Cervical Cancer: Symptoms, Causes, Screening and Prevention

Cervical cancer occurs when abnormal cells in the cervix grow out of control. The cervix is the lower part of the uterus that connects to the vagina.

According to the American Cancer Society, an estimated 13,490 new cases of cervical cancer and 4,200 deaths were projected in the United States in 2026.

Early detection can significantly improve outcomes, which is why it is important to pay attention to symptoms and stay current with screening.

“An important part of screening for cancer is to see your doctor and be evaluated for any concerning symptoms,” Dr. Janco says.

In the early stages of cervical cancer, symptoms may be mild or absent.

Because early cervical cancer may not cause noticeable symptoms, regular screening is critical to detect abnormal cervical cell changes before they develop into cancer.

“Not all precancerous cervical cells will become cancerous, but some will, so it is important to detect changes and treat them, if necessary,” says Dr. Janco.

As the disease progresses, symptoms may include:

• Abnormal vaginal bleeding, including bleeding after sex
• Bleeding between menstrual periods or after menopause
• Unusual vaginal discharge, which may be watery or tinged with blood
• Heavier or longer-lasting menstrual periods than usual
• Persistent pelvic pain or pain during sex

These symptoms can also be caused by conditions other than cervical cancer, such as infections or hormonal changes, but they should always be evaluated by a healthcare provider.

In more advanced stages of cervical cancer, symptoms may become more severe and include worsening of pelvic pain, difficulty urinating or swelling in the legs. If you experience any of these symptoms, seek medical evaluation promptly.

Most cervical cancers are caused by persistent infection with high-risk HPV types.

HPVs are very common. In most cases, they do not cause serious problems. Most infections clear on their own. However, a small number can last over time. These long-lasting infections may lead to changes in cervical cells, increasing the risk of cervical cancer.

“Many people are exposed to HPV, and for most, it does not cause problems,” Dr. Janco says. “But there are important steps you can take to protect your health, including getting the HPV vaccine, staying up to date with screenings and having any unusual symptoms evaluated .”

Cervical cancer rates have dropped in the United States since the HPV vaccine became available in 2006.

The HPV vaccine is recommended through age 26 and may be given up to age 45, based on individual risk and shared decision-making. It is most effective when given in childhood or early adolescence before exposure to the virus.

“The earlier you get it, the better. It’s protective and can reduce the risk of other HPV-related cancers as well, such as anal, head and neck cancers,” Dr. Janco says.

Other risk factors for cervical cancer

• Weakened immune system (from certain illness or medications that suppress the immune system)
• Smoking
• Age (most common in women over 30)
• Factors that increase HPV exposure (multiple sexual partners, other sexually transmitted infections)
• Exposure to diethylstilbestrol (DES) before birth (DES used till 1971 to prevent miscarriage)

Following recommended cervical cancer screening is essential. Precancerous changes and early-stage cancers often do not cause symptoms. Getting screened is the best way to detect abnormalities early when they are easiest to treat.

“Your doctor can discuss with you how often you need these tests and perform them during your gynecologic exam. Depending on your prior screening and personal risk factors, you may need to be screened more often,” Dr. Janco says.

When cervical cancer is found early, before it spreads past the cervix, the 5-year survival rate is about 92%.

Cervical cancer screening is done using:

• Pap tests (Pap smears): Detect abnormal or precancerous cervical cells.

• HPV tests: Detect high-risk types of HPV that can lead to cervical cancer

A gynecologic visit may include a pelvic exam. While the pelvic exam itself is not a screening test for cervical cancer, it is important for assessing the health of the vulva and vaginal skin and the uterus and ovaries.

These screening guidelines are based on recommendations from the American College of Obstetricians and Gynecologists and the U.S. Preventive Services Task Force for people at average risk of cervical cancer:

Ages 21–29: Pap test every 3 years

Ages 30–65: Talk with your health care provider about the best screening option for you. Recommended options include:

• Primary HPV testing every 5 years
• Pap test every 3 years OR
• Co-testing (Pap + HPV) every 5 years

Age 65+: Screening may stop if prior results are normal and are not at high risk. But this decision should be discussed between the patient and their doctor. “Even if routine screening is stopped, any concerning symptoms should be evaluated,” Dr. Janco says.

Free or low-cost screening programs are available for women who are uninsured or underinsured.

If screening results are abnormal or symptoms are present, further testing may be needed. This can include:

• Colposcopy: A closer examination of the cervix using a special magnifying device
• Biopsy: Removing a small sample of tissue to check for precancerous or cancerous cells
• Imaging tests: Such as CT or MRI scans to determine if cancer has spread

Yes — cervical cancer is one of the most preventable cancers.

• HPV vaccination protects against the types of HPV most likely to cause cervical cancer.
• Routine or recommended screening helps detect abnormal cells early, before they become cancer.
• Lifestyle choices can reduce your risks, including not smoking and limiting number of sexual partners/

Treatment depends on the stage of the disease, whether it has spread and individual factors, such as overall health and fertility goals.

At Scripps, treatment for cervical cancer is individualized depending on the stage and type of cervical cancer. Treatment may include surgery, radiation, chemotherapy or a combination.

“A treatment plan for cervical cancer is individualized and depends on a patient’s diagnosis as well as other factors, such as reproductive plans and prior treatment,” Dr. Janco says.

Treatment options include:

Surgery

Various procedures can be used to remove abnormal cells or cancerous tissue, including:

• Cryosurgery, laser surgery, LEEP and cone biopsy (typically for precancerous changes or very early-stage cancer)
• Trachelectomy (removal of the cervix, which may preserve fertility)
• Hysterectomy (removal of the uterus)

Radiation therapy

• Often used for locally advanced cervical cancer
• May be combined with chemotherapy and sometimes immunotherapy

Systemic therapy (including chemotherapy, immunotherapy and targeted therapies)

• Commonly used with radiation
• May also be used for metastatic or recurrent cervical cancer

Combination therapy

Many patients receive multiple treatments for the best outcomes.

Cervical cancer rates have been declining in the U.S., largely due to screening and the HPV vaccine, which help prevent the disease or catch it early. Even so, it’s important to stay on top of your health.

Pay attention to symptoms like unusual bleeding, discharge or pelvic pain. Keep up with regular screening since early changes often have no symptoms. Along with HPV vaccination and routine care, these steps can help protect your health and lower your risk.