Cervical cancer develops in the cervix, the passageway that connects the lower part of the uterus to the vagina and, along with the vagina, forms the birth canal. This type of gynecological cancer begins with abnormal changes in healthy cells on the surface of the cervix. If left untreated, the abnormal cells may begin to grow uncontrollably, bind together and form cancerous tumors.
When cellular abnormalities in the cervix are detected early, cervical cancer can often be prevented or successfully treated. Therefore, having regular screenings, such as routine Pap smears, is the most important step a woman can take to protect herself. A Pap test can detect precancerous abnormal cells on the cervix (cervical dysplasia) as well as early-stage and advanced cervical cancer.
Cervical cancer types
The two main types of cervical cancer, which can be distinguished by the appearance of the cancerous cells when viewed under a microscope, are:
- Squamous cell carcinoma – Accounting for approximately 80% of cervical cancers, squamous cell carcinomas originate in the thin, flat, scale-like cells that line the bottom of the cervix.
- Adenocarcinoma – Accounting for approximately 20% of cervical cancers, adenocarcinomas develop in the mucus-producing glandular cells that line the upper portion of the cervix.
Some cervical tumors include both squamous cancer cells and glandular cancer cells. These relatively uncommon cancers are known as adenosquamous carcinomas. Very rarely, other types of cancer can develop in the cervix, such as small cell cancers, lymphomas and sarcomas. Another type of cervical cancer is metastatic cervical cancer, which begins in the cervix and spreads to other parts of the body.
Cervical cancer causes and risk factors
The human papillomavirus (HPV)—a common sexually transmitted infection—is the leading cause of cervical cancer. However, there are more than 200 types of HPV, and the majority are harmless and resolve on their own. Only a few high-risk strains of HPV, such as HPV-16 and HPV-18, can remain and cause healthy cells in the cervix to undergo abnormal changes that eventually cause them to become cancerous.
Usually, the body’s immune system will effectively target and destroy any type of HPV—including the high-risk strains—within a few months. However, when exposed to HPV, women who have a weakened immune system have a heightened risk of developing cervical cancer. The immune system can be weakened by:
- A primary or acquired immune deficiency
- An allergic reaction
- An autoimmune condition
- Smoking or other forms of tobacco use
- Excessive consumption of alcoholic beverages.
Cervical cancer signs and symptoms
In general, there are no early warning signs of cervical cancer. Usually, symptoms become noticeable only after the tumor progresses and spreads beyond the cervix. Some common signs of advanced cervical cancer, which can vary depending on the organs and tissues affected, include:
- Light bleeding or spotting in between menstrual periods
- Menstrual periods that are heavier than usual
- Menstrual periods that last longer than usual
- Abnormal vaginal bleeding after sexual intercourse or a pelvic examination
- Pain during sexual intercourse
- Unusual vaginal discharge
- Vaginal bleeding after menopause
- Persistent pain in the pelvis or lower back
It is important to understand that many cervical cancer symptoms can also be caused by other, less serious conditions, such as infections. Therefore, the best course of action is to promptly discuss any unusual changes with a physician who can provide a proper diagnosis and appropriate treatment if necessary.
Cervical cancer diagnosis
A cervical cancer diagnosis can be made based on changes detected in the cells of the cervix. Because these changes usually do not produce symptoms until the cancer progresses to an advanced stage, regular screenings aimed at early detection and prevention are essential. When detected early, cervical cancer is highly curable.
The diagnostic process for cervical cancer may include a:
- Pelvic examination – A medical professional will visually and manually inspect the vagina, cervix, uterus, fallopian tubes, ovaries and rectum.
- Pap smear – Using a small cone-shaped brush or tiny plastic spatula, a physician will gently collect cell samples from any abnormal areas of the cervix and vagina for microscopic evaluation by a pathologist.
