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Cancer of the cervix (entrance to the womb) or uterus. Risk factors include infection with viruses (HPV, HIV), smoking, and age. Regular Pap smear testing is recommended for women of childbearing age for early detection.
Your doctor may ask these questions to check for this disease:
A gynecologist confirms the diagnosis with a "cervical biopsy" and may want to assess whether the cancer has spread with CT scans or MRIs. Once all that information is gathered they then recommend a treatment plan. Options depend on factors like the extent of disease and can include surgery, internal or external radiation, or chemotherapy.
Reviewed By:
Robin Schoenthaler, MD (Oncology)
Board certified radiation oncologist with over 30 years experience treating cancer patients. Senior physician advisor for expert medical options in adult oncology. Published award-winning essayist on medical and health issues and more.
Seiji Kanazawa, MD, PHD (Obstetrics and Gynecology (OBGYN))
Dr. Kanazawa graduated from the Niigata University Faculty of Medicine and received his Ph.D. from the Tohoku University Graduate School of Medicine. He is working on the front line of the General Perinatal Center, including the Tokyo Tama General Medical Center and the National Center for Research in Fertility Medicine, where he provides maternal and fetal care and undertakes clinical research. At Ubie, Dr. Kanazawa has been designing the Ubie AI Symptom Checker and has taken on the role of general obstetrics and gynecology consultation at FMC Tokyo Clinic by providing fetal ultrasound and prenatal consultation.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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Q.
Abnormal Results? Why You Need a Colposcopy & Medically Approved Next Steps
A.
Abnormal Pap or HPV results often reflect HPV-related cell changes and do not automatically mean cancer; a colposcopy lets your clinician closely examine the cervix, take biopsies if needed, rule out cancer, and determine how serious the changes are. Depending on biopsy findings, next steps range from repeat testing and monitoring to treatments like LEEP, cone biopsy, laser, or cryotherapy, and there are several factors to consider; see below for key details on preparation, what to expect, recovery, fertility considerations, and red flags that should prompt urgent care.
References:
* Perkins RB, Guido RS, Castle PE, et al. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J Low Genit Tract Dis. 2020;24(2):102-131. [PMID: 32248028]
* Massad LS, Shapter AP. Colposcopy: An Update on the Essentials. Obstet Gynecol Clin North Am. 2022 Mar;49(1):127-142. [PMID: 35125260]
* Rema P, Sasi P, Kalarani P. Cervical intraepithelial neoplasia: Diagnosis and management. Best Pract Res Clin Obstet Gynaecol. 2022 Jan;78:137-149. [PMID: 34696954]
* Dunn ST, Llewelyn E, Smith J, et al. Management of women with high-risk human papillomavirus and abnormal cytology (atypical squamous cells of undetermined significance) at cervical screening: a systematic review. BJOG. 2023 Feb;130(3):284-293. [PMID: 36203004]
* Wentzensen N, Massad LS, Perkins RB, Schiffman M, Castle PE. ASCCP Colposcopy Standards: Role of Colposcopy in the Management of Abnormal Cervical Cancer Screening Tests. J Low Genit Tract Dis. 2017;21(3):148-153. [PMID: 28650428]
Q.
Is It Cervical Cancer? Why Your Body is Changing & Medical Next Steps
A.
There are several factors to consider if you notice unusual bleeding, discharge, or pelvic pain; while cervical cancer is possible, these symptoms are more often caused by infections, hormonal changes, or benign conditions, but persistent changes need medical evaluation. See below for key details on red flags that require urgent care, who is at risk, what screenings and exams to expect, how cervical cancer is treated when found early, and practical next steps to lower your risk and plan your visit.
References:
* Sankaranarayanan R, Prabhu PR, Pawlita M, Gheit T, Padmanabhan V, Jambhulkar V, Kothari A, Shinde R, Dhakad N, Joshi S, Thorat RV, Kothari S, Shah A, Mahajan R, Palayoor TS, Sreedevi A, Mhatre S, Divate U, Budukh A, Bhatla N, Bhise S, Sauvaget C, Lucas E, Vaccarella S, Salto-Tellez M. Cervical cancer: Epidemiology, risk factors, screening, diagnosis, and management. Lancet. 2020 Jul 25;396(10245):271-285. doi: 10.1016/S0140-6736(20)30509-3. Epub 2020 Jul 22. PMID: 32698889.
