Cervical cancer

Symptoms of cervical cancer

The symptoms of cervical cancer aren't always obvious. It may not cause any symptoms at all until it's reached an advanced stage.

This is why it's very important that you attend all of your cervical screening appointments.

Unusual bleeding

In most cases, vaginal bleeding is the first noticeable symptom of cervical cancer. It usually occurs after having sex.

Bleeding at any other time, other than your expected monthly period, is also considered unusual. This includes bleeding after the menopause (when a woman's monthly periods stop) and in between periods.

See your GP for advice if you experience any type of unusual vaginal bleeding.

Other symptoms

Other symptoms of cervical cancer may include pain and discomfort during sex, pelvic pain and an unpleasant smelling vaginal discharge.

Advanced cervical cancer

If the cancer spreads out of your cervix and into surrounding tissue and organs, it can trigger a range of other symptoms, including:

• constipation
• blood in your urine (haematuria)
• loss of bladder control (urinary incontinence)
• bone pain
• swelling of one of your legs
• severe pain in your side or back caused by swelling in your kidneys, related to a condition called hydronephrosis
• changes to your bladder and bowel habits
• loss of appetite
• weight loss
• tiredness and a lack of energy

When to seek medical advice

You should contact your GP if you experience:

• bleeding after sex
• bleeding outside of your normal periods
• new bleeding after the menopause

Vaginal bleeding is very common and can have a wide range of causes, so it doesn't necessarily mean you have cervical cancer. Unusual vaginal bleeding is a symptom that needs to be investigated by your GP.

Causes of cervical cancer

In Northern Ireland the probability that a woman will develop cervical cancer before the age of 75 is approximately 1 in 138.

Almost all cases of cervical cancer are caused by the human papilloma virus (HPV). HPV is a very common virus that can be passed on through any type of sexual contact with a man or a woman.

There are more than 100 different types of HPV, many of which are harmless. Some types of HPV can cause abnormal changes to the cells of the cervix. This can eventually lead to cervical cancer.

Two strains of the HPV virus (HPV 16 and HPV 18) are known to be responsible for 70 per cent of all cases of cervical cancer. These types of HPV infection don't have any symptoms, so many women won't realise they have the infection.

It's important to be aware that these infections are relatively common. Most women who have them don't develop cervical cancer.

Using condoms during sex offers some protection against HPV. But it can't always prevent infection, because the virus is also spread through skin-to-skin contact of the wider genital area.

In Northern Ireland a HPV vaccine is offered to girls aged 12 and 13.

Screening for cervical cancer

Routine cervical screening has been temporarily paused due to the ongoing situation with coronavirus (COVID-19). Tests for non-routine cervical screening for example, repeat tests, will continue. Further information on paused screening programmes is available on the coronavirus (COVID-19) health services page

In Northern Ireland, cervical screening is offered to women aged between 25 and 64. It aims to prevent cervical cancer. The screening test, often called a smear test, detects early precancerous changes in cells that line the cervix.

Most changes are caused by persistent infection with high risk types of the human papillomavirus (HPV). Abnormal changes can be treated.

All women registered with a GP who fall within the screening age ranges are automatically invited to attend for a screening test.

Women aged between 25 and 49 are invited every three years and women aged between 50 and 64 are invited every five years.

Make sure your GP has your correct name and address so you receive your invitation for screening.

If you develop symptoms in between screenings you should contact your GP.

• Cervical screening

Treating cervical cancer

If cervical cancer is diagnosed at an early stage, it's usually possible to treat it using surgery. In some cases, it's possible to leave the womb in place, but it may need to be removed.

The health professional looking after your care will discuss with you the most appropriate treatment.

The surgical procedure used to remove the womb is called a hysterectomy.

Radiotherapy is an alternative to surgery for some women with early stage cervical cancer. In some cases, it's used alongside surgery.

More advanced cases of cervical cancer are usually treated using a combination of chemotherapy and radiotherapy.

Some of the treatments used can have significant and long-lasting side effects, including early menopause and infertility.

Outlook

The stage at which cervical cancer is diagnosed is an important factor in determining a woman's outlook.

The staging, given as a number from one to four, indicates how far the cancer has spread. Stage ‘one’ is early. Stage ‘four’ is late.

For women in Northern Ireland diagnosed with cervical cancer, five years after diagnosis and treatment:

• for early (stage I) disease 97.1 per cent will still be alive
• for late (stage IV) disease, the figure falls to 16.1 per cent

This is why early detection through screening is so important.

Women affected by cervical cancer

Following the success of the screening programme and the early detection of cell changes, the number of cervical cancer cases in Northern Ireland has reduced.

It's possible for women of all ages to develop cervical cancer. But the condition mainly affects sexually active women aged between 30 and 45. Cervical cancer is very rare in women under 25.

• Cervical cancer (Northern Ireland Cancer Registry website)
• Cervical cancer (NHS website)

More useful links

• How to use your health services
• Action Cancer
• Marie Curie
• Cancer Focus Northern Ireland
• Macmillan Cancer Support
• Cancer Research UK