What is cervical cancer? Cervical cancer is cancer that starts in the cervix—the lower part of the uterus. The cervix is the circular tissue structure connecting the uterus and vagina. Cancer in the cervix develops slowly, usually over several years. It starts with the growth of abnormal cells that are not cancerous. The appearance of these precancerous cells may be the first evidence of cancer that develops years later. They can be detected with a Pap test. If precancerous cells on the surface of the cervix multiply abnormally and spread deeper into the cervix, or to other tissues or organs, the disease is then called cervical cancer, or invasive cervical cancer. It’s different from cancer that begins in other parts of the uterus (such as endometrial cancer) and requires different treatment. Cervical cancer can cause abnormal vaginal bleeding and discharge and pain with sex, but most women do not notice signs or symptoms of cervical cancer until it has grown into tissues beyond the cervix. What are the different types of cervical cancer? There are different types of cervical cancer including: Squamous cell carcinoma, which begins in the cervical cells closest to the vagina. This is the most common type of cervical cancer, accounting for 90% of cases. Adenocarcinoma, which develops in the cervical gland cells closest to the uterus. It is the second most common form of cervical cancer. Mixed carcinoma, which has features of both squamous cell and adenocarcinoma. It is much less common. Who gets cervical cancer? Cervical cancer is relatively uncommon compared to other cancers, mainly due to effective screening with the Pap test. Just over 13,000 American women will get cervical cancer this year. This represents 0.7% of new cancer cases for the year. As a comparison, nearly 300,000 women will develop breast cancer. The most recent data for the United States also shows: The rate of new cervical cancer cases has been stable for the last 10 years. About 0.6% of women will develop cervical cancer during their lifetime. More than 65% of cases occur in women between 35 and 64 years of age. Just over 20% of cases are found in women 65 years and older. Hispanic women are most likely to get cervical cancer, followed by African Americans, American Indian/Alaskan Natives, and Caucasians. Asians and Pacific Islanders are least likely to develop cervical cancer. Women who smoke are twice as likely as nonsmokers to get cervical cancer. Can you die from cervical cancer? Cervical cancer is highly preventable with regular screening. It is also very treatable in early cervical cancer stages, when it is still confined to the cervix and uterus. Cervical cancer survival is described in terms of a 5-year relative survival rate. This rate looks at people with the same type and stage of cancer five years after diagnosis. It compares them to people of the same age and sex in the general population. The comparison shows how much cervical cancer can shorten life. When cervical cancer is only in the cervix and uterus, the 5-year relative survival is 92%. With regional spread to nearby structures, the rate is 56%. The rate drops to 17% when it has spread to distant sites, such as the bones, liver or lungs. Overall, more than 4,000 women will die from cervical cancer this year. This represents a dramatic reduction from the past. The statistic has fallen by more than 50% over the last 40 years, thanks to regular screening. It continues to trend downward, falling by 0.7% per year. How does cervical cancer affect quality of life? Health-related quality of life (HRQoL) describes how a disease affects a person’s overall well-being. It includes mental, physical and emotional health. It also includes social and sexual functioning and the ability to perform daily functions and roles. Non-health factors, such as finances, can play a role in HRQoL as well. Cancer of any kind can affect HRQoL and cervical cancer is no exception. It’s not surprising cervical cancer and its treatment affect a woman’s sex life. Research has shown women with cervical cancer tend to have a decreased interest in sex, increased fear of sex, and a negative perception of their sexuality. In women who attribute importance to sex, family and social well-being can be very low. Focusing positively on other aspects of relationship can help increase HRQoL in this area. Factors associated with a higher HRQoL in women with cervical cancer can include: Having a positive self-perceived health status, which was the number one predictor of good HRQoL in one study Living with a spouse or partner Not having any coexisting chronic conditions Not smoking Participating in leisure activities Women with these characteristics may have a better HRQoL than those who do not. Women who have radiation therapy tend to have lower HRQoL due to treatment-related side effects. These effects can persist after treatment is complete. What causes cervical cancer? Cervical cancer is almost always the result of HPV (human papillomavirus) infection. Researchers have found that select strains of the virus express two proteins that turn off tumor suppressor genes. These genes are one way the body controls cell growth and death. When they are turned off, cells can grow and divide more than they should. HPV infection of the cervix can result in cervical cells growing too much and, in some cases, this turns into cancer. However, the majority of women with HPV infection will not develop cervical cancer. So, other factors probably make cervical cancer more likely in infected women. Other risk factors for cervical cancer include: Age less than 17 years at first full-term pregnancy Family history of cervical cancer, which may indicate a genetic link Long-term use of birth control pills Previous genital herpes infection Smoking Three or more full-term pregnancies Weakened immune system Lifestyle factors may also play a role in developing cervical cancer. This includes being overweight and eating a diet low in fruits and vegetables. How are you diagnosed with cervical cancer? Having regular Pap tests is the most effective way of finding cervical cancer early. In fact, Pap tests can find abnormal cells before they become cervical cancer. Doctors find these precancerous changes far more often than actual cervical cancer. If a Pap test is abnormal, additional testing is necessary to diagnose or rule out cervical cancer. Diagnosing cervical cancer may involve: Colposcopy, which uses a lighted instrument (colposcope) to examine the cervical cells Biopsy, which takes a sample of tissue from the cervix to examine it for cancer After diagnosing cervical cancer, doctors often use imaging exams to determine the extent or stage of cancer. Cervical cancer treatment depends on the stage. Surgery is usually an option for early cervical cancers. Sometimes, doctors can remove all of very early cancers during a biopsy. In other cases, more radical surgery is necessary to remove the uterus and possibly nearby pelvic structures. Other treatment options include chemotherapy, radiation therapy, and targeted therapy. Additional cervical cancer facts Cervical cancer is one of the most preventable cancers. Doctors can screen for precancerous changes using a Pap smear. They can also test cervical cells for the presence of HPV. These tests can be done as part of a regular gynecologic exam. The frequency of screening will depend on your age, previous screening results, and your medical history. Children and adults up to age 26 can protect themselves from HPV infection by getting the HPV vaccine. Males can benefit from the vaccine as well. HPV is also responsible for anal and head and neck cancers. Plus, protecting males from infection can help prevent infections in females. January is Cervical Cancer Awareness Month. Learn more about cervical cancer at the American Cancer Society and the Centers for Disease Control and Prevention.