Cervical Cancer: Symptoms, Causes, Stages & Prevention

Cervical cancer remains one of the most common cancers affecting women worldwide, often diagnosed between the ages of 35 and 44, though it can develop earlier or later in life. Because it usually begins silently, without noticeable symptoms, many women are unaware of the risk until the disease has progressed. That is why understanding early detection, prevention, and available treatment options is so important. In this guide, we walk through cervical cancer step by step—covering its symptoms, stages, diagnosis, treatment approaches, and practical prevention strategies. 

What is Cervical Cancer?

Cervical cancer develops in the cervix, the lower part of the uterus that connects to the vagina. Most cases are caused by persistent infection with high-risk types of human papillomavirus (HPV). 

The disease usually begins with precancerous changes in cervical cells. If these abnormal cells are not detected and treated, they can gradually develop into invasive cancer over several years. 

Cervical Cancer Symptoms

Early-stage cervical cancer often causes no symptoms, which is why regular screening is critical. As the disease progresses, symptoms may include: 

• Abnormal vaginal bleeding (between periods, after intercourse, or after menopause) 

• Unusual vaginal discharge (watery, foul-smelling, or blood-tinged) 

• Pain during intercourse 

• Pelvic or lower back pain 

• Painful urination or blood in urine (in advanced stages) 

• Swelling of the legs (advanced disease) 

These symptoms may also occur due to other conditions. Consult a gynaecologist if symptoms persist. 

Cervical Cancer Causes

Cervical cancer is mainly caused by persistent infection with certain types of human papillomavirus (HPV). HPV is a common virus that spreads through sexual contact. In many cases, the body clears HPV naturally, but when high-risk types of the virus remain in the body for years, they can cause abnormal changes in the cells of the cervix. Over time, these abnormal cells may develop into cervical cancer.

Common Causes and Risk Factors of Cervical Cancer:

• Persistent infection with high-risk HPV types
• Early sexual activity
• Having multiple sexual partners
• Weak immune system
• Smoking or tobacco use
• Long-term use of birth control pills
• Having multiple pregnancies
• Lack of regular Pap smear or HPV screening tests

Cervical Cancer: Different Stages

Cervical cancer is staged using the FIGO (International Federation of Gynecology and Obstetrics) system, based on tumor size and spread. 

Stage 0: Carcinoma in Situ

Abnormal cells are confined to the surface layer of the cervix. 

Stage I: Cancer Limited to the Cervix

• IA: Microscopic cancer, detected only under a microscope. 

• IA1: Invasion =3 mm 

• IA2: Invasion >3 mm but =5 mm 

• IB: Visible tumor confined to the cervix. 

Stage II: Cancer Extends Beyond the Cervix

Cancer spreads beyond the cervix but not to the pelvic wall or lower third of the vagina. 

Stage III: Spread Within the Pelvis

Cancer reaches the lower vagina, pelvic wall, or causes kidney blockage. It may involve nearby lymph nodes. 

Stage IV: Advanced Cancer

• IVA: Spread to nearby organs (bladder or rectum) 

• IVB: Spread to distant organs (lungs, liver, etc.) 

How is Cervical Cancer Diagnosed?

Diagnosis involves screening, biopsy, and imaging. 

Screening Tests

• Pap smear: Detects precancerous or cancerous cell changes. 

• HPV DNA test: Identifies high-risk HPV strains. 

Diagnostic Procedures

• Colposcopy: Magnified examination of the cervix after abnormal screening. 

• Biopsy: Removal of cervical tissue for laboratory analysis. 

Imaging Tests

• CT scan 

• MRI 

• PET scan 

• Chest X-ray 

These help determine the extent of spread. 

Blood Tests

Used to assess overall health and organ function before treatment. 

Treatment Options for Cervical Cancer

Treatment for cervical cancer depends on the stage, tumor size, overall health, and fertility considerations. 

Surgery

Often used in early stages: 

• Conization (Cone biopsy): Removes a cone-shaped portion of abnormal tissue. 

• Radical hysterectomy: Radical hysterectomy is the removal of the uterus, cervix, surrounding tissue, and nearby lymph nodes. (Ovaries are not always removed unless medically indicated.) 

• Trachelectomy: Removes the cervix but preserves the uterus for fertility. 

Note: Laser therapy and cryosurgery are typically used for precancerous lesions, not invasive cervical cancer. 

Radiation Therapy

Uses high-energy rays to destroy cancer cells. 

• External beam radiation therapy (EBRT) 

• Brachytherapy (internal radiation) 

Often combined with chemotherapy in advanced stages. 

Chemotherapy

Uses anti-cancer drugs to kill or slow cancer cells. Commonly combined with radiation (chemoradiation). 

Targeted Therapy

Drugs such as Bevacizumab (Avastin) block tumor blood vessel growth. 

Immunotherapy

Drugs like Pembrolizumab (Keytruda) help the immune system attack cancer cells in advanced or recurrent cases. 

How Can You Prevent Cervical Cancer?

Prevention focuses on HPV vaccination, screening, and lifestyle measures. 

HPV Vaccination

The HPV vaccine protects against high-risk HPV strains. 

• Recommended at ages 11–12 

• Catch-up vaccination up to age 26 

• May be considered for adults aged 27–45 after medical consultation 

Regular Screening

• Pap smears every 3 years (ages 21–29) 

• Ages 30–65: Pap + HPV test every 5 years (preferred) or Pap alone every 3 years 

Safe Sexual Practices

• Condom use reduces (but does not eliminate) HPV risk 

• Limiting sexual partners lowers exposure risk 

Healthy Lifestyle

• Quit smoking 

• Maintain a balanced diet 

• Manage conditions like HIV properly 

Conclusion

Cervical cancer is largely preventable and highly treatable when detected early. Routine screening, HPV vaccination, and healthy lifestyle habits significantly reduce risk. Because early stages often show no symptoms, regular Pap and HPV testing are essential. 

Early diagnosis improves survival rates and expands treatment options. Awareness and proactive healthcare decisions remain the most effective tools in reducing the burden of cervical cancer. 

For expert consultation and advanced cervical cancer care, seek treatment at a trusted multispecialty hospital with experienced gynecologic oncology specialists.

Article by Dr. Renu Raina Sehgal
Chairperson - Department of Obstetrics & Gynaecology
Artemis Hospitals