Cervical Cancer Symptoms and Diagnosis

In its early stages, cervical cancer typically has no symptoms — which is why regular screenings are essential.

If you have changes in the cells of your cervix — the narrow tube connecting the uterus to the vagina — that could lead to cervical cancer, you won't experience any symptoms.

In fact, most women don't experience any symptoms until a pre-cancer becomes an invasive cancer.

Symptoms of Cervical Cancer

When cervical cancer invades nearby tissue, the most common symptoms are:

Abnormal vaginal bleeding: This includes bleeding after having vaginal intercourse, bleeding after you've gone through menopause, and having longer or heavier menstrual periods than usual.

Unusual vaginal discharge: This may happen between your periods or after menopause. The discharge may contain some blood.

Pain during vaginal intercourse: Even without bleeding or discharge, vaginal pain may be a sign of cervical cancer.

Pap Smear for Cervical Cancer

The best way to prevent cervical cancer is to be tested regularly, according to the American Cancer Society.

The Pap smear is a simple, quick, painless test that your gynecologist or primary care doctor can perform in the office.

This test can identify pre-cancerous changes in cells before they become invasive cancer.

Doctors generally recommend Pap testing beginning at age 21. Mayo Clinic experts advise women ages 21 to 65 to get tested every 3 years.

Women ages 30 and older may be tested every 5 years if their Pap test is combined with testing for HPV (human papillomavirus), the common sexually transmitted infection that can cause cervical cancer.

If you have any of the following risk factors, your doctor may recommend more frequent tests:

• A previous cervical cancer diagnosis
• A Pap smear that showed pre-cancerous cells
• Exposure to diethylstilbestrol (DES) before birth
• HIV infection
• A weakened immune system due to organ transplant, chemotherapy, or chronic corticosteroid use

Here's what to expect during your Pap smear:

You'll be asked to take off your clothes and wear a hospital-type gown.

You'll lie on your back on an exam table with your knees bent. Your feet will rest in supports.

Your doctor will gently insert an instrument called a speculum into your vagina. This device holds the vaginal walls open so that the doctor can get a good view of your cervix. You may feel pressure as your doctor inserts the speculum.

Your doctor will collect cervical cell samples using a soft brush or other device. This is quick and usually painless.

Your doctor will transfer the cells to a special container that will be sent to a lab for testing. Your doctor will tell you when to expect the results.

HPV DNA Test

A Pap smear may be combined with an HPV DNA test, which looks for the types of HPV that are most likely to cause cervical cancer.

This test may also be done later on if Pap smear results are abnormal and your doctor decides that further testing is needed.

Cervical Cancer Diagnosis

A "positive" Pap smear means that the test detected unusual cells.

Several different positive results are possible, and a positive result doesn't necessarily mean that you have cervical cancer.

Here are some of the positive results the test may deliver, and possible actions your doctor may recommend:

Atypical squamous cells of undetermined significance (ASCUS): This means that the squamous cells that line the surface of your cervix are slightly abnormal, but may not be pre-cancerous.

Your doctor will most likely have your sample analyzed again to check for HPV. If you have HPV, your doctor will suggest more testing.

If you don't have HPV, there's no need to be concerned, say Mayo Clinic experts.

Squamous intraepithelial lesion: This means that the test may have detected pre-cancerous cells.

Low-grade results mean that pre-cancerous cells are years away from becoming cancerous. Your doctor may recommend more frequent Pap tests.

High-grade results signal a greater chance that the cells may become cancerous sooner. Additional testing will be needed soon.

Squamous cell cancer or adenocarcinoma cells: This result suggests abnormal cells that may be cancerous.

Your doctor may use a special instrument called a colposcope to more closely examine your cervix, vagina, and vulva.

In this procedure, called a colposcopy, your doctor may take a tissue sample (called a biopsy) from any abnormal tissue and send it to a lab for analysis.

Cervical Cancer Stages

"Staging" a cancer means finding out how far the cancerous cells have spread so your medical team can recommend the best treatment plan for you.

In this process, tests will determine:

• The size of the tumor
• How much it has spread to areas in and around the cervix
• Whether the cancer has spread to lymph nodes or distant organs (known as metastasis)

There are four main stages of cervical cancer (after stage 0). Many of these stages can be further broken down to provide more information about exactly how far the cancer has spread.

Here are the main stages of cervical cancer:

Stage 0: Also known as carcinoma in situ, this is a very early stage of cervical cancer. The cancer cells are located only on the surface of the cervix.

Stage I: The cancer has spread within the cervix itself, but hasn't spread anywhere else.

Stage II: The cancer has spread beyond the cervix and uterus, but hasn't spread to the walls of the pelvis or distant sites.

Stage III: The cancer has spread to the lower part of the vagina or pelvic walls. It may block the tubes that carry urine from the kidneys to the bladder, but it hasn't spread to lymph nodes or distant sites.

Stage IV: The cancer has spread to nearby organs or other parts of the body.