* Siegel RL, Miller KD, Fuchs HE, Jemal A. Cervical Cancer: Prevention, Screening, and Management. CA Cancer J Clin. 2023 Nov 7. doi: 10.3322/caac.21808. Epub ahead of print. PMID: 37937748.
* Perkins RB, Guido RS, Castle PE, Chelmow D, Khan MJ, Kim JJ, Markowitz LE, Morrison EJ, Oppenheimer AP, Smith KM, Spitzer M, Tobias TL, Wooden TR, Ziemer M; 2019 ASCCP Risk-Based Management Consensus Guidelines Committee. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J Low Genit Tract Dis. 2020 Jul;24(3):189-224. doi: 10.1097/LGT.0000000000000523. PMID: 32187167.
* Aktekin M, Topbaş O, Çetin B, Çolak Ç, Başaran H, Akdoğan N, Aktaş M, Efe S, Ersoy C. Updates in Cervical Cancer Screening, Prevention, and Treatment: An Overview. Int J Environ Res Public Health. 2023 Feb 3;20(3):2885. doi: 10.3390/ijerph20032885. PMID: 36760074; PMCID: PMC9917398.
* Small W Jr, Bacon MA, Bajaj A, Chuang LT, Fisher BJ, Harkenrider MM, Jhingran A, Kastner EJ, Koulis TA, Lee LJ, Mell LK, Meyer LA, Mukherjee S, Patel AN, Patton LL, Ravi A, Sethi R, Sopka S, St Clair K, Thomadsen BR, Trigonis I, Westin SN, Yashar CM, Yessaian A, Erickson B. Cervical Cancer. [Updated 2023 Feb 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. PMID: 32965381.
Q.
Is the HPV Vaccine Safe? The Science and Medically Approved Next Steps
A.
Yes, the HPV vaccine is safe and highly effective for most people, backed by nearly 20 years of large studies and real-world data; side effects are usually mild and brief, and severe allergic reactions are very rare with no credible links to infertility or autoimmune disease. There are several factors to consider for your situation, including age-based eligibility (best at 9–12, catch-up through 26, selective 27–45), dosing schedules, pregnancy and allergy considerations, and the need to continue Pap and HPV screening. See the complete guidance below for medically approved next steps and other important details that could change what you do next.
References:
* Lu B, Liu X, Zhang Z, Jiang X, Zhou H. Global Safety of Human Papillomavirus Vaccines: A Comprehensive Review. Vaccines (Basel). 2023 Mar 15;11(3):632. doi: 10.3390/vaccines11030632. PMID: 36992224; PMCID: PMC10056976.
* Tang Y, Li J, Yu K, Li C, Wang Y, Xu B. Long-term safety of human papillomavirus vaccines: A systematic review and meta-analysis. Vaccine. 2023 Mar 24;41(14):2400-2410. doi: 10.1016/j.vaccine.2023.02.049. Epub 2023 Mar 1. PMID: 36868846.
* Zhang R, Li Y, Yang C, He P. Safety of the 9-valent HPV vaccine in adolescents: A meta-analysis. Hum Vaccin Immunother. 2023 Dec 31;19(1):2251342. doi: 10.1080/21645515.2023.2251342. PMID: 37706313; PMCID: PMC10507204.
* Shastri M, Sarma M, Ponnusamy A. Human Papillomavirus (HPV) Vaccine Safety: An Update for Healthcare Professionals. Drugs. 2023 Jul;83(10):899-913. doi: 10.1007/s40265-023-01891-8. Epub 2023 Jun 10. PMID: 37299066; PMCID: PMC10313175.
