Cervical Cancer



The cervix is a lower part of the reproductive system. The cervix connects the vagina (birth canal) to the upper part of the uterus. The outer layer of the cervix is called the ectocervix whereas the inside layer of the cervix is called the endocervix. Cervical cancer is the second highest cause of incidence and mortality among females in India followed by breast cancer. According to the Globocan 2018 report, the incidence rate and mortality rate was reported to be 8.4% and 7.7% respectively.

Types of Cervical Cancer

Majority of the cervical cancers (around 70-80%) are squamous cell carcinomas. These cancers develop from cells in the exocervix. Squamous cell carcinomas most often begin in the transformation zone (where the exocervix joins the endocervix).

Adenocarcinomas are less likely to occur as compared to the squamous cell cancer. Adenocarcinomas are cancers that develop from glandular cells. Cervical adenocarcinoma develops from the mucus-producing gland cells of the endocervix.

Adenosquamous carcinomas or mixed carcinomas are rare type of cervical cancer. It accounts for only 5-6% of all cervical cancers. This type has both squamous as well as glandular cancer cells.

Small cell cancer is diagnosed in 3% of the women’s and it is a very rare form of cervical cancer.


Human papillomavirus (HPV) causes about 91% of cervical cancers. There are over 100 different types of HPV, most of which are considered low-risk and do not cause cervical cancer. High-risk HPV types may cause cervical cell abnormalities or cancer. More than 70% of cervical cancer cases can be attributed to two types of the virus, HPV-16 and HPV-18, often referred to as high-risk HPV types.

Risk Factors

Human papillomavirus infection

It is one of the most important risk factor for cervical cancer. It can spread through sexual activity or through skin-to-skin contact. It can infect the cells present on the surface of the skin.


The women who smoke are more likely to develop cervical cancer. It weakens the immune system because of which it is unable to fight HIV infections.

Sexual history

Increased risk of developing cervical cancer if there is a sexual history and exposure to HPV.

Weak immune system

The weak immune system increases the risk of HPV infections. For example the women who are being treated for autoimmune disease are also at risk of developing cervical cancer.

Chlamydia infection

The risk is higher in women showing past or current Chlamydia infection.

Long-term use of birth control pills

Women who take oral pills for a long-time are at a higher risk of developing cervical cancer.

Signs & symptoms

Abnormal bleeding, such as

Bleeding between regular periods

Bleeding after sexual intercourse

Bleeding after douching

Bleeding after a pelvic exam

Bleeding after menopause

Pelvic pain not related to your menstrual cycle

Heavy or unusual discharge that may be watery, thick, and possibly have a foul odor

Increased urinary frequency

Pain during urination


Colposcopy:A colposcopy is a test to examine the cervix in detail. The doctor or specialist nurse takes samples of any abnormal area for further tests.

LLETZ: Large Loop Excision of the Transformation Zone. This is the most common treatment/ examination for abnormal cervical cells.

Cone biopsy: A cone biopsy is a small operation to remove a cone shaped piece of tissue from the cervix.