# Cervical cancer: symptoms, treatment and survival > Source: World Aid Network — https://worldaidnetwork.org/cancer/cervical-cancer > Last reviewed: 2026-06-19 ## In short Cervical cancer affects the cervix, the entrance to the womb. Almost all cases are caused by a common virus called HPV — and this makes it one of the most preventable cancers of all. Two things protect you: the HPV vaccine (offered to children aged 11–13) and cervical screening (the smear test), which finds early changes before they ever become cancer. One of the most preventable cancers — through the HPV vaccine and screening. World Aid Network funds treatment for patients who cannot pay. ## At a glance - ~3,200: UK cases each year - HPV (99.7%): Main cause - Over 93%: Survival when caught early - HPV vaccine + screening: Prevention ## What is cervical cancer? Cervical cancer affects the cervix, the entrance to the womb. Almost all cases are caused by a common virus called HPV — and this makes it one of the most preventable cancers of all. Two things protect you: the HPV vaccine (offered to children aged 11–13) and cervical screening (the smear test), which finds early changes before they ever become cancer. Cervical cancer is one of the most preventable cancers in the world. It is caused by persistent infection with high-risk strains of human papillomavirus (HPV) in 99.7% of cases — and both HPV vaccination and NHS cervical screening (the 'smear test') are proven to prevent it. Approximately 3,200 women are diagnosed with cervical cancer in the UK every year, and around 850 die from it annually. The NHS HPV vaccination programme — now offering the Gardasil-9 vaccine to girls and boys aged 11–13 — and the cervical screening programme together aim to eliminate cervical cancer as a public health problem in the UK by 2040. This guide answers the twenty most commonly searched questions about cervical cancer in the UK, drawing on NHS and WHO sources. NHS cervical screening invites all women and people with a cervix aged 25–49 every three years and those aged 50–64 every five years. A cervical sample (previously called a 'smear test') collects cells from the cervix using a small brush. The sample is now tested first for high-risk HPV: if HPV is not detected, no further action is taken; if HPV is detected, cells are examined for CIN. Those with CIN 1–3 are referred for colposcopy. Colposcopy is a clinic examination of the cervix using a magnifying instrument and acetic acid or iodine solution to highlight abnormal areas. Biopsies are taken to confirm CIN grade. CIN1 is usually managed with watchful waiting; CIN2 and CIN3 (pre-cancerous) are treated with LLETZ (large loop excision of the transformation zone) — a simple outpatient procedure that removes the abnormal area with a wire loop under local anaesthetic. Treated CIN2/3 rarely progresses to cancer. ## When should you see a doctor about cervical cancer? Most of these symptoms have a less serious cause — but it is always worth getting them checked. See a GP if you notice a new or persistent change. If you feel very unwell, contact NHS 111 or seek urgent help. Take a note of how long the symptom has lasted and whether it is getting worse. You do not need every sign on a list to book an appointment. This guide is general information from World Aid Network, not a diagnosis and not UK NHS care. Only a clinician can assess you. - Vaginal bleeding after sex - Bleeding between periods or after the menopause - Unusual vaginal discharge - Pain or discomfort during sex, or pain in the pelvis - Any unexpected bleeding — get it checked, even if screening was normal ## What are hPV, vaccination and prevention? Human papillomavirus (HPV) is an extremely common sexually transmitted infection — approximately 80% of sexually active people will be infected with HPV at some point in their lives. Most infections clear naturally without causing harm. However, persistent infection with high-risk HPV strains (particularly HPV 16 and HPV 18, which together cause approximately 70% of cervical cancers) can cause pre-cancerous changes (cervical intraepithelial neoplasia, CIN) that, if untreated, progress to cervical cancer over 10–20 years. The NHS now offers the Gardasil-9 vaccine (protecting against nine HPV strains including 16 and 18) to all boys and girls aged 11–13. Vaccination before first sexual activity provides near-complete protection against HPV 16/18 infection. Adults who missed school vaccination can request it up to age 25. HPV vaccination combined with cervical screening is projected to reduce cervical cancer incidence by over 90% in vaccinated generations. ## How is cervical cancer treated? Early-stage cervical cancer (Stage IA–IIA) is treated surgically. Depending on the stage and fertility wishes, options