- Colposcopy – A physician will gently insert a smooth, tube-shaped tool (speculum) into the vagina to hold the vaginal walls open, then use a lighted, magnifying instrument with a special lens attached to the end (colposcope) to closely examine the cervix.
- Biopsy – If any abnormalities are found in a pelvic exam, Pap smear or colposcopy, a physician may perform a colposcopy-guided cervical biopsy, cone biopsy or endocervical curettage (ECC) to remove a sample of the suspicious tissue for microscopic evaluation by a pathologist, who can confirm or rule out cervical cancer.
Cervical cancer stages
After diagnosing cervical cancer, the physician will typically order further testing, such as imaging, to determine whether the cancerous cells have spread within the cervix or to other parts of the body. The information gathered from this process, which is known as cervical cancer staging, will be used to plan treatment.
The main stages of cervical cancer are:
- Stage 0 – Precancerous abnormal cells have formed on the surface of the cervix.
- Stage 1 – Cancerous cells have advanced beyond the surface of the cervix and grown into deeper layers of cervical tissue, the uterus or nearby lymph nodes.
- Stage 2 – Cancerous cells have spread beyond the cervix and uterus but not into the lower third of the vagina or the pelvic wall.
- Stage 3 – Cancerous cells have reached the lower third of the vagina and/or the pelvic wall.
- Stage 4 – Cancerous cells have invaded the bladder or rectum and/or spread beyond the pelvis.
Cervical cancer treatment
For advanced cervical cancer that is likely to spread or has already begun to metastasize, treatment may involve a combination of surgery, radiation therapy and/or chemotherapy.
Frequently asked questions (FAQs) about cervical cancer
Although cervical cancer is highly treatable, a diagnosis can be unsettling and raise a lot of questions. While the best source of reliable information is always a trusted medical professional who can offer individualized advice, the following FAQ-type articles provide some general information that may be helpful:
- How can cervical cancer be prevented?
- What age group is most at risk for cervical cancer?
- What are precancerous cells?
- Can HPV vaccination eliminate cervical cancer?
- Should I get the cervical cancer vaccine?
- How long does it take for cervical cancer to develop?
- What are the warning signs of cervical cancer?
- What are the early signs of cervical cancer?
- What are the first symptoms of cervical cancer?
- How does cervical cancer affect the rest of the body?
- Are cervical cancer symptoms different at each stage?
- Three reasons cervical cancer is often misdiagnosed
- How treatable is cervical cancer?
- Do certain foods fight cervical cancer?
- What are the risks of cervical cancer surgery?
- Four things you should know about chemotherapy for cervical cancer
- How do I manage the side effects of cervical cancer treatment?
Benefit from world-class care at Moffitt
Moffitt’s renowned gynecological clinic offers comprehensive care for patients with cervical cancer and other gynecological tumors. Our multispecialty team includes experts in all specialties, including gynecologic oncology, radiology, pathology, radiation oncology, plastic surgery, nursing and social work. This collaborative team determines the specific needs of each patient and then uses that knowledge—along with the latest diagnostic tools, technologies and evidence-based pathways—to create a highly individualized treatment plan.
Our cervical cancer services are available to patients at every step of their cancer journey, including those who:
- Have not been diagnosed but are interested in cervical cancer screening
- Are newly diagnosed with cervical cancer
- Would like a second or third opinion regarding a cervical cancer diagnosis or treatment plan
- Are experiencing a cervical cancer recurrence and would like to consult with a new physician
- Require a complex surgical procedure
- Have other conditions that may complicate cervical cancer treatment
- Are experiencing difficulties in finding appropriate care
As a National Cancer Institute-designated Comprehensive Cancer Center, Moffitt performs extensive research and has a robust portfolio of clinical trials. We are proud of the progress we have made to date, and we continue to make great strides in redefining how cervical cancer and other gynecological tumors are diagnosed and treated.
If you have a cervical cancer diagnosis, you can request an appointment with a specialist in our gynecological clinic by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.