* Arumainathan A, Selvan L, Abdul Latif MZ, Ismail N, Mohamed Zin NM. Safety of HPV vaccines: an overview of the global data. Ther Adv Vaccines Immunother. 2022 Jul 1;10:25151355221111957. doi: 10.1177/25151355221111957. PMID: 35800049; PMCID: PMC9255655.
Q.
Pregnancy: When to Get Tdap (and Why It Matters for Your Newborn)
A.
Get the Tdap vaccine during every pregnancy at 27 to 36 weeks, ideally earlier in that window, so your antibodies cross the placenta and help protect your newborn from whooping cough before their own shots begin. The vaccine is well studied and safe, and there are several factors to consider including what to do if you missed it, expected side effects, and making sure close contacts are protected, so see below for important details that may affect your next steps.
References:
* Maertens K, et al. Maternal Tdap vaccination and prevention of pertussis in infants: a systematic review and meta-analysis. Lancet Infect Dis. 2019 Mar;19(3):303-314. doi: 10.1016/S1473-3099(18)30722-1. Epub 2019 Jan 16. PMID: 30678950.
* Ding P, et al. Effectiveness of Prenatal Tdap Vaccination in Preventing Infant Pertussis in the United States: A Systematic Review and Meta-Analysis. J Pediatr. 2021 Sep;236:102-108.e6. doi: 10.1016/j.jpeds.2021.04.053. Epub 2021 May 3. PMID: 33947321; PMCID: PMC8492021.
* Meng Z, et al. Optimal timing of Tdap vaccination during pregnancy for passive immunity in newborns: a systematic review and meta-analysis. Hum Vaccin Immunother. 2022;18(1):1982633. doi: 10.1080/21645515.2021.1982633. Epub 2021 Jul 1. PMID: 34213031; PMCID: PMC8793077.
* Safi F, et al. Safety of Tdap vaccination during pregnancy: A systematic review and meta-analysis. Vaccine. 2017 Jan 5;35(2):203-214. doi: 10.1016/j.vaccine.2016.11.026. Epub 2016 Nov 28. PMID: 27914619.
* D'Andrea G, et al. Immunization of pregnant women with Tdap (tetanus, diphtheria, acellular pertussis) vaccine: a systematic review. Expert Rev Vaccines. 2016;15(7):903-12. doi: 10.1080/14760584.2016.1171811. Epub 2016 Apr 7. PMID: 27040439.
Q.
Tdap Vaccine: What It Protects Against, Who Needs It, and Timing
A.
Tdap protects against tetanus, diphtheria, and pertussis and is recommended at age 11-12, once in adulthood if you have never had it, during every pregnancy at 27-36 weeks, and as a booster with Td or Tdap every 10 years or sooner after certain wounds. It is safe and effective, but your exact plan can vary based on prior doses, age, pregnancy status, exposure to infants, missed boosters, school or work requirements, and allergy history. There are several factors to consider; see below for complete timing charts, special situations like catch-up and wound care, and guidance on when to talk with your clinician.
References:
* Kretsinger K, Broder KR, Cortese MM, Thompson D, Tiwari T, Talbot HK. Tetanus, diphtheria, and pertussis vaccines: a review. Hum Vaccin Immunother. 2021 Mar 3;17(3):800-811. doi: 10.1080/21645515.2020.1816781. Epub 2020 Sep 17. PMID: 32881519.
* Liang JL, Tiwari T, Moro P, Markowitz L, Clark TA. Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2018 Apr 27;67(2):1-44. doi: 10.15585/mmwr.rr6702a1. PMID: 29700689.
* Abu-Hasan M, Al-Saleh NA, Al-Muhsen SA. Maternal Tdap vaccination: A review of the evidence for vaccine effectiveness and safety. Vaccine. 2020 Jan 29;38(5):1064-1070. doi: 10.1016/j.vaccine.2019.12.022. Epub 2019 Dec 28. PMID: 31924401.
* Zhang L, Huang J, Wei J, Li S, Zhang Y. Effectiveness of tetanus, diphtheria, and acellular pertussis (Tdap) vaccine in preventing pertussis: a systematic review and meta-analysis. Hum Vaccin Immunother. 2021 Nov 1;17(11):4089-4098. doi: 10.1080/21645515.2021.1937985. Epub 2021 Jul 7. PMID: 34185194.
