What is Cervical Cancer?

Cervical cancer is cancer of the cervix (also known as the neck of the womb) which connects the womb and vagina. Cervical cancer can affect anyone with a cervix at any age but primarily at 30 - 45 years of age. It is very rare under 25 years of age. In the UK we have a very successful cervical screening programme which is estimated to save over 4,000 lives each year. Around 3,200 women are diagnosed with cervical cancer in the UK each year.

How does it develop?

Nearly all squamous cervical cancers are caused by a common sexually transmitted infection called human papillomavirus (HPV). This is why the UK government is vaccinating children at an early age before they are potentially exposed to the HPV virus (i.e. before they experience sexual activity).

Around 80% of people will come into contact with  HPV at some stage during their life, but this usually clears up on its own without the need for any treatment.

HPV is a group of viruses, of which there are more than 100 different types. It is spread through skin to skin sexual contact (so does not require penetrative sex to be transmitted).

If the body is unable to clear the virus, there is a risk of abnormal cells developing, which could become cancerous over time.

Key signs of cervical cancer - symptoms

The symptoms of cervical cancer aren’t always obvious, it may not cause any symptoms at all until it’s reached an advanced stage. Some women and people with cervixes do not experience any signs of cervical cancer at all.

This is why it’s very important that you attend all of your cervical screening appointments.

Unusual bleeding

In most cases, vaginal bleeding is the first of the cervical cancer symptoms to be noticeable. It often occurs after having sex.

Bleeding at any other time, other than your expected monthly period, is also considered unusual, this also includes bleeding after the menopause.

Other symptoms

Other signs of cervical cancer may include pain and discomfort during sex and an unpleasant smelling vaginal discharge.

The majority of people with these symptoms do not have cervical cancer, and more likely to be experiencing other conditions, such as infections, but if you have any of these symptoms, it is important to get them checked out.

Risk Factors

The fact that HPV infection is very common but cervical cancer is relatively uncommon suggests that only a very small proportion are vulnerable to the effects of an HPV infection. There appear to be additional risk factors that affect someone’s chance of developing cancer of the cervix. These include:

  • Smoking – People with a cervix who smoke are twice as likely to develop cervical cancer as those who don’t; this may be caused by the harmful effects of chemicals found in tobacco on the cells, which make the immune system less effective, and less able to clear the HPV virus from your body and more vulnerable to the effects of the virus.
  • Immunosuppression drugs – People who are on immunosuppression drugs long term (organ transplant recipients), can be at increased risk of retaining the HPV virus and developing cervical cancer.

How is it diagnosed?

You’ll be referred to a gynaecologist if the results of your cervical screening test suggest that there are abnormalities in the cells of your cervix. However, in most cases, the abnormalities do not mean you have cervical cancer.

You may also be referred to a gynaecologist if you have abnormal vaginal bleeding, or other worrying cervical cancer symptoms, such as if your GP has noticed a growth inside your cervix during an examination.

Additionally, your gynaecologist or a specialist nurse may perform a colposcopy – an examination to look for abnormalities in your cervix. During a colposcopy, a small microscope with a light source at the end (colposcope) is used. As well as examining your cervix, your gynaecologist may remove a small tissue sample (biopsy) so that it can be checked under a microscope for cancerous cells.

Cervical Cancer Treatment

Treatment for cervical cancer depends on the size of the cancer cell collection and the shape of it.

The prospect of a complete cure is good for cervical cancer diagnosed at an early stage, this decreases the further the cancer has grown into or around the cervix.

Removing abnormal cells
If your screening results show that you don’t have cervical cancer, but there are biological changes that could turn cancerous in the future, a number of treatment options are available. These include:

  • Large loop excision of the transformation zone (LLETZ) – the abnormal cells are removed under local anaesthetic.
  • Cone biopsy – the area of abnormal tissue, in the shape of a cone, is removed during surgery

There are three main types of surgery for cervical cancer:

  • Radical trachelectomy – the cervix, surrounding tissue and the upper part of the vagina are removed, but the body of the womb is left in place. This cervical cancer treatment is only a suitable if the diagnosis is made at a very early stage. In addition lymph nodes that are related to this area are sampled to check for microscopic spread.
  • Hysterectomy – the cervix and womb are removed, which is recommended for early cervical cancer, and in some cases a course of radiotherapy may follow to help prevent the cancer coming back.
  • Pelvic exenteration – a major operation that’s usually only recommended when cervical cancer returns what was thought to be a previously successful course of treatment, in which the cervix, vagina, womb, bladder, ovaries, fallopian tubes and rectum are removed.

Radiotherapy is also considered as part of cervical cancer treatment; an alternative to surgery with a similar cure rate and has the advantage of avoiding an operation when the cancer is close to the bladder or colon.

Further information and support

We have tailored information on cervical cancer for trans men, non-binary and intersex people with a cervix, which you can read here.

For further information about cervical cancer, treatment options and support, please visit Jo’s Cervical Cancer Trust.