Overview

What is cervical cancer? A Mayo Clinic expert explains

Learn more about cervical cancer from Mayo Clinic gynecologic oncologist Kristina Butler, M.D., M.S.

I'm Dr. Kristina Butler, a gynecologic oncologist at Mayo Clinic. In this video, we'll cover the basics of cervical cancer: What is it? Who gets it? The symptoms, diagnosis, and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. Cervical cancer happens when cells in the cervix, the lower part of the uterus that connects to the vagina, start to become abnormal. Small changes in the cell DNA tells them to multiply out-of-control, and cells accumulate in growths called tumors. Thankfully, advances in medical technology and specifically the use of Pap tests, have significantly helped us identify cervical cancer in patients earlier than ever before. What was once the most common cause of cancer death for American women is now caught sooner and therefore more curable.

Who gets it?

While it isn't perfectly clear what sparks the cervical cells to change their DNA, it is certain that human papilloma virus, or HPV, plays a role. HPV is spread by skin to skin contact often during sexual encounters. Over 85% of the general population has been exposed. But most people with HPV never develop cervical cancer. However, reducing your risk of one helps reduce your risk of the other. I recommend getting both the HPV vaccine and regular screening tests. Other risk factors for cervical cancer include multiple sexual encounters. But it only takes one to contract HPV, so it's important to always practice safe sex. A weakened immune system and also smoking are linked to higher risk. One drug called DES was popular in the 1950s as a miscarriage prevention drug. So if your mother took it while pregnant, you may have higher risk as well.

What are the symptoms?

Unfortunately, the early stages of cervical cancer generally show no signs or symptoms. And this is why we emphasize getting Pap smears every three to five years and yearly pelvic exams. Once the cancer has progressed, it can show these symptoms: Unusual vaginal bleeding, for example, after intercourse or between periods or after menopause. Watery, bloody vaginal discharge that may be heavy or have an odor. And pelvic pain or other pain can also occur during intercourse.

How is it diagnosed?

Most guidelines suggest starting regular screening for cervical cancer at age 21. And during these screenings, a provider collects cells from the cervix to be tested in the lab. HPV DNA tests examine the cell specifically for HPV that can lead to pre-cancer. A Pap test, or commonly called a Pap smear, tests the cells for abnormalities. The process of these tests are not painful but can be mildly uncomfortable. If your provider suspects cervical cancer, they may start a more thorough examination of the cervix. This may include a colposcopy, which is a special tool that shines light through the vagina into the cervix to magnify the view for your provider. During the colposcopy, your provider might take several deeper samples of cells to examine. This could include a punch biopsy that collects tiny samples of cells, or an endocervical curettage that uses a narrow instrument to take an internal tissue sample. And if after further examination, the sample tissue is worrisome, your doctor may run more tests or collect other tissue samples from deeper layers of the cells. This could use a LEEP or cone biopsy procedure to give the clearest picture possible.

How is it treated?

Treating cervical cancer isn't one-size-fits-all. Your doctor will consider the whole picture of your health and your personal preferences before making a recommendation. And this will include one or several treatment methods. For early cervical cancer, we typically treat with surgery to remove the abnormal growths. For more advanced cervical cancer, there's also chemotherapy, a drug that runs the body killing cancer cells in its path. Radiation therapy uses high-powered beams with energy focused on the cancer cells. There's also targeted drug therapy that blocks specific weaknesses present within the cancer cells. And immune therapy, a drug treatment that helps your immune system recognize cancer cells and attack them.

What now?

No one can be prepared for a cancer diagnosis. However, there are ways we can help reduce anxiety and feel more in control of the situation. Learning about the condition can make you feel more empowered and confident in the decisions about your care. So ask lots of questions and request additional resources. Find support. Ask for help from your family and friends. If you feel more comfortable expressing yourself in a support group, there are many available both online and in-person. Set goals that you can achieve and feel good about. And most importantly, take care of yourself. This time can be difficult and fatiguing. Eat well, relax and get enough rest. If you'd like to learn even more about cervical cancer, watch our other related videos or visit mayoclinic.org. We wish you well.

Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.

Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer.

When exposed to HPV, the body's immune system typically prevents the virus from doing harm. In a small percentage of people, however, the virus survives for years, contributing to the process that causes some cervical cells to become cancer cells.

You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection.

Products & Services

Symptoms

Early-stage cervical cancer generally produces no signs or symptoms.