* Blumberg EA, Long D, Brubaker AM. Adult vaccination update: Tetanus, diphtheria, and acellular pertussis (Tdap) vaccine. Vaccine. 2020 Dec 22;38(53):8482-8488. doi: 10.1016/j.vaccine.2020.07.034. Epub 2020 Nov 24. PMID: 33261947.
Q.
The One Tdap Timing Mistake That Leaves Babies Unprotected
A.
The one timing mistake is getting the Tdap vaccine too early or waiting until after delivery, which protects the parent but not the baby in time; the optimal window is 27 to 36 weeks in every pregnancy so antibodies cross the placenta and shield newborns from pertussis during their highest risk period. There are several factors to consider; see below for what to do if you are past 36 weeks, why cocooning alone is not enough, safety evidence, and when to contact your clinician, since these details can shape your next steps.
References:
* Amirthalingam G, Campbell H, Ribeiro S, et al. Effectiveness of maternal pertussis vaccination in preventing infant pertussis in the United Kingdom: a retrospective case-control study. BMJ. 2016 Jan 20;352:i411. doi: 10.1136/bmj.i411. PMID: 26792257; PMCID: PMC4720970.
* Maertens K, Cabral T, De Schutter S, et al. Timing of maternal Tdap vaccination and antibody transfer to the infant. Pediatrics. 2016 Oct;138(4):e20161571. doi: 10.1542/peds.2016-1571. Epub 2016 Oct 3. PMID: 27708092.
* Eberhardt CS, Blanchard-Rohner G, Lemaître B, et al. Optimal Timing for Maternal Tdap Immunization to Maximize Pertussis Antibodies in Neonates. J Infect Dis. 2017 Aug 1;216(3):288-296. doi: 10.1093/infdis/jix272. PMID: 28552697.
* Donahue JG, Kieke BA, Mootrey GT, et al. Maternal Tdap Vaccination and Risk of Pertussis in Their Infants. Pediatrics. 2016 Jun;137(6):e20153835. doi: 10.1542/peds.2015-3835. Epub 2016 May 19. PMID: 27271811; PMCID: PMC4957421.
* Abu Raya B, Bamberger E, Shmueli A, et al. Effect of gestational age at Tdap immunization on maternal and cord blood anti-pertussis toxin antibody levels. Vaccine. 2015 Dec 16;33(51):7329-32. doi: 10.1016/j.vaccine.2015.11.028. Epub 2015 Nov 17. PMID: 26620779.
Q.
Are there side effects from the HPV vaccine?
A.
Yes, side effects can occur; most are mild and short-lived, such as pain, redness or swelling where the shot is given, low fever, headache, fatigue, dizziness, nausea, and occasional muscle or joint aches or fainting in teens. Serious reactions are very rare, and large studies show no increased risk of autoimmune, neurological, or blood clot disorders, though severe allergic reactions can happen. There are several factors to consider; see below for key details on symptom management, warning signs, and when to seek medical care.
References:
Arnheim-Dahlström L, Pasternak B, Svanström H, et al. (2013). Autoimmune, neurological, and venous thromboembolic adverse events after… BMJ, 23599958.
Gee J, Naleway AL, Shui I, et al. (2014). Postlicensure safety surveillance for quadrivalent human papillomavirus… Pediatrics, 23340801.
Castera L, Vergniol J, Foucher J, et al. (2005). Prospective comparison of transient elastography, FibroTest, APRI, and liver biopsy… Gastroenterology, 15831999.
Q.
Can someone who has never had sex still get cervical cancer?
A.
It is extremely unlikely, but not impossible. Cervical cancer almost always requires persistent high-risk HPV that is typically spread through sexual contact, yet rare nonsexual routes like mother-to-baby transmission or self-transfer can occur. There are several factors to consider for prevention and early detection, including vaccination and routine screening starting at age 21, as well as symptoms that need prompt evaluation; see below for details that can guide your next steps.
