Cervical Cancer

Cervical cancer begins in cells of the cervix, the lower part of the uterus that connects with the vagina. It often develops gradually from abnormal cell changes. Screening can identify changes before they become cancer, while diagnosis after symptoms usually involves examination, imaging and a tissue sample.

Cervical cancer may present with bleeding after sex, bleeding between periods, bleeding after menopause or persistent pelvic pain. Bleeding after sex is a very common presentation of cervical cancer, but it also has non-cancer causes. Persistent pelvic pain can occur when disease affects nearby tissues. Any unusual bleeding deserves medical assessment rather than a conclusion about its cause.

Most cervical cancers are linked to persistent infection with high-risk types of human papillomavirus, or HPV. The infection can cause cell changes over time, although an HPV infection does not mean that cervical cancer is present. Other changes, including damage to cell-control mechanisms, can allow abnormal cells to multiply and invade nearby tissue.

Cervical cell changes may remain limited to the surface or progress into deeper tissue. If cancer extends beyond the cervix, it may involve nearby pelvic structures, lymph nodes or distant organs. The team uses examination, biopsy and imaging to describe the extent and plan treatment. Earlier detection can allow treatment before wider spread.

Risk is influenced by persistent high-risk HPV infection, reduced immune function, smoking and a history of cervical cell abnormalities. Limited access to screening can also mean changes are found later. These factors do not determine an individual diagnosis; people with no obvious risk factor can still develop cervical cancer.

A cervical screening test checks for HPV and cell changes according to the screening pathway. If an abnormal result or symptom needs closer assessment, colposcopy allows the cervix to be viewed under magnification and a biopsy may be taken. A cone biopsy removes a cone-shaped sample when a larger tissue assessment is needed. Pathology confirms the diagnosis and imaging helps plan care.

Treatment depends on the tumour’s size, location, spread, cell type and your health and fertility priorities. Options may include surgery such as radical hysterectomy, radiotherapy, chemotherapy or immunotherapy. Some people receive combined treatments. The team will discuss effects on fertility, bladder and bowel function, sexual wellbeing and menopause before treatment begins.

Treatment can affect energy, bleeding, bowel or bladder habits, sex and fertility. Report new symptoms early and ask for rehabilitation, sexual-health, fertility or emotional support when relevant. Keep follow-up appointments and bring questions about activity, contraception, pregnancy planning and returning to work.

Cervical cancer or its treatment may cause bleeding, pelvic pain, urinary or bowel changes, lymphoedema, fatigue, early menopause or fertility difficulties. Seek urgent care for heavy bleeding, faintness, severe pain, fever with illness or inability to pass urine. Your treatment team can explain which symptoms need same-day advice.

HPV vaccination, recommended cervical screening, not smoking and using barrier protection can reduce risk, though none removes it completely. Screening is still useful after vaccination because vaccines do not cover every high-risk HPV type. Follow the local screening advice and attend promptly when invited.

Cervical cancer care may involve a gynaecological oncologist, pathologist, radiologist, oncology nurses and fertility or rehabilitation specialists. Ask who will coordinate your care, what the biopsy shows and how each option affects fertility and daily function. Palliative care can help with symptoms and support alongside treatment or when goals change.