Signs and symptoms of more-advanced cervical cancer include:

  • Vaginal bleeding after intercourse, between periods or after menopause
  • Watery, bloody vaginal discharge that may be heavy and have a foul odor
  • Pelvic pain or pain during intercourse

When to see a doctor

Make an appointment with your doctor if you have any signs or symptoms that concern you.

From Mayo Clinic to your inbox

Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Causes

Cervical cancer begins when healthy cells in the cervix develop changes (mutations) in their DNA. A cell's DNA contains the instructions that tell a cell what to do.

Healthy cells grow and multiply at a set rate, eventually dying at a set time. The mutations tell the cells to grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from a tumor to spread (metastasize) elsewhere in the body.

It isn't clear what causes cervical cancer, but it's certain that HPV plays a role. HPV is very common, and most people with the virus never develop cancer. This means other factors — such as your environment or your lifestyle choices — also determine whether you'll develop cervical cancer.

Types of cervical cancer

The type of cervical cancer that you have helps determine your prognosis and treatment. The main types of cervical cancer are:

  • Squamous cell carcinoma. This type of cervical cancer begins in the thin, flat cells (squamous cells) lining the outer part of the cervix, which projects into the vagina. Most cervical cancers are squamous cell carcinomas.
  • Adenocarcinoma. This type of cervical cancer begins in the column-shaped glandular cells that line the cervical canal.

Sometimes, both types of cells are involved in cervical cancer. Very rarely, cancer occurs in other cells in the cervix.

Risk factors

Risk factors for cervical cancer include:

  • Many sexual partners. The greater your number of sexual partners — and the greater your partner's number of sexual partners — the greater your chance of acquiring HPV.
  • Early sexual activity. Having sex at an early age increases your risk of HPV.
  • Other sexually transmitted infections (STIs). Having other STIs — such as chlamydia, gonorrhea, syphilis and HIV/AIDS — increases your risk of HPV.
  • A weakened immune system. You may be more likely to develop cervical cancer if your immune system is weakened by another health condition and you have HPV.
  • Smoking. Smoking is associated with squamous cell cervical cancer.
  • Exposure to miscarriage prevention drug. If your mother took a drug called diethylstilbestrol (DES) while pregnant in the 1950s, you may have an increased risk of a certain type of cervical cancer called clear cell adenocarcinoma.

Prevention

To reduce your risk of cervical cancer:

  • Ask your doctor about the HPV vaccine. Receiving a vaccination to prevent HPV infection may reduce your risk of cervical cancer and other HPV-related cancers. Ask your doctor whether an HPV vaccine is appropriate for you.
  • Have routine Pap tests. Pap tests can detect precancerous conditions of the cervix, so they can be monitored or treated in order to prevent cervical cancer. Most medical organizations suggest beginning routine Pap tests at age 21 and repeating them every few years.
  • Practice safe sex. Reduce your risk of cervical cancer by taking measures to prevent sexually transmitted infections, such as using a condom every time you have sex and limiting the number of sexual partners you have.
  • Don't smoke. If you don't smoke, don't start. If you do smoke, talk to your doctor about strategies to help you quit.

Cervical cancer care at Mayo Clinic

June 17, 2021

Living with cervical cancer?

Connect with others like you for support and answers to your questions in the Gynecologic Cancers support group on Mayo Clinic Connect, a patient community.

Gynecologic Cancers Discussions

carla702
Immunotherapy with Clear Cell Carcinoma- Endometrial

5 Replies Thu, Nov 10, 2022

whengzy19
Diagnosed with endometrium adenocarcinoma few days ago

28 Replies Wed, Nov 09, 2022

Becky, Volunteer Mentor
The Patient Portal—Help or Hindrance?

64 Replies Tue, Nov 01, 2022

See more discussions
  1. AskMayoExpert. Cervical cancer (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2019.
  2. Lobo RA, et al. Malignant diseases of the cervix. In: Comprehensive Gynecology. 7th ed. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed June 14, 2019.
  3. Niederhuber JE, et al., eds. Cancers of the cervix, vulva and vagina. In: Abeloff's Clinical Oncology. 6th ed. Philadelphia, Pa.: Elsevier; 2020. https://www.clinicalkey.com. Accessed June 14, 2019.
  4. Cervical cancer. Plymouth Meeting, Pa.: National Comprehensive Cancer Network. https://www.nccn.org/professionals/physician_gls/default.aspx. Accessed June 14, 2019.
  5. AskMayoExpert. Cervical cancer screening (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
  6. Palliative care. Plymouth Meeting, Pa.: National Comprehensive Cancer Network. https://www.nccn.org/professionals/physician_gls/default.aspx. Accessed June 14, 2019.