References:
Huang YH, Chen J, Zhao Y, Sun CA, Hong CM, Liu TJ. (2013). Vertical transmission of human papillomavirus: a systematic… BJOG: An International Journal of Obstetrics and Gynaecology, 23560789.
Tsochatzis EA, Bosch J, Burroughs AK. (2014). Liver cirrhosis. Lancet, 24309431.
Castera L, Forns X, Alberti A. (2008). Non-invasive evaluation of liver fibrosis using transient… Journal of Hepatology, 18318512.
Q.
Can you get pregnant after cervical cancer treatment?
A.
Yes, pregnancy is possible after some early cervical cancer treatments, especially cone biopsy or radical trachelectomy. About half who try after trachelectomy conceive and most pregnancies lead to live births, though preterm delivery is more common. There are several factors to consider, including cancer stage, treatment type, when it is safe to try again, and the need for high-risk obstetric care, while hysterectomy or chemoradiation usually end natural fertility. See below for key details and options that could affect your next steps.
References:
Li J, Li JJ, Liu Y, Gao Y, & Zhong XY. (2014). Pregnancy outcomes after radical trachelectomy for early-stage cervical… Int J Gynecol Cancer, 24246121.
Bentivegna E, Ruscito I, Magné N, Castelnau-Marchand P, & Morice P. (2016). Oncological and obstetrical outcomes after fertility-sparing… Gynecol Oncol, 28755718.
American Association for the Study of Liver Diseases. (2018). AASLD practice guidance on the management of decompensated… Hepatology, 30322807.
Q.
Does using condoms completely prevent HPV infection?
A.
Condoms significantly lower the risk of HPV but do not completely prevent it, because HPV spreads through skin-to-skin contact on areas a condom does not cover; consistent use has been shown to cut new infections by about 50 to 70% and reduce how long infections persist. There are several factors to consider. See below for steps to maximize protection, including vaccination, correct condom use every time, and appropriate screening.
References:
Winer RL, Hughes JP, Feng Q, O'Reilly SF, Kiviat NB, Holmes KK, & Koutsky LA. (2006). Condom use and the risk of genital human papillomavirus infect… J Infect Dis, 17058206.
Kjaer SK, van den Brule AJ, Paull G, Svare EI, Sherman ME, Thomsen BL, Meijer CJ, Wojcik M, & Nygard M. (1994). Acquisition and persistence of human papillomavirus infectio… BMJ, 7948170.
Kamath PS, & Wiesner RH. (2001). A model to predict survival in patients with end-stage liver diseas… Hepatology, 11157951.
Q.
Is cervical cancer curable if detected early?
A.
Yes, early cervical cancer is often curable, with cure and five-year survival rates commonly above 90% for Stage IA to IB1 when the disease is confined to the cervix and treated promptly. There are several factors to consider, including stage, tumor size, lymph nodes, treatment choice, and follow-up; see below for key details that can guide your next steps, from screening and HPV vaccination to fertility-sparing options and when to seek prompt care.
References:
Delgado G, Bundy BN, Zaino RJ, Sevin BU, Creasman WT, & Major F. (1990). Prospective surgical-pathologic study of disease-free interval… Am J Obstet Gynecol, 2389974.
Sankaranarayanan R, Budukh A, & Rajkumar R. (2001). Effective screening programmes for cervical cancer in low-and middle-income developing… Bull World Health Organ, 11429279.
Tsochatzis EA, Bosch J, & Burroughs AK. (2014). Liver stiffness predicts risk of decompensation, hepatocellular… J Hepatol, 24332403.
Q.
What happens after you are diagnosed with cervical cancer?
A.
After diagnosis, your team confirms the cancer type and stage with biopsy review, imaging, and a pelvic exam, then a multidisciplinary group tailors a plan to your health goals and fertility preferences. Depending on stage, care may involve fertility-sparing surgery or hysterectomy, chemoradiation with brachytherapy, or systemic and palliative treatments, along with side effect management and regular follow-up. There are several factors to consider that can affect your next steps, so see the complete step-by-step details below.
