Cervical Cancer

Cervical cancer usually affects women between 40 and 55 years of age, with 16,000 cases of invasive cervical cancer diagnosed annually in the United States. Pap smears are an effective screening tool.

Cervical cancers start as an abnormality of cells on the surface of the cervix. These abnormalities are not cancerous. They include dysplasia, squamous intraepithelial lesions (SIL) and carcinoma in situ. If undetected or untreated, these pre-invasive abnormalities eventually may invade normal cells of the cervix. As a result, cancer may develop, invading surrounding tissues or lymph nodes and possibly spreading to other parts of the body.

If these lesions have not invaded normal cells of the cervix, treatments may be relatively simple and straightforward.

Pre-cancerous changes of the cervix usually don't cause pain. In fact, they generally don't cause symptoms and aren't detected unless a woman has a pelvic exam and a Pap smear.

Symptoms usually don't appear until abnormal cervical cells become cancerous and invade nearby tissue. When this happens, the most common symptom is abnormal bleeding, which may start and stop between regular menstrual periods or may occur after sexual intercourse, douching or a pelvic exam. Menstrual bleeding may last longer and be heavier than usual.

Bleeding after menopause also may be a symptom of cervical cancer. Increased vaginal discharge is another symptom of cervical cancer.

Cervical cancer is diagnosed by having a pelvic exam and a Pap test.

  • Pelvic Exam — A pelvic exam is done to check a woman's vagina, uterus, bladder and rectum. The doctor feels these organs for any lumps or changes in their shape or size. To see the upper part of the vagina and the cervix, the doctor inserts an instrument called a speculum into the vagina.
  • Pap Test — For a Pap test, the doctor collects cells from the cervix and upper vagina. A medical laboratory checks for abnormal cells.

There are a number of ways to treat cervical cancer.

Loop Electrosurgical Excision Procedure (LEEP)

This simple procedure can be performed in the doctor's office under local anesthetic. An electrically charged wire loop is used to remove the outer portion of the cervix containing the abnormal tissue, which then can be examined under a microscope to confirm that no cancer remains. In the great majority of cases, women are cured after one LEEP procedure and are able to return to full activity shortly thereafter.


This is a procedure that freezes and kills the abnormal cells on the cervix. In this procedure, which is performed in the doctor's office and usually does not require an anesthetic, a silver probe that has been cooled with liquid nitrogen is placed against the cervix. This freezing kills the outer layer of cells that are abnormal on the cervix.

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Reviewed by health care specialists at UCSF Medical Center.