Cervical Cancer Signs and Symptoms

Early and Late Symptoms of Cervical Cancer

woman experiencing pelvic pain wondering about the signs and symptoms of cervical cancer
Every woman should know that signs and symptoms of cervical cancer. Istockphoto.com/Stock Photo©champja

Cervical cancer signs and symptoms vary from woman to woman, though there are often few symptoms in the early stages of the disease. For this reason, it's extremely important for women to receive regular Pap smears, as the earlier and most treatable stages of cancer can often be seen only under a microscope. What symptoms should every woman be aware of, and what later symptoms may indicate a progression or recurrence?

Importance of Recognizing the Signs of Cervical Cancer

It's important to note right away that all of the symptoms of cervical cancer can be symptoms of other conditions as well—and that these other conditions are in fact a more common cause of these symptoms. Yet, since survival rates for cervical cancer are better the earlier it is diagnosed, it's best to be on the cautious side and talk to your doctor if you experience any of these signs. On the other hand, it's important to note that cervical cancer screening with Pap smears is not 100 percent effective in detecting cervical cancer. If you are having any of these symptoms, talk to your doctor even if your Pap smear results are normal.

We have come a long way in the prevention and early detection of cervical cancer, with the death rate from the disease down almost 50 percent since 1980. Sometimes it's easy to forget that cervical cancer was once a leading cause of cancer-related deaths for women in the United States.

We are not there yet, however, and in 2018 it's estimated that 13,240 women will be diagnosed, and over 4,170 will die from the disease.

Anatomy of Cervical Cancer and Relation to Symptoms

In considering the symptoms of cervical cancer it's helpful to review exactly where the cervix is located. The cervix—also called the uterine cervix—is the lowest part of the uterus where it attaches to the vagina.

This region of the pelvis is also home to the bladder and a portion of the colon, and symptoms of disease in any of these organs can overlap with others.

Early Cervical Cancer Signs and Symptoms

The majority of the time, abnormal changes in the cervix develop over several years, although cancers have developed over shorter periods of time, even less than one year. Since cervical cells go through a series of changes in becoming cancer cells, it is possible to screen for early changes that suggest cancer may develop. During this precancerous and early cancer stage there are usually few if any symptoms.

Precancerous Cells and Carcinoma In Situ

The terminology describing precancerous cells is very confusing. Keep in mind that most of these "precancerous cells" so not become cancer cells. Abnormal cells found on a Pap smear are referred to as cervical dysplasia. These changes are given a "grade" of I to III depending on how abnormal the cells appear. Since Pap smears show a scattering of cells gathered in a scraping of the cervix, these cells are harder to evaluate than cells seen together as in a biopsy. (If you're confused about terms such as ASCUS, LGSIL, HGSIL, and AGC, learn more about  Pap smear terminology).

Abnormal cells found during a colposcopy and biopsy are termed cervical intraepithelial neoplasia (CIN). (Learn more about the differences between normal cells and cancer cells.)

The earliest stage of cervical cancer is stage 0 or carcinoma in situ. In these tumors, the cells have not yet spread beyond a region called the basement membrane and are considered noninvasive. When a cancer has spread beyond this basement membrane—when it is stage I to stage IV—it is considered an invasive cancer.

Most Common Signs and Symptoms of Cervical Cancer

Cervical cancer doesn't usually cause symptoms until the tumor it is invasive.

The term invasive doesn't mean that a cancer has spread or even that it has invaded nearby tissues, it only means that the cancer has penetrated through the basement membrane. Even stage I cervical cancer is considered invasive by this definition. The most common symptoms include bleeding, pain, and discharge (see below.)

Abnormal Vaginal Bleeding (Dysfunctional Uterine Bleeding)

Abnormal uterine bleeding is the most common first symptom of cervical cancer. This bleeding can take several forms including:

  • Abnormal uterine bleeding. Bleeding between menstrual periods is a common early symptom of cervical cancer, and can occur anywhere in a cycle. Bleeding after menopause is also of concern, considering that half of women develop cervical cancer in middle age, and 15 percent of these cancers are diagnosed after the age of 65. Postmenopausal bleeding should always be evaluated.
  • Bleeding after intercourse (post-coital bleeding). Bleeding after Intercourse—even if just a small amount—should be evaluated. Post-coital bleeding is more likely related to another condition, such as an infection, but should always prompt a visit to your doctor, even if the bleeding is light.
  • Excess menstrual bleeding. Periods that are heavier than normal or longer than normal for you should be mentioned to your doctor. Keep in mind that every woman is different. For example, periods which last 5 days could be of concern for someone whose periods usually last 2 days or for someone whose periods usually last 9 days.

This uterine bleeding is sometimes fairly light and can, at times, be easily dismissed. Make sure to talk to your doctor if you notice even a small spot of blood at a time when you are not having your period.

