Cervical cancer is cancer that affects the cervix. This is the lower part of the uterus that forms a canal into the vagina.

Cervical cancer used to be a major cause of cancer deaths in people who are assigned female at birth in the United States. However, advances in cervical cancer screening and the use of the HPV vaccine have led to great improvements in this statistic.

You may be wondering exactly how common cervical cancer is currently or what risk factors are associated with it. Keep reading to learn the answers to these questions and more.

According to the World Health Organization (WHO), cervical cancer is the fourth most common cancer in females. In 2018, it accounted for an estimated 570,000 new diagnoses and 311,000 deaths worldwide.

In the United States, the National Cancer Institute estimates that cervical cancer will account for 14,480 new diagnoses and 4,290 deaths in 2021. This corresponds to 0.8 percent of all new cancer diagnoses and 0.7 percent of all cancer deaths for 2021.

Cervical cancer trends

Cervical cancer can happen in females of any age. However, there are some trends. According to the American Cancer Society (ACS):

  • Cervical cancer is most commonly diagnosed in females between ages 35 and 44 years.
  • The average age at the time of diagnosis is 50 years old.
  • Cervical cancer is rare in females who are under 20 years old.
  • Over 20 percent of cervical cancer diagnoses are in females who are over 65 years old.

While cervical cancer used to be a leading cause of cancer deaths in females in the United States, improvements in screening have helped lower these numbers. In fact, cervical cancer rarely happens in females who receive regular screenings before age 65 years.

The introduction of the HPV vaccine has also helped reduce the incidence of cervical cancer. A 2020 study involving over 1 million females ages 10 to 30 years old found that HPV vaccination before age 17 years reduced the risk of cervical cancer by almost 90 percent.

Having human papillomavirus (HPV) is the leading risk factor for cervical cancer. In fact, according to the Centers for Disease Control and Prevention (CDC), HPV causes more than 9 out of 10 cases of cervical cancer.

There are many different types of HPV. Some of these types lead to genital warts and are not associated with cancer. You may see these referred to as low-risk HPV types.

Some types of HPV are considered high risk because they’re associated with cancer. There are about 14 types of high-risk HPV, with types 16 and 18 causing most cancers.

HPV is transmitted from one person to another through skin-to-skin contact and can be transferred during sexual activity. Because high-risk HPV types do not often cause symptoms, it’s possible to have the virus and not know it.

Dispelling HPV stigma

There’s a degree of social stigma associated with HPV. Some may worry that having HPV means that they’ll be perceived as “dirty” or “promiscuous.” Others may be concerned that a partner who’s contracted HPV has been unfaithful.

However, these are both myths.

HPV is actually incredibly common. In fact, it’s estimated that over 80 percent of females and people who are assigned male at birth will be exposed to HPV at some point in their lifetime.

Additionally, because HPV is so common and most infections are asymptomatic, it’s very difficult to tell when and where someone contracted the virus.

Additional risk factors

Additional risk factors for cervical cancer include:

  • Smoking. Tobacco smoke contains many chemicals that can cause cancer. According to the American Cancer Society, females who smoke are twice as likely to develop cervical cancer as those who do not.
  • Having a weakened immune system. Because the immune system can help respond to cancer cells, having a weakened immune system can increase cervical cancer risk. This can happen due to:
    • undergoing certain treatments for cancer
    • receiving an organ transplant
  • Family history. If other females in your family, particularly a mother or a sister, have or had cervical cancer, you may be at a higher risk.
  • Sexual history. Factors related to sexual history can increase cervical cancer risk, likely by increasing the risk of exposure to HPV. These include:
    • having multiple sexual partners
  • Using oral contraceptives for a long time. Taking oral contraceptives for a long period of time can increase cervical cancer risk. Your risk level can go back down when you stop taking them.
  • Having multiple pregnancies. Females who have given birth to 3 or more children are at an increased risk for cervical cancer.
  • Having chlamydia. Some research has found that having sexually transmitted disease (STD) chlamydia can raise the risk of cervical cancer.
  • Eating a diet low in nutrients. Having a diet that’s limited in fruits, vegetables, and antioxidants may increase cervical cancