The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on September 21, 2021.

Cervical cancer overview

Cervical cancer is the fourth most common cancer in women worldwide. With improved screening methods, the number of women with cervical cancer has decreased dramatically through the years. However, the American Cancer Society estimates 14,480 new cases of cervical cancer will be diagnosed in the United States in 2021.

What causes cervical cancer?

Cervical cancer is uncontrolled cell growth that starts in the cervix, or the passageway that connects the bottom of the uterus to the top of the vagina. It allows sperm to travel to the uterus and menstrual fluid to flow out. It also dilates during labor so the baby may pass through the birth canal.

The cervix has two sections:

  • The exocervix is the outer area, which is visible during a physical exam.
  • The endocervix, farther inside, is the opening into the uterus.

The place where these two sections of the cervix meet is called the “transformation zone”—and it’s where cancer most often starts. Precancerous cells may also develop here, which may turn into cancer. If precancerous cells are found, they may be treated to prevent cancer from forming.

Cervical cancer forms when the cells that line the cervix begin to develop abnormal changes. Over time, these mutated cells may grow out of control and form a tumor. Routine Pap screening may help detect abnormal cells in the cervix, so they’re able to be treated. Most women are advised to get a Pap test starting at age 21.

Who gets cervical cancer?

The Centers for Disease Control and Prevention estimates that more than 90 percent of all cervical cancers are caused by a human papillomavirus (HPV) infection. Not every woman who has HPV will develop a cervical tumor, though treatment with the HPV vaccine is known to help prevent cancer of the cervix.

Unlike most other cancers, cervical cancer is often diagnosed in young to middle-aged women. According to the National Cancer Institute (NCI):

  • The average age of a woman diagnosed with cancer of the cervix is 50.
  • More than one-third of new cervical cancer diagnoses are in women between 20 and 44 years old.
  • About 80 percent of all cervical cancer diagnoses are in women younger than 65.

Women are more likely to develop cervical cancer if they:

  • Use birth control pills long term
  • Have had a full-term pregnancy before age 20
  • Have had chlamydia
  • Have a mother or sister who had cervical cancer
  • Took or have a mother who took the hormonal medication diethylstilbestrol to prevent miscarriage between 1938 and 1971

Cervical cancer symptoms

Most women don’t notice symptoms in the early stages of cervical cancer, which makes early diagnosis challenging.

In later stages of cervical cancer, symptoms may include:

  • Vaginal bleeding
  • Urinary tract infection (UTI)
  • Pain in the pelvic area
  • Pain during sex

Types of cervical cancer

The two main types of cervical cancer are:

Squamous cell carcinoma accounts for about 90 percent of all cases.

Adenocarcinoma of the cervix develops in gland cells. Cervical adenocarcinoma is somewhat rare, but it has become more common in recent decades.

Some cervical tumors may involve both squamous cells and glandular cells.

Diagnosing cervical cancer

The Pap smear—also known as a Pap test—is used to diagnose cervical cancer. During a Pap smear, the doctor takes a sample of cells from the cervix with a small brush or swab. Then the sample is sent to a lab to be examined for any signs of cancer or precancer.

Physical exams may also help detect abnormalities. The doctor may use a speculum to look inside the vagina and check the ovaries and uterus by inserting two fingers while pressing down on the abdomen with the other hand.

If a Pap smear shows cell changes, additional tests may be recommended. These may include:

  • Colposcopy allows the doctor to look at the cervix through a speculum, then check for abnormal areas using a solution called acetic acid.
  • Biopsy removes a small sample of tissue to check for abnormal cells in a lab.

If a patient is diagnosed with cervical cancer after the biopsy results, doctors may recommend additional tests to determine the stage of cancer. These tests may include a computed tomography (CT) scan, positron emission tomography (PET) scan, X-ray, magnetic resonance imaging (MRI)—or a combination of these. An exam of the rectum or bladder may also be performed.

Treating cervical cancer

At Cancer Treatment Centers of America® (CTCA), our gynecological oncologists work with cervical cancer patients to design a treatment plan tailored to their specific diagnosis and needs. Treatment options for cancer of the cervix include:

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Targeted therapy
  • Immunotherapy

Clinical trials help doctors find new treatments and improve current treatments. Patients should ask their cancer care team for help finding and evaluating trials, to see whether one is the right approach. Information on current cervical cancer trials is available through the NCI database.