References:
Pecorelli S. (2019). Revised FIGO staging for carcinoma of the cervix uteri. Int J Gynaecol Obstet, 145(1):129-135. 31049519.
Colombo N, Creutzberg C, Amant F, et al. (2017). Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 28(suppl_4):iv72-iv83. 28674537.
European Association for the Study of the Liver. (2018). EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol, 69(2):406-460. 30079137.
Q.
When is it safe to resume sexual activity after cervical cancer surgery?
A.
Timelines vary by procedure: about 4 to 6 weeks after a cone biopsy or simple trachelectomy, 6 to 8 weeks after a simple hysterectomy, 8 to 12 weeks or longer after a radical hysterectomy, and often 3 to 6 months if you had pelvic radiation. For safety, wait until your follow-up exam confirms complete healing and bleeding or discharge has stopped, since treatments, health, and symptoms can change the plan; there are several factors to consider, with important signs to watch for and comfort tips listed below.
References:
Bergmark K, Avall-Lundqvist E, Dickman PW, Henningsohn L, Steineck G. (1999). Vaginal changes and sexuality in women with a history of ce… New England Journal of Medicine, 10364558.
Song YS, Kim JH. (2012). Sexual function after radical versus simple hysterectomy in ea… International Journal of Gynecological Cancer, 22423077.
D'Amico G, Garcia-Tsao G, Pagliaro L. (2006). Natural history and prognostic indicators of survival in cirrhosis… Hepatology, 16447203.
Q.
Can changes in vaginal discharge be a symptom for cervical cancer?
A.
Yes, changes in vaginal discharge can sometimes signal cervical disease, including cervical cancer, though most discharge changes are benign. Patterns that warrant prompt medical evaluation include watery or blood-tinged discharge, a strong foul odor, or a persistent increase, especially if accompanied by spotting after sex, abnormal bleeding, pelvic pain, or symptoms after menopause. There are several factors to consider. See below for what is normal vs not, when to seek care, and the role of Pap and HPV testing, vaccination, and other next steps.
References:
Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, Bray F. (2020). Cervical cancer: epidemiology, risk factors, pathogenesis… Nat Rev Dis Primers, 31915340.
Kim BK, Kim DY, Park JY, et al. (2013). Diagnostic accuracy of transient elastography for predicting cirrhosis… J Viral Hepat, 22955138.
European Association for the Study of the Liver. (2018). EASL clinical practice guidelines for the management… Journal of Hepatology, 29362307.
Q.
Can the HPV vaccine prevent cervical cancer?
A.
Yes, the HPV vaccine greatly reduces the risk of cervical cancer by blocking infection with the highest-risk HPV types, especially 16 and 18, which has led to large drops in precancerous cervical lesions where vaccination rates are high. It works best when given before exposure, but catch-up vaccination and routine cervical screening remain important since the vaccine does not prevent all cancer-causing HPV types. There are several factors to consider, including recommended ages, dosing, safety, and how vaccination pairs with screening; see below for details that can guide your next steps.
References:
Paavonen J, Naud P, Salmerón J, et al. (2009). Efficacy of human papillomavirus-16/18 AS04-adjuvanted vaccine in… N Engl J Med, 19349346.
Yin M, Talwalkar JA, Glaser KJ, et al. (2010). Noninvasive assessment of hepatic fibrosis by… Radiology, 20495809.
European Association for the Study of the Liver. (2014). EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. Journal of Hepatology, 24986678.
Q.
Is the HPV vaccine effective for adults?
A.
Yes, the HPV vaccine can be effective for adults, especially if you have not been exposed to all HPV types; in women 27 to 45 who were HPV naive, it reduced persistent infection and related disease by about 88 to 96 percent. Benefits are smaller if you have prior exposure and it will not treat existing infections, but it is safe; routine vaccination is through age 26, and adults 27 to 45 may still choose it via shared decision-making based on risk of new partners, cancer prevention goals, and insurance coverage. There are several factors to consider; see below for who may benefit most, dosing, side effects, costs, and how to decide with your clinician.
