What is cervical cancer?

Cervical cancer occurs in the cervix (the opening between the womb and the vagina). It is more likely to arise in women under the age of 45.

Abnormal cells usually grow slowly but can spread into surrounding tissue and beyond, to other areas of your body.

These include ^{Footnote [1]}:

• Unusual vaginal bleeding, such as heavier bleeding than usual, bleeding during or after sex, after the menopause or between your periods.
• Painful sex.
• Unusual vaginal discharge.
• Pain in your lower back, abdomen or between hip bones.

If you experience any of these, consult your doctor. 

Note that cervical cancer doesn’t always have symptoms in the early stages, so it’s important to take up invitations for regular cervical screening (smear tests). This involves taking a sample of cells from the cervix using a soft brush.

Most cervical cancers are caused by certain types of human papillomavirus (HPV), known as high-risk HPV.

HPV is a very common virus that is spread through sexual contact and usually does not cause any symptoms. In most people, the body’s immune system clears the virus naturally, so they may never know they had it.

However, in some cases, the virus can stay in the body and cause changes to the cells of the cervix. Over time, these changes may develop into cervical cancer if they are not treated.

There is a vaccine available that protects against HPV. It is routinely offered to children aged 12–13 to help prevent infection and reduce the risk of cervical cancer later in life.

The NHS offers more information about the causes of cervical cancer.

The risk factors for developing cervical cancer include:

• HPV infection.
• Smoking.
• A family history of cervical cancer.
• Having a weakened immune system.
• Having multiple pregnancies or having a child before age 17.
• If you’ve had cancer of the vagina, vulva, kidney or bladder in the past.
• If you’ve taken the oral contraceptive pill for longer than five years.

Cervical cancer is usually detected by taking a sample of cells from the cervix during a cervical screening test (smear test). These cells are examined in a laboratory.

If your test shows abnormal results, you will be referred to a gynaecologist for further assessment, usually through a colposcopy. This is a procedure where a doctor or nurse closely examines the cervix using a special microscope ^{Footnote [2]}.

During the colposcopy, the doctor may take a small sample of tissue (biopsy) under local anaesthetic. The procedure usually takes around 15 to 30 minutes. If a biopsy is taken, it can take several weeks to receive the results.

You’ll be given a return appointment to discuss your results, or you may be told you’ll receive a letter. 

If cancer is found you may need imaging tests such as MRI scan, CT scan, PET scan or a chest X-ray, to see if the cancer has spread beyond the cervix.

Doctors might also propose a more in-depth internal examination of your cervix under general anaesthesia.

The main treatment for cervical cancer is surgery, particularly if the cancer is found at an early stage. In some cases, you may be offered additional treatments after surgery to reduce the risk of the cancer coming back ^{Footnote [3]}.

If the cancer has spread beyond the cervix, you are more likely to be offered one or more treatments such as: radiotherapy, chemotherapy and surgery. Your doctors will discuss what’s best for you.

Surgery

If cervical cancer is found early, surgery is usually the main treatment option.

Some treatments can affect your fertility, so it’s important to talk to your doctor about your options before treatment begins. For example, you might want to discuss ways of preserving your fertility, such as freezing your eggs.

If the cancer is more advanced or has come back, you may be offered more extensive treatment. This can include wider surgery to remove nearby tissues such as the lymph nodes, and sometimes other organs (for example, the bladder), or the cervix, womb and ovaries.

Cervix surgery

If your cancer is very small, you may be able to have a small part of the cervix removed.

Or your doctor may be able to remove most of your cervix, the tissue around it and the upper part of your vagina, leaving your womb in case you want to have a baby in the future.

These surgeries are done under general anaesthesia and may mean you need a short stay in hospital.

Hysterectomy

This operation involves removing the uterus (womb) and cervix under a general anaesthetic.

In some cases, the ovaries can be left in place, unless your doctors advise that they should also be removed.

This surgery can be used to treat certain early-stage cervical cancers. It may be described differently depending on how the womb is removed from the body ^{Footnote [4]}:

• An abdominal hysterectomy (via a cut in the tummy).
• A vaginal hysterectomy (womb removed through the vagina).
• A laparoscopic hysterectomy (keyhole surgery on the tummy).

An abdominal hysterectomy takes longer to recover from. You’ll stay for several days and it can take six weeks or more, to feel back to normal.

Laparoscopic and vaginal hysterectomies involve a shorter hospital stay and a recovery period of two to three weeks.

Chemotherapy

Chemotherapy is a type of medicine that destroys cancer cells by interfering with how they grow and divide.

It may be used on its own or combined with radiotherapy (called chemoradiotherapy). This can help to shrink the cancer before treatment or reduce the risk of it coming back after surgery.

It may also be offered if your cancer is advanced, has spread to other parts of your body, or has come back.

Radiotherapy

Radiotherapy uses high‑energy radiation (similar to X-rays) to destroy cancer cells. It works by damaging the cancer cells so they can no longer grow or divide.

Radiotherapy is carefully targeted to the affected area to reduce damage to healthy tissues. In cervical cancer, it may be used:

• As the main treatment
• With chemotherapy (chemoradiotherapy)
• After surgery to reduce the risk of the cancer coming back
• To help control symptoms

Radiotherapy can be given from outside the body or internally, close to the cervix.

Regular smear tests can detect early signs that cervical cancer may be developing. 

The NHS cervical screening programme is available to women aged between 25-64. Others with a cervix (trans men and non-binary people) should liaise with their GP practice to ensure that they can access screening, as they won't be automatically included in screening invitations.

You’ll usually get a letter in the post, inviting you to go for a smear test at your local doctor’s surgery.

What happens at the smear test?

When you arrive at the GP practice for your appointment, you’ll need to undress from the waist down. Some people like to wear something they can leave on, but lift up, during the test.

You’ll lie down on a bed with a sheet over your upper legs and you’ll be asked to bend your legs keeping your feet together and knees apart. If you’re uncomfortable in this position talk to the nurse or doctor about changing your position.

The doctor or nurse will take a sample of cells from your cervix using a soft brush which is inserted through a tube-shaped speculum.

It can be uncomfortable but doesn’t usually take any longer than a few minutes.

These cells are then sent off to a laboratory to be checked for changes that could develop into cancer if left untreated.

The results of your smear test

Your results letter will tell you if you have HPV or any abnormal cells. If you have neither you won’t need to have another smear test for three or five years, depending on your age. 

If your test shows HPV, but no abnormal cell changes, you’ll be offered another smear test in a year’s time to check if the infection has gone. If there are abnormal cell changes, you’ll be asked to have further testing, usually through a colposcopy. If you are diagnosed with cervical cancer, the NHS has information about where you can find help and support.

Cervical cancer does not always cause symptoms in its early stages, so it is important to attend regular cervical screening (smear test) appointments when you’re invited.

You could claim for treatment for cervical cancer using your health insurance. First, get a referral from your GP, or through our Digital GP app^. Then you can make a claim through MyAviva, online or call us. 

If we confirm your claim meets the terms of your policy, we'll pay for the treatment directly, subject to your policy terms and conditions. Just be sure to tell us if you need more tests or treatment, or if your hospital or specialist changes. 

It’s good to have one less thing to worry about. It takes Aviva. 

^ These services are non-contractual and can be withdrawn or amended by Aviva at any time.