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Cervical Cancer

Cervical cancer is a neoplasm that originates from the abnormal and uncontrolled growth of cells in the cervix, the lower part that connects the uterus to the vagina.

It is, after breast cancer, the second most common cancer among women worldwide.

The main cause is infection with Human Papillomavirus (HPV), a very common virus primarily transmitted through sexual contact. In most cases, HPV infection resolves spontaneously, but in some cases it can persist and cause cellular changes that, over time, may develop into a tumor. Prevention of cervical cancer is mainly based on HPV vaccination and early diagnosis through Pap tests and HPV tests, which are essential for detecting potential precancerous lesions and intervening promptly.

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What Is Cervical Cancer?

Cervical cancer (or cancer of the uterine cervix) is a form of gynecological neoplasm that develops from the cells lining the cervix, the lower part of the uterus that connects the uterine cavity to the vagina.

The uterus is an organ of the female reproductive system with a shape similar to an inverted funnel, composed of two main parts:

  • Uterine body, the upper portion where the embryo implants during pregnancy.
  • Cervix or uterine neck, the lower part that opens into the vagina.

The cervix is divided into two regions:

  • Endocervix, the inner part lined with glandular cells.
  • Ectocervix (or exocervix), the outer part lined with squamous cells.

The junction between these two types of cells is called the transformation zone (or squamocolumnar junction), and it is precisely here that most cervical cancers arise.

Types of Cervical Cancer

The most common forms of cervical cancer are:

  • Squamous cell carcinoma – represents about 70–80% of cases and originates from the squamous cells lining the outer part of the cervix.
  • Cervical adenocarcinoma – less common (about 20–25% of cases), develops in the glands that produce mucus in the cervical canal.

Cervical cancer tends to develop slowly, progressing through precancerous lesions that can be effectively detected and treated before evolving into an invasive form.

Thanks to this gradual progression, cervical cancer is today one of the most preventable cancers, thanks to regular screening programs (Pap test and HPV test) and HPV vaccination, which significantly reduce the risk of developing the disease.

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What Are the Symptoms of Cervical Cancer?

In the early stages, cervical cancer is often asymptomatic. For this reason, early diagnosis through gynecological screening programs is essential.

When symptoms do appear, they may include:

  • Abnormal vaginal bleeding, especially outside of the menstrual cycle or after sexual intercourse (the most common symptom).
  • Pain or discomfort during sexual intercourse.
  • Persistent pelvic pain that may radiate to the back or lower limbs.
  • Unusual vaginal discharge, in terms of color, odor, or consistency.

These symptoms are not always specific to cervical cancer and can be common to other gynecological conditions, but their presence requires specialist evaluation.

Regular gynecological check-ups and adherence to screening tests (HPV test and Pap test) allow for the detection of precancerous lesions before they develop into cancer. If one or more symptoms are present, it is important to consult a gynecologist promptly for an accurate diagnosis and the initiation of the most appropriate treatment.

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How Do You Diagnose Cervical Cancer?

The diagnosis of cervical cancer can occur at a very early stage thanks to gynecological screening programs. Secondary prevention is, in fact, the main tool for detecting cellular changes before they develop into cancer.

The main screening tests are:

  • Pap test – allows the detection of cellular changes in the cervix, enabling early diagnosis of precancerous or cancerous lesions.
  • HPV test – detects the presence of Human Papillomavirus (HPV), responsible for most cervical cancers, even before it causes visible changes in the cells.

According to national guidelines, women aged 25 to 30 (not vaccinated or vaccinated after age 15) should have a Pap test every three years, while women over 30 should undergo an HPV test every five years.

If screening tests detect abnormalities, the gynecologist may prescribe further diagnostic evaluations, including:

  • Pelvic examination, to assess the morphology and consistency of the tissues.
  • Colposcopy, an examination that allows the cervix and vagina to be observed under magnification using a colposcope, identifying any suspicious areas. During the procedure, a biopsy may be performed, which involves taking a small tissue sample that is then analyzed in a laboratory (histological examination) to confirm the diagnosis.
  • Magnetic Resonance Imaging (MRI), CT scan, or PET scan, useful for determining the extent of the tumor and planning the most appropriate treatment.

Early diagnosis of cervical cancer is crucial: detecting and treating precancerous lesions helps prevent the onset of the disease and ensures a high probability of cure.

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How Do You Treat Cervical Cancer?

The treatment of cervical cancer varies depending on several factors, including the patient’s age, the stage and location of the tumor, the extent of the disease, the presence of other medical conditions, and the desire to preserve fertility.
The main treatment options include:

Surgery

Surgery is the treatment of choice in the early stages of cervical cancer. Depending on the extent of the disease, possible interventions include:

  • Conization, which involves the removal of a cone-shaped portion of cervical tissue containing the tumor lesion. It is indicated in early cases and can allow fertility preservation.
  • Radical hysterectomy, which is the complete removal of the uterus, sometimes combined with the removal of pelvic lymph nodes or other nearby structures if involved.

The goal of surgery is to completely remove the tumor while preserving organ function and the patient’s quality of life whenever possible.

Chemotherapy

Chemotherapy can be used at different stages of treatment:

  • Neoadjuvant, before surgery, to reduce tumor size and facilitate removal.
  • Adjuvant, after surgery, in combination with radiotherapy, to reduce the risk of recurrence.
  • In advanced or metastatic cases, as palliative therapy to relieve symptoms and improve quality of life.

Chemotherapy drugs work by blocking the growth and spread of cancer cells.

Radiotherapy

Radiotherapy uses high-energy radiation to destroy cancer cells. It may be indicated:

  • Before or after surgery, as a complementary treatment.
  • As an alternative to surgery, in cases where surgery is not possible.
  • In combination with chemotherapy (chemoradiotherapy), to enhance its effectiveness.

Modern radiotherapy planning allows the dose to be focused on the affected areas, minimizing side effects on healthy tissues.

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Reviewed November 2025.