Signs of Cervical Cancer

Cervical cancer is one of the most preventable forms of cancer. Almost all cervical cancer cases are caused by certain types of human papillomavirus (HPV)—types that are largely vaccine-preventable. And early detection methods are highly effective at catching pre-cancerous changes to the cervix before they get more serious.

However, this doesn't mean that the risk of cervical cancer has vanished. In the US each year, an estimated 13,000 new cases are diagnosed and over 4,000 people will die from the disease.

Early cervical cancer doesn't necessarily produce symptoms, which makes it important to know the signs of the cancer for early detection. The symptoms that are described with cervical cancer usually come with advanced disease. Here are the cervical cancer signs experts say to be aware of.

What Is Cervical Cancer?

Cervical cancer develops when cells on your cervix, which is the very bottom part of your uterus, mutate. Nearly all cases of cervical cancer are caused by an HPV infection. HPV is the most common sexually transmitted infection (STI); almost 42 million Americans have the virus.

Most times the virus will go away on its own within two years without health problems. However, certain types of HPV can lead to cancer of the cervix (as well cancer of the mouth, throat, anus, and penis).

Cervical cancer is the fourth most common cancer in women globally. It used to be the leading cause of cancer death for women in the US, but routine screenings have dramatically decreased its numbers in the US.

The overall five-year survival rate for cervical cancer is 67%, but this number jumps to 92% when the cancer is detected at the earliest, most treatable stages. Treatment becomes more complicated when cancer is more advanced. Depending on how advanced the illness is, you might need surgery, radiation, chemotherapy, immunotherapy, or a combination of treatments.

Cervical Cancer Detection

Cervical cancer is easy to detect through testing, even at the earliest stages. Your healthcare provider takes a sample of cells from your cervix and sends them to a lab for analysis, an exam more commonly known as a Pap smear. The test can even identify precancerous cell changes on the cervix that might become cervical cancer if they are not treated appropriately.

While healthcare providers are adept at spotting cervical cancer, detecting it yourself is a lot more complicated. There is no self-exam to check for disease. Cancer in the cervix develops slowly and silently. Without routine testing, you might not have a clue what's going on with your body. Symptoms only show up when the disease is quite advanced.

Early Warning Signs

At its earliest stages, cervical cancer typically has no symptoms at all.

The fact that cervical cancer doesn't make its presence known until its later stages means that staying on top of your regular health care is essential. Just because your cervix isn't bothering you doesn't mean that there isn't a chance something is wrong.

"It is typical for patients to not experience any symptoms related to their cervical cancer until advanced disease is present," Kristen Kelley, MD, an internal medicine specialist at Huntsman Cancer Institute and Hospital in Utah, told Health. "This underscores the importance of undergoing regular cervical cancer screening with human papillomavirus (HPV) testing and Papanicolaou smear ('Pap smear') exams for early detection and treatment of cervical cancer prior to the development of symptoms."

Symptoms of Advanced Cervical Cancer

For cervical cancer to result in symptoms noticeable to the you, the cancer must be large enough, according to Dr. Kelley. If cancer develops into sizable lesions or tumors, you may start to notice the hallmark symptoms.

Vaginal Bleeding

Unusual vaginal bleeding is a common symptom of advanced cervical cancer, according to Dr. Kelley. "Cancerous tissue is often friable, meaning it is fragile and bleeds easily," Dr. Kelley explained. "The blood vessels that form are abnormal and are prone to bleeding. Invasion into surrounding normal tissue can also cause damage and bleeding."

Some examples of bleeding related to cervical cancer are:

• Blood spots or light bleeding between or following periods
• Menstrual bleeding that is longer and heavier than usual
• Bleeding after intercourse, douching, or a pelvic examination
• Bleeding after menopause

While any bleeding other than normal menstrual bleeding should get your attention, it doesn't automatically mean you have cancer.

Other reasons for vaginal bleeding include STIs or endometriosis. Your healthcare provider can help you get appropriate treatment for any type of unusual bleeding.

Unusual Vaginal Discharge

Most times, vaginal discharge is perfectly normal. Your cervix and vagina are lined with mucus membranes. The membranes produce the typical vaginal discharge that keeps the delicate tissues protected, as well as provide lubrication during sexual activity.

