Cervical cancer

Cervical cancer signs and symptoms

Precancerous changes in cervical cells rarely cause symptoms. The only way to know if there are abnormal cells that may develop into cancer is to have a cervical screening test. If early cell changes develop into cervical cancer, the most common signs include:

• vaginal bleeding between periods

• menstrual bleeding that is longer or heavier than usual

• pain during intercourse

• bleeding after intercourse

• pelvic pain

• a change in your vaginal discharge such as more discharge or it may have a strong or unusual colour or smell

• vaginal bleeding after menopause

These symptoms can be caused by other conditions but if you are worried or symptoms persist, contact your doctor. This is important for anyone with a cervix, whether you are straight, lesbian, gay bisexual or transgender.

Causes of cervical cancer

Almost all cases of cervical cancer are caused by persistent infection with some high-risk types of the human papillomavirus (HPV); this is the biggest risk factor for cervical cancer. The other main risk factor for cervical cancer is smoking.

There is some evidence that women who have taken the contraceptive pill for five years or more are at increased risk of developing cervical cancer in people with HPV. The risk is small and taking the pill has also been shown to reduce to risk of other cancers such as ovarian and uterine.

Other risk factors include:

• smoking and passive smoking

• a weakened immune system

• if your mother was prescribed diethylstilbestrol (DES), an artificial form of the female hormone oestrogen during pregnancy (between 1939 and 1971).

Around eight out of 10 women will become infected with genital HPV at some time in their lives. Most women who have the HPV infection never get cervical cancer; only a few types of the HPV result in cervical cancer.

Diagnosis of cervical cancer

If your screening test results suggest you have symptoms of cancer you will be referred to a specialist for further tests.

The usual tests to diagnose cervical cancer are:

After a diagnosis of cervical cancer

After finding out you have cervical cancer, you may feel shocked, anxious, upset or confused. These are all normal responses. Everyone reacts differently and there is no right way to feel. You may find it helpful to talk to family and friends about your feeling. Talk about your treatment options with your doctor and seek as much information as you need.

Find out more information:

Treatment for cervical cancer

Treatment Team

• GP (General Practitioner) -

  looks after your general health and works with your specialists to coordinate treatment.

• Gynaecological oncologist -

  diagnoses and treats cancers of the female reproductive system

• Radiation oncologist -

  prescribes and coordinates radiation therapy treatment.

• Medical oncologist -

  prescribes and coordinates the course of chemotherapy.

• Cancer care coordinators -

  coordinate your care, liaise with the multidisciplinary team and support you and your family throughout treatment.

• Dietitian -

  recommends an eating plan to follow while you are in treatment and recovery.

• Other allied health professionals -

  such as social workers, pharmacists, and counsellors

Screening for cervical cancer

The Pap smear test has changed to the new Cervical Screening Test.

The incidence and mortality rates due to cervical cancer have halved in Australia since the introduction of the National Cervical Screening Program in 1991. The program offered a free Pap smear test every two years to women between the ages of 18 and 70.

As of 1 December 2017, the Pap smear test has been replaced with the new Cervical Screening Test. Under the new program, most women aged 25-74 will be tested every five years. If you have previously had a Pap smear test, you should have your first HPV test two years after your last Pap test. If you have a negative HPV result, you can wait five years before your next screening test. The changes recognise the introduction in 2006 of a vaccine against specific strains of HPV. This will be part of the renewal of the National Cervical Screening Program. The new screening program is designed to work together with the HPV vaccination program. Australian children aged 12 to 13 are offered the HPV vaccine at school through the Australian Immunisation Program. The vaccine is free for everyone aged 12-25. The new screening program is designed to work together with the HPV vaccination program.

From 1 July 2022, cervical screening participants aged 25-74 have the choice to screen either by a self-collected vaginal sample or a clinician-collected sample from the cervix, accessed through a healthcare provider in both cases.

Self-collection

Self-collection is done in a private space (e.g. a bathroom) in a health clinic. A health care provider will give you a self-collection swab and explain how to collect your own cell sample. Or, if you prefer, the provider can assist you to collect the sample without using a speculum. Self-collection is only available to people who do not have any signs or symptoms of cancer.

Health provider collected

For health provider collected tests, a doctor or nurse gently inserts an instrument (called a speculum) into the vagina to widen the vaginal walls and get a clearer view of the cervix. They will then use a brush or spatula to remove some cells from the cervix. This can feel slightly uncomfortable, but usually takes only 1–2 minutes. The cell sample is then placed in a container of liquid and sent to a laboratory to check for HPV.

For further information on HPV and testing go to Cancer Council's cervical screening website.

Information on the renewed program can be found on the Australian Government Department of Health's screening website. Australia is set to be the first country to eliminate cervical cancer as a public health issue which is why it is so important to have the Cervical Screening Test.

To learn more about eliminating cervical cancer as a public health issue click here to watch the video.

Preventing cervical cancer

HPV vaccine

This is a vaccine against specific types of HPV that cause almost all cervical cancers. Gardasil 9 has been developed to protect against nine types of HPV which cause around 90% of cervical cancers. Through the National Immunisation Program, most girls and boys girls in Australia aged 12-13 and under will receive the HPV vaccine in school-based programs. The vaccine is free for everyone aged 12-25 and is given as one injection.

Find out more about the HPV vaccine here.

Having the HPV vaccine does not mean that you should not have regular Cervical Cancer Screening Tests. If you have been vaccinated against HPV, you should have your first screening at age 25 and then every five years. For more information go to Cancer Council's cervical screening page.

Prognosis for cervical cancer

It is not possible for a doctor to predict the exact course of a disease, as it will depend on each person's individual circumstances. However, your doctor may give you a prognosis, the likely outcome of the disease, based on the type of cervical cancer you have, the test results, the rate of tumour growth, as well as your age, fitness and medical history.

Cervical cancer can be effectively treated when it is found early. Most women with early cervical cancer will be cured.

Treatment for cervical cancer may make it more difficult, or impossible, to become pregnant. If fertility is important to you, talk to you doctor before treatment commences.