Cervical cancer

Cervical cancer begins in the cervix, the narrow lower section of the uterus. It results from cells growing abnormally and potentially invading or spreading elsewhere in the body.

Signs and symptoms

In its early stages, there are usually no noticeable signs. Later, symptoms can include unusual vaginal bleeding, pelvic discomfort, or pain during sex. While bleeding after intercourse may have other causes, it can also point to cervical cancer.

United States

Over 99% of cases are tied to infection with genital human papillomavirus (HPV), though most people with HPV never develop the disease. Risk increases for those who smoke, have a weakened immune system, use birth control, began sexual activity at a young age, or have had multiple sexual partners.

Cervical cancer typically evolves from precancerous changes over a span of 10 to 20 years. About 75% of cases are squamous cell carcinomas, and 20–25% are adenocarcinomas. Diagnosis usually involves cervical screening followed by a biopsy, with medical imaging used to check if the cancer has spread beyond the cervix.

The most cost-effective public health strategy against cervical cancer is HPV vaccination. These vaccines target two to seven high-risk HPV strains and can prevent up to 90% of cervical cancers. By the end of 2024, 147 countries included the HPV vaccine in their national immunization schedules for girls, and as of 2022, 47 countries also offered it to boys. Since the vaccines don’t prevent all cervical cancers, regular screening is still recommended.

By country

Screening can detect precancerous changes, which can be treated to stop cancer from developing. Treatment options may include surgery, chemotherapy, radiation therapy, or immunotherapy. In the United States, the five-year survival rate is 69%, though outcomes depend heavily on how early the cancer is caught.

Epidemiology

Globally, cervical cancer ranks as the fourth most common cancer and the fourth leading cause of cancer death among women, with over 660,000 new cases and roughly 350,000 deaths in 2022—about 8% of all cancer cases and deaths. Nearly 90% of cases and deaths occur in low- and middle-income countries, where it accounts for 17% of all female cancers, compared to just 2% in high-income nations. In developed countries, widespread cervical screening programs have sharply reduced rates.