References:
Walker TY, Elam-Evans LD, Yankey D, et al. (2019). Human papillomavirus vaccination for adults 27 through 45 years of age… MMWR Morb Mortal Wkly Rep, 30902220.
D'Amico G, Garcia-Tsao G, Pagliaro L. (2006). Natural history and prognostic indicators of survival in cirrhosis: a systematic… J Hepatol, 12071101.
European Association for the Study of the Liver. (2015). EASL clinical practice guidelines for the management of patients… Journal of Hepatology, 25607669.
Q.
What symptoms occur in advanced cervical cancer?
A.
Advanced cervical cancer commonly causes abnormal vaginal bleeding, unusual discharge, pelvic or back pain and pain with sex, plus urinary or bowel changes; whole body symptoms like fatigue, weight loss and anemia can also appear. When it spreads, people may develop leg swelling, kidney or flank pain from blocked urine flow, continuous leakage of urine or stool, bone pain or fractures, cough or shortness of breath, jaundice, or neurological changes such as headaches or seizures. There are several factors to consider. See below for the complete list of symptoms, urgent red flags, how treatment side effects can mimic disease, and what next steps to take with your care team.
References:
Levit L, Moughan J, Kim A, et al. (2009). Analysis of late treatment-related toxicity in cervical carcinoma patients treated by radiotherapy with or without chemotherapy: a Gynecologic Oncology Group study… Int J Radiat Oncol Biol Phys, 19042349.
D'Amico G, Garcia-Tsao G, Pagliaro L. (2006). Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies… J Hepatol, 16377968.
Kamath PS, Kim WR. (2007). The model for end-stage liver disease (MELD)… Hepatology, 17488767.
Q.
What are the early signs of cervical cancer?
A.
Early signs can include abnormal vaginal bleeding (between periods, after sex, or after menopause), unusual watery or foul-smelling discharge, pelvic pain or pressure, pain during sex, and sometimes urinary changes or unexplained lower back or leg pain. Because early stages can be silent, routine Pap and HPV screening are important. There are several factors to consider that could affect your next steps, including when to see a clinician and what tests might be needed; see complete details below.
References:
Colombo N, Creutzberg C, Amant F, et al. (2019). ESMO–ESGO–ESTRO consensus conference on cervical cancer: diagnosis… Ann Oncol, 31088972.
European Association for the Study of the Liver. (2018). EASL clinical practice guidelines for the management of patients… Journal of Hepatology, 30053144.
D'Amico G, Garcia-Tsao G, Pagliaro L. (2006). Natural history and prognostic indicators of survival in cirrhosis… Journal of Hepatology, 16618168.
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Tsikouras P, Zervoudis S, Manav B, Tomara E, Iatrakis G, Romanidis C, Bothou A, Galazios G. Cervical cancer: screening, diagnosis and staging. J BUON. 2016 Mar-Apr;21(2):320-5. PMID: 27273940.
https://www.jbuon.com/archive/21-2-320.pdfBurd EM. Human papillomavirus and cervical cancer. Clin Microbiol Rev. 2003 Jan;16(1):1-17. doi: 10.1128/CMR.16.1.1-17.2003. PMID: 12525422; PMCID: PMC145302.
https://journals.asm.org/doi/10.1128/CMR.16.1.1-17.2003Olusola P, Banerjee HN, Philley JV, Dasgupta S. Human Papilloma Virus-Associated Cervical Cancer and Health Disparities. Cells. 2019 Jun 21;8(6):622. doi: 10.3390/cells8060622. PMID: 31234354; PMCID: PMC6628030.
https://www.mdpi.com/2073-4409/8/6/622Buskwofie A, David-West G, Clare CA. A Review of Cervical Cancer: Incidence and Disparities. J Natl Med Assoc. 2020 Apr;112(2):229-232. doi: 10.1016/j.jnma.2020.03.002. Epub 2020 Apr 8. PMID: 32278478.
https://www.sciencedirect.com/science/article/abs/pii/S0027968420300432?via%3Dihub