Cervical Cancer: A Complete Guide
From prevention to treatment
- Cervical cancer is one of the most preventable cancers: there is both a vaccine and screening for it.
- A positive HPV result (HPV was found) or the word CIN on your test report does not mean cancer.
Find your starting point:
- If you are healthy and have no symptoms, start with cervical cancer screening.
- If your result is abnormal, the next step is further tests to reach a clear diagnosis.
- If you have been diagnosed with CIN, the next steps are follow-up and treatment of the precancerous changes (dysplasia).
- If cervical cancer has been confirmed, the next step is cervical cancer treatment.
- For prevention, get the HPV vaccine.
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Understanding cervical cancer and its warning signs
What is cervical cancer?
It is a cancer that starts in the cervix (the lower part of the uterus, which opens into the vagina) and is almost always linked to a persistent infection with human papillomavirus (HPV). In most cases, precancerous changes (CIN) come first.
What increases the risk of cervical cancer?
The most important factors are a persistent infection with high-risk types of HPV and not being screened regularly. Smoking, a weakened immune system (including HIV infection or medicines that suppress the immune system) and long-term use of birth control pills also contribute to a higher risk.
Cervical cancer is not known to be an inherited disease. A family history usually does not change your screening schedule; the main cause is a persistent HPV infection.
How is cervical cancer different from uterine and ovarian cancer?
These cancers start in different places (the cervix, the body of the uterus and the ovaries) and are investigated and treated in different ways. For cervical cancer, there is effective screening with the Pap test (Pap smear; in the UK, a smear test) and the HPV test.
Where and when can I get the Gardasil vaccine?
To find out the right time to get it and where it is available near you, read the full vaccine guide and ask your local doctor or health center about your own situation. Guide to HPV
From HPV infection to cancer: a process that takes years
About 9 in 10 HPV infections go away on their own within two years, cleared by the immune system.
Only a long-lasting (chronic) infection with a high-risk type that the body does not clear may lead to cell changes. If these changes are not found and followed up, they may later turn into cancer.
This process usually takes 15 to 20 years. In people with a weakened immune system, it can take as little as 5 to 10 years.
This long time span is what makes screening so effective: it gives a window of several years to find the changes and stop them.
The early stages often cause no symptoms, which is why screening matters.
- Spotting after sex: This is common and often has a non-cancerous (benign) cause, such as inflammation or cervical ectropion (what many people call a “wound” on the cervix). But because it is sometimes a sign of changes in the cervix, it is best to have it checked, especially if it keeps happening.
- Abnormal bleeding: Bleeding between periods, and especially any bleeding after menopause, should always be checked.
- Unusual discharge: Discharge that smells strong or unpleasant, contains blood, or is unusual and does not go away is worth having checked. It is often caused by an infection rather than cancer.
In most cases these symptoms have a benign (non-cancerous) cause, but it is best to have them checked. A single symptom on its own does not mean cancer.
Choosing the best path for your situation
Screening for women with no symptoms
When to be screened depends on your age. It does not depend on whether you are married or whether your periods have stopped.
“I’ve had the vaccine,” “I’ve never had penetrative sex,” “I’m no longer sexually active” or “I’ve gone through menopause”: none of these is a reason to skip screening.
An abnormal Pap test or a positive HPV test
An abnormal result does not mean cancer. Most abnormal results show mild changes, and many of these go away on their own. The next step depends on the type of result and your age, and is usually one of two things: a repeat test after some time, or a colposcopy.
If you are waiting for results: An “unclear” result means more checks are needed. It does not mean cancer has been confirmed.
Your doctor has recommended a colposcopy
Being sent for a colposcopy does not mean you have cancer.
A colposcopy is usually done without general anesthesia, as an outpatient procedure (you go home the same day).
CIN (precancerous changes) found on a biopsy
CIN is not cancer. It is a precancerous change in the cells of the cervix, and many low-grade cases go away on their own.
Low-grade changes usually only need monitoring, and higher-grade changes are usually managed with a short outpatient procedure.
After treatment: Regular follow-up means your condition is under control. It does not mean it will definitely come back.
A "wound" on the cervix: laser or freezing has been suggested
What people call a “wound” on the cervix is often benign cervical ectropion (once called “cervical erosion”). If it causes no symptoms, it usually does not need treatment.
Whether to have laser treatment is decided after the cause of the symptoms is clear and you have been checked for precancerous changes or cancer.
Confirmed cervical cancer: choosing treatment
In some early stages, it is possible to keep the uterus and preserve fertility.
After the biopsy and staging, your care team recommends the most suitable treatment.
You have the right to a second opinion: If you have been given different opinions or are still unsure, you can also ask another specialist for their opinion.
After treatment: Continuing checkups beyond 5 years does not mean the disease is still there or has come back. It is part of long-term follow-up care.
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Frequently asked questions about cervical cancer
A “wound” on the cervix and inflammation of the cervix are common and usually not cancer. Even so, it is best to have the findings checked with an exam and the relevant tests, and sometimes a colposcopy is needed for a more precise diagnosis.
- Colposcopy and biopsy: On their own, a colposcopy and a diagnostic biopsy usually do not reduce fertility.
- CIN treatment: In most cases, pregnancy is still possible and fertility is preserved.
- Early-stage cancer: In some early stages, it is possible to keep the uterus and preserve fertility.
No pill, herbal remedy or cream has been proven to treat CIN.
Traditional and herbal remedies are not a substitute for medical treatment.
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