Pelvic Pain

Pelvic pain can be a symptom of cervical cancer but has many other possible causes as well. It's important to note that pelvic pain can also be an early symptom of ovarian cancer; a cancer which is also much easier to treat in the early stages of the disease and has been coined the "silent killer" for the lack of symptoms in the early stages. Most causes of pelvic pain, however, are benign conditions, such as menstrual-related cramps. Pelvic pain may be constant or intermittent, sharp or dully and achy, and localized or spread throughout your abdomen and back.

Pain during intercourse, also called dyspareunia could also be a symptom of cervical cancer. Discomfort during intercourse that persists should always be evaluated, both for the physical conditions that may be responsible, and for the emotional impact it may have.

Vaginal Discharge

Abnormal vaginal discharge is another possible sign of cervical cancer, though this symptom has many other (and more common) causes as well. There may or may not be an odor associated with the discharge, and the discharge may be of any color, light or heavy, intermittent or constant. Overall, vaginal discharge due to cancer tends to be reddish brown in color, but this can vary significantly.

Most women have vaginal discharge at some time, and most of the time this is related to ordinary hormonal changes. If you're concerned you can check out these tips on when to see your doctor with vaginal discharge.

Later Symptoms of Cervical Cancer

There are 4 different stages of invasive cervical cancer. The symptoms of higher stages or the progression of cervical cancer can affect many regions of the body.

Some of these symptoms may be related to the changes in metabolism associated with cancer, such as unintentional weight loss (a loss of 5 percent of body weight over a 6 to 12 month period), fatigue, and nausea.

Symptoms related to the growth of a mass in the pelvis may include back pain (which can extend into the legs). Pressure from a tumor in the pelvis may also cause swelling in one or both legs. Bowel and bladder symptoms ranging from pain with urination or bowel movements to incontinence may occur.

When cervical cancer spreads (metastasizes) to other regions of the body, symptoms may be related to the area to which it spreads. For example, bone and back pain may occur when cervical cancer spreads to bones and coughing may occur if it spreads to the lungs.

What to Do if You Have Cervical Cancer Symptoms

If you are experiencing cervical cancer symptoms, make an appointment with your healthcare provider. Most often these symptoms will be related to another, less serious condition, but cervical cancer is very treatable when caught in the early stages.

When you make your appointment, the receptionist will ask the reason for your visit. Be sure to inform him of your symptoms. This may determine how soon you should see your doctor. If you feel uncomfortable speaking to the receptionist about your symptoms, ask to speak to a nurse.

Before your appointment, write down your symptoms. Include information such as when and how often you experience the symptoms, what medications (if any) alleviate the symptoms, and how long you have had the symptoms. All of this information will help your doctor make a proper diagnosis.

Risk Factors for Cervical Cancer

Having certain risk factors may increase your risk of developing cervical cancer, but many people who develop cervical cancer do not have any obvious risk factors. If you have any of these risk factors, it may increase the chance that your symptoms are of concern, but talk to your doctor even if you don't have any these. Factors which increase the risk of cervical cancer include:

  • History of HPV infection
  • Smoking
  • Having a greater number of children (high parity)
  • A suppressed immune system (for example, from HIV or cancer chemotherapy)
  • Having intercourse at an early age
  • Having a high number of sexual partners
  • Exposure to diethylstilbestrol (DES) in utero (DES exposure is a risk for a rare form of cervical cancer called clear cell cervical cancer but has not been used in the U.S. since 1971)

Cervical Cancer Screening

As noted earlier, the advent of Pap smear screening for cervical cancer has halved the death rate from the disease since 1980. Make sure to follow the guidelines for screening, but keep in mind that these are general guidelines designed for the population as a whole. There may be reasons to have screening (or to not screen) for you as an individual that are not covered under these recommendations. It's also important to note that screening tests are meant for people who are asymptomatic—who have no symptoms of a disease. If you have any of the symptoms listed earlier, further tests may be needed beyond a screening Pap smear. If you are unsure if you need these tests, check out these guidelines for cervical cancer screening.

Diagnosing Cervical Cancer

There are a number of ways in which cervical cancer is diagnosed. Check out these tests used to diagnose cervical cancer.

A Word from Verywell

As noted above, the common symptoms of cervical cancer have many other possible causes as well. Most often, a workup will find that your symptoms are related to a different, and much less serious condition. The motto "better safe than sorry" may be the best mantra if you experience symptoms that could be early signs of any cancer.

When talking to your doctor about your symptoms, remember that medicine is not a black and white science. If you have a normal Pap smear but no explanation for your symptoms, talk to your doctor. If you continue to have symptoms which are unexplained or otherwise feel worried, ask for further tests or request a second opinion. Be your own advocate for your health care.


American Cancer Society. Key Statistics for Cervical Cancer. Updated 01/04/18. https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html

American Society of Oncology. Cervical Cancer: Symptoms and Signs. Updated 07/2017. https://www.cancer.net/cancer-types/cervical-cancer/symptoms-and-signs

National Cancer Institute. Cervical Cancer Treatment (PDQ) – Health Professional Version. Updated 01/31/17. https://www.cancer.gov/types/cervical/hp/cervical-treatment-pdq