include: LLETZ or cone biopsy (for very early Stage IA1); radical trachelectomy (removal of the cervix while preserving the uterus — a fertility-sparing option for Stage IA2–IB1); or radical hysterectomy with pelvic lymph node dissection. Laparoscopic and robotic surgical approaches are used in specialist centres. Locally advanced cervical cancer (Stage IB3–IVA) is treated with definitive chemoradiotherapy — concurrent weekly cisplatin chemotherapy and external beam radiotherapy followed by brachytherapy (internal radiotherapy delivered directly to the cervix). This is equally effective to surgery for early-stage disease and preferred for locally advanced disease. Bevacizumab added to platinum-based chemotherapy has improved survival for recurrent/metastatic cervical cancer. ## What are the key takeaways? The most important points on cervical cancer for patients, families and donors. - Cervical cancer is caused by HPV in 99.7% of cases — making it almost entirely preventable through HPV vaccination (Gardasil-9, offered to 11–13 year olds) and NHS cervical screening. - Attend NHS cervical screening: every 3 years age 25–49, every 5 years age 50–64. Screening detects pre-cancerous changes (CIN) before cancer develops, which are treated simply in outpatients. - Key symptoms include: abnormal vaginal bleeding (after sex, between periods or after the menopause), unusual vaginal discharge, and pelvic pain. Any of these should be reported to your GP. - Early cervical cancer is highly curable. Five-year survival: Stage I >80%; Stage II 60–70%; Stage III 35–45%; Stage IV 15–20%. - Globally, cervical cancer kills over 340,000 women per year — 90% in low-income countries, where HPV vaccination and screening are unavailable to most women. ## What will a donation for cervical cancer treatment provide? A gift to World Aid Network's Cancer Emergency Appeal helps pay for diagnosis and treatment that a poor patient has been recommended but cannot afford. Typical partner costs start at £10 for tests and £50 for a chemotherapy session. Trustees direct gifts to the most urgent cases. This is treatment access, not laboratory research and not UK NHS care. Clinicians in partner hospitals decide the medical plan. We fund the bill in Pakistan, Indonesia and Malaysia. The Cancer Emergency Appeal funds all types of cancer. Trustees direct gifts to the most urgent hospital bills in Pakistan, Indonesia and Malaysia. - £10 — Diagnostic tests that help a partner oncologist confirm the next step - £25 — Cancer medication towards a treatment cycle a family cannot afford - £50 — One chemotherapy session for a patient who would otherwise be turned away - £100 — Surgical support or a fuller block of treatment costs ## How can I donate to help people with cervical cancer? Donate by card on this page or at worldaidnetwork.org/donate and choose the Cancer Emergency Appeal. World Aid Network is a UK CIO with Charity Commission registration in progress; Gift Aid applies once registration is granted. If you need UK support as a patient or relative, see a GP, NHS 111, Macmillan or the specialist UK charity for this cancer. We fund treatment overseas; we are not a UK helpline. ## How do you attend cervical screening (the smear test)? Cervical screening finds HPV and early cell changes before they become cancer. In the UK it is offered to women and people with a cervix aged 25 to 64. - Go when invited: Invitations usually come every three years from 25 to 49, then every five years to 64. - Do not wait if you have symptoms: Bleeding after sex, between periods or after the menopause should be checked by a GP even if screening was recent. - Ask for adjustments if you need them: You can request a female sample-taker, a smaller speculum, or more time. Tell the nurse if you feel anxious. - Keep the HPV vaccine in mind: The vaccine is offered in schools at 11 to 13. Missed doses are often available free up to 25. ## Frequently asked questions ### What is cervical cancer? Cervical cancer is a malignant tumour of the cervix — the lower part of the uterus that connects to the vagina. It is caused by persistent infection with high-risk strains of human papillomavirus (HPV) in 99.7% of cases. Around 3,200 women are diagnosed in the UK each year and approximately 850 die annually. It is one of the most preventable cancers through HPV vaccination and NHS cervical screening. ### What causes cervical cancer? Persistent infection with high-risk HPV strains — particularly HPV 16 and 18, which together cause approximately 70% of cervical cancers — is responsible for 99.7% of all cervical cancers. HPV is transmitted sexually. Most HPV infections clear spontaneously; it is persistent high-risk HPV infection that causes pre-cancerous cellular changes (CIN) which, if untreated over 10–20 