynecologic cancers are also invited to participate in OCRA’s comprehensive virtual Staying Connected Support Series. Sessions are offered on a weekly and monthly basis, and cover a wide range of topics. Registration is required. View the support series schedule and register today.

OCRA’s online support forum through Inspire provides a warm, welcoming space for patients, survivors and loved ones to talk about life with cervical cancer.