Hesperian Health Guides

Cancer and Other Problems of the Cervix

In this chapter:

Problems of the cervix that are not cancer

(the cervix is the opening of the womb)

a womb, showing location of the cervix
nabothian cysts on the cervix

Nabothian cysts are small bumps on the cervix that are filled with fluid. They can be seen during a pelvic exam with a speculum. These cysts are harmless, so no treatment is needed.

Polyps are dark red growths, sometimes found at the cervix. They also grow inside the womb. They do not need to be treated. For more about them, see “Common Growths of the Womb.”

Inflammation of the cervix. Many infections of the vagina, including trichomonas and some other STIs, can affect the cervix and cause growths, sores, or irritation and bleeding after sex. For more information, including treatment, see the chapter on STIs.

Cancer of the cervix (cervical cancer)

Cancer of the cervix is the most common cause of death from cancer among women in many parts of the world. Most cervical cancer is caused by the Human Papilloma Virus, or HPV. There are many types of HPV and only a few of them can cause cervical cancer. (Another type of HPV causes genital warts.)

HPV is a common infection. Many people get it, and then it goes away without treatment. But HPV infections that do not go away can cause cancer. Because this cancer grows slowly, there is time to find it early and cure it completely. Unfortunately, many women die from cervical cancer because they never knew they had it. Now there is a [[#vacc|vaccine that can prevent HPV.

The best time to be screened for cervical cancer is around the age of 30, and every 3 to 5 years after that.

People with HIV are more likely to get cervical cancer because their immune systems are less able to fight the HPV. They should be screened for cervical cancer even if they are younger than 30. If the results are normal, then they should be tested every 3 years.

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Warning signs:

There are usually no outward signs of cancer of the cervix until it has spread and is more difficult to treat. Because early signs of cancer can be found on the cervix during a pelvic exam, regular exams are very important.

Later warning signs are abnormal bleeding from the vagina, including bleeding after sex, and persistent abnormal discharge or bad smell from the vagina. If you have any of these signs, try to get a pelvic exam and a screening test.

IMPORTANT! If you are treated with medicines for vaginal discharge and do not get better, have your cervix examined and get a cancer screening test.

Finding and treating cancer of the cervix

If you are a health worker, try to get training in testing for cervical cancer. Encourage your community to offer cancer screening and low-cost treatment (cryotherapy)

Because cancer of the cervix can be cured if found early but does not have early warning signs you can see, it is good to test for it regularly. Three screening tests look for early signs of cervical cancer. Each test is done during a pelvic exam and requires touching the cervix with a cotton swab or small brush.

Visual inspection with acetic acid

A health worker examines the cervix by looking at it through a speculum. Then she puts vinegar (acetic acid) on a cotton swab and wipes it on the cervix. The acetic acid makes any abnormal tissue turn white. This test gives you the result right away and you can often receive treatment the same day. It is low cost and easy to learn how to do.

The Pap test

For this test, a health worker gently takes some cells from the cervix and sends them to a laboratory to be examined with a microscope. This test looks for abnormal cells that may be cancer or pre-cancer. You will need to return in 2 to 3 weeks to get the results

a woman lying on an exam table while a health worker holds a speculum
It is easy and inexpensive to test for cervical cancer
HPV test

Like the Pap test, a health worker takes some cells from the cervix and sends them to a laboratory to be examined for HPV, a virus that increases risk for cervical cancer. You will need to return in 2 to 3 weeks to get the results. If the test is positive and shows you have HPV, you should get a Pap test or visual inspection to find out if you have abnormal cells and need treatment.

Other tests

These tests are sometimes used to find cancer when a Pap test or visual inspection shows abnormal cells.

  • Colposcopy. A doctor uses a special lens to magnify the cervix so it is easier to see signs of cancer.
  • Biopsy. A small bit of tissue is taken from the cervix and sent to a laboratory to be examined for cancer cells.
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deciding about treatment

If a screening test shows that you have pre-cancer or cancer, you need treatment. Treatment for pre-cancer is simple, using methods that destroy the abnormal tissue. Cryotherapy, which can be done in a small clinic, freezes and kills the pre-cancer. Another method that can be done in a small clinic, thermal ablation, uses heat to kill the pre-cancer. Also, a simple surgery can remove the pre-cancer cells from the cervix.

Cancer is usually treated in a hospital or center specializing in cancer treatment

If found and treated before it spreads, cancer can be cured. Treatment may involve removing part of the cervix, or you may need a hysterectomy (removal of the womb, including the cervix) to get rid of the cancer.

Cancer that has spread beyond the cervix to other parts of the body may need radiation therapy and medicines as well as surgery to remove the cervix, womb, and other parts that the cancer has reached.

Deaths from cancer of the cervix can be prevented

To find and treat more cancers early, we can:

  • learn how common cancer of the cervix is in your community and what risk factors can be reduced. Are girls married or pushed to have sex at a young age? Do people know how to protect themselves and each other from STIs?
a woman waiting in a health center near a sign that recommends testing for cancer"
  • help people avoid or quit smoking tobacco.
  • learn about cancer screening and work to make it more available. Finding cancer of the cervix early can save lives.

Developing screening programs may seem too costly but they are cheaper than treatment. Screening programs can help the most while costing the least if they:

  • test people over 35, especially people who are middle-aged. Cancer of the cervix rarely affects the young.
  • test more people less often. Testing everyone at risk every 5 to 10 years will find many more cancers than testing fewer people more often.
  • train local health workers in how to do visual inspection, use cryotherapy or thermal ablation, and give Pap tests.

There is a “HPV vaccine” that now protects against cervical cancer and is used in many countries. It is given to girls and boys when they are 7 to 11 years old, before they start having sex. Ask to make it available in your community

This page was updated:13 Nov 2023