years, can progress to invasive cancer. Smoking, immunosuppression and long-term combined oral contraceptive use modestly increase the risk of progression from HPV infection to cervical cancer. ### What are the symptoms of cervical cancer? Early cervical cancer may cause no symptoms. The NHS advises seeing a GP promptly if you experience: bleeding after sex (post-coital bleeding); bleeding between periods (inter-menstrual bleeding) or after the menopause (any post-menopausal bleeding is abnormal); unusual vaginal discharge (particularly if it is bloodstained, watery or has an unpleasant odour); or pelvic pain not associated with your period. These symptoms do not necessarily indicate cancer but always require medical assessment. ### What is HPV and how does it cause cervical cancer? Human papillomavirus (HPV) is an extremely common group of viruses transmitted through skin-to-skin genital contact. Most people clear HPV naturally without any symptoms or health consequences. High-risk HPV strains (16, 18, 31, 33, 45 and others) integrate into cervical cell DNA, causing abnormal cell changes — cervical intraepithelial neoplasia (CIN) — over years. Without treatment, CIN can progress to invasive cervical cancer. The process takes 10–20 years in most cases, providing a long window for screening to detect and treat pre-cancerous changes. ### What is the HPV vaccine? The NHS offers the Gardasil-9 HPV vaccine — protecting against nine high-risk HPV strains including types 16 and 18 (responsible for ~70% of cervical cancers) plus types 31, 33, 45, 52 and 58 — to all girls and boys aged 11–13 through the school vaccination programme. Vaccination before first sexual activity provides near-complete protection. People who missed school vaccination can request it free until age 25. Vaccination is the most effective prevention measure for cervical cancer. ### What is a smear test? A cervical smear test (now called a cervical sample or cervical screening) is a procedure in which a small brush is used to collect a sample of cells from the cervix. The NHS now tests the sample first for high-risk HPV: if HPV-negative, the result is normal and the person is recalled in 3 or 5 years. If HPV-positive, cells are examined for CIN. The whole procedure takes a few minutes and is performed by a nurse or doctor. It is done at your GP surgery or sexual health clinic. ### What does an abnormal smear test result mean? An abnormal result most commonly means high-risk HPV was detected in the sample. This does not mean you have cancer — HPV is very common and most infections clear without causing harm. If HPV is found alongside abnormal cells (CIN), you will be referred for colposcopy. CIN (cervical intraepithelial neoplasia) describes pre-cancerous changes that, if treated, rarely progress to cancer. The NHS Two Week Wait pathway is for actual suspected cancer — a colposcopy referral for CIN is not an urgent cancer referral. ### What is CIN? CIN (cervical intraepithelial neoplasia) is pre-cancerous change in the cells of the cervix caused by persistent HPV infection. It is graded CIN1 (mild dysplasia — often regresses spontaneously), CIN2 (moderate dysplasia) and CIN3 (severe dysplasia/carcinoma in situ — the highest-grade pre-cancer, requiring treatment). CIN is not cancer and causes no symptoms. It is detected through cervical screening and treated before it can progress. LLETZ (large loop excision) treats CIN2 and CIN3 effectively in outpatients. ### What is colposcopy? Colposcopy is a detailed examination of the cervix using a colposcope — a magnifying instrument that illuminates and magnifies the cervix. A colposcopist applies acetic acid (vinegar) and/or iodine solution to highlight areas of abnormal cells. The procedure is similar to a smear test — you lie on a couch and a speculum is inserted. It is not painful for most women, though some feel discomfort. Biopsies may be taken from abnormal areas to determine the CIN grade. Results are usually given within four weeks. ### What is LLETZ treatment? LLETZ (large loop excision of the transformation zone) is the standard outpatient treatment for CIN2 and CIN3. Under local anaesthetic injected into the cervix, a thin wire loop carrying an electrical current removes the area of abnormal cells from the cervix. The procedure takes approximately 15 minutes and is performed at a colposcopy clinic. The removed tissue is sent for histopathology to confirm complete excision of the abnormal area. LLETZ is highly effective — approximately 90–95% of women require no further treatment. ### How is cervical cancer treated? Treatment depends on stage. Early-stage (IA–IB1): surgery — LLETZ, cone biopsy, radical trachelectomy (fertility-preserving) or radical hysterectomy with lymph node dissection. Locally advanced (IB3–IVA): concurrent chemoradiotherapy — weekly cisplatin chemotherapy and external beam radiotherapy, followed by brachytherapy (internal radiotherapy directly to the cervix). Recurrent/metastatic: platinum-based chemotherapy ± bevacizumab (NICE-approved); pembrolizumab for PD-L1-positive recurrent disease. ### What is the survival rate for cervical cancer? Five-year survival rates in England: Stage I — over 80%; Stage II — approximately 65%; Stage III — approximately 35–45%; Stage IV — approximately 15–20%. Overall five-year survival for all stages combined is approximately 63%. Survival has improved with the introduction of chemoradiotherapy, bevacizumab and immunotherapy. Women diagnosed through cervical screening (pre-cancer or very early cancer) have survival rates approaching 100%. ### Can I still get cervical cancer if I have had the HPV vaccine? HPV vaccination provides very high protection against the HPV strains most commonly causing cervical cancer (16, 18 and others), but does not protect against all HPV strains. It is therefore still recommended that vaccinated women attend NHS cervical screening as scheduled — the combination of vaccination and screening gives the highest possible protection. Women vaccinated before first sexual activity with Gardasil-9 have near-complete protection against the HPV strains it covers. ### Can you get cervical cancer if you have never had sex? It is extremely rare because HPV — the cause of almost all cervical cancers — is transmitted through sexual contact. Very rare non-HPV-related cervical cancers have been reported. For this reason, young women who have never been sexually active are generally advised that they may not need to attend cervical screening until they become sexually active, though the NHS still invites them at the standard ages. This is a discussion to have with a GP. ### Does the cervical screening age of 25 mean younger women are not at risk? Cervical cancer is very rare in women under 25. Pre-cancerous CIN changes in women under 25 are common but very likely to resolve without treatment, and the benefits of screening this age group do not outweigh the risks of overtreatment. The NHS starts screening at 25 based on this evidence. Young women under 25 should still consult their GP if they develop symptoms (post-coital bleeding, inter-menstrual bleeding or unusual discharge). HPV vaccination at 11–13 provides the best protection for this age group. ### Does cervical cancer affect fertility? Treatment for early cervical cancer can be designed to preserve fertility in some women. Radical trachelectomy — surgical removal of the cervix while preserving the uterus — is an option for carefully selected women with Stage IA2–IB1 cervical cancer who wish to have children. Pregnancy after radical trachelectomy is possible but carries higher risk of preterm labour. LLETZ treatment for CIN does not significantly affect fertility but may slightly increase the risk of preterm birth in subsequent pregnancies. Hysterectomy and radiotherapy both end the possibility of pregnancy. ### Is cervical cancer linked to the contraceptive pill? Long-term use of the combined oral contraceptive pill is associated with a modest increase in the risk of progression from HPV infection to cervical cancer — approximately doubling the risk after 10+ years of use (though this may partly reflect higher sexual activity and therefore higher HPV exposure in pill users). This increased risk disappears within about 10 years of stopping the pill. The absolute risk increase is small, and the contraceptive pill's benefits (including reduced risk of ovarian and endometrial cancer) usually outweigh this risk when weighed individually. ### How does cervical cancer affect women in developing countries? Cervical cancer is the fourth most common cancer in women worldwide and the leading cause of cancer death in women in many low-income countries. Over 340,000 women die from cervical cancer globally each year — 90% of them in low- and middle-income countries where HPV vaccination and cervical screening are largely unavailable. World Aid Network funds cancer treatment through locally-licensed oncologists. Expanding access to cancer care in the regions WAN operates reduces this inequality. ## How you can help World Aid Network funds cancer treatment for poor patients in Pakistan, Indonesia and Malaysia through locally licensed oncologists. Donate at https://worldaidnetwork.org/cancer/cervical-cancer or https://worldaidnetwork.org/donate?cause=cancer-treatment&appeal=cancer-emergency ## Sources - NHS — Cancer: https://www.nhs.uk/conditions/cancer/ - Cancer Research UK --- This is general information, not medical advice, published by World Aid Network. Always consult a qualified clinician about your own health.