A disruption to the reproductive system can change the appearance, consistency, or odor of discharge. This includes cervical cancer, but any kind of infection, including yeast infections, can affect discharge as well.

Changes in your discharge that could point to cervical cancer include:

• Increased discharge
• Discharge that doesn't stop
• Watery discharge that is heavy and has a foul odor or contains blood (might be pale red, pink, or brown)

Pelvic Pain

"When cancer is advanced and has spread outside the uterus and into the pelvis or abdominal cavity, pain is often associated," Dr. Kelley said. The pain can be described as pelvic heaviness or abdominal bloating.

Keep in mind that there are many possible explanations for abdominal pain other than cervical cancer, including injury or infection. But you should speak to your healthcare provider about new or worsening pain as soon as possible.

Pain During Sex

The pain might also come during sex. That's because cervical cancer can cause inflammation and damage to the cervix or surrounding vaginal tissue, according to Dr. Kelley.

Contact to the tumor or the surrounding affected area with a penis, finger, or sex toy might result in new or unusual discomfort. Of course, there are other causes for painful sex, including vaginal infections, endometriosis, and changes due to childbirth or menopause, but your healthcare provider can figure out the cause and offer any necessary treatment.

Symptoms of Even More Advanced Cervical Cancer

It is possible for cervical cancer to spread to the vagina, lymph nodes, bladder, intestines, lungs, bones, and liver. When this happens, the symptoms may be more severe depending on the tissues and organs to which the disease has spread. These symptoms can include:

• Back pain
• Bone pain or fractures
• Fatigue
• Leaking of urine or feces from the vagina
• Leg pain
• Loss of appetite
• Single swollen leg
• Weight loss

Of course, these issues can be related to a number of other conditions; your healthcare provider can diagnose the underlying cause of these symptoms.

Preventing Cervical Cancer

The experts emphasized that cervical cancer is preventable. Besides practicing safe sex, you can take the following steps to dramatically reduce your risk of developing cervical cancer.

Get the HPV Vaccine

The HPV vaccine is highly effective in protecting against the types of HPV that cause 90% of cervical cancers. The US Food and Drug Administration has approved it for people of all sexes between the ages of 9 and 45, though it's most effective when administered in two doses around the age of 12. If you are older, you may need a three-dose series.

Since 2006, when HPV vaccines were first used in the US, researchers have seen notable changes in the incidence of cervical cancer. "While it is difficult to fully quantify the population-level benefit of HPV vaccination, studies suggest the greatest benefit in reduction of cervical cancer incidence in women," Kathleen "Katie" Kerrigan, DO, an oncologist at St. John's Health in Wyoming, told Health.

A study of US cancer registry data showed a decline in cervical cancer rates from 1999 to 2017. "The authors concluded that this reduction in cervical cancer was driven by HPV vaccination in women ages 15-20," Dr. Kerrigan said.

Get Your Pap Smear

Keeping up with your regular cervical cancer screenings is crucial in preventing precancers from developing into cancer. The cervical cancer screening guidelines as of 2023 are:

• For ages younger than 21: No screening
• For ages 21 to 29: Pap smears every three years for those aged 21 to 29
• For ages 30 to 65, one of the following: A Pap smear only every three years, an HPV test only every five years, or an HPV test and Pap smear every five years
• For ages over 65: No screening after thorough negative test results

Regular HPV testing is recommended because knowing HPV is present tells your healthcare provider to be extra vigilant. "Routine HPV screening is very important in the gynecology clinic to identify high-risk, pre-cancerous changes on a woman's cervix," Dr. Kerrigan said. "Management of these pre-cancerous changes can help prevent the development of cervical cancer."

If you have any concerns about your health or your risk of getting cervical cancer, give your healthcare provider a call. They can help you assess your risks and advise you about what steps you can take to stay healthy.

A Quick Review

Nearly all cases of cervical cases are caused by a virus human papillomavirus (HPV). Symptoms often don't show up until the late stages of the cancer. The five-year survival rate of cervical cancer dramatically increases if it's detected early. Therefore, it's important to get regularly screened for HPV by getting regular HPV tests and/or Pap smears. Talk to your healthcare provider to find out what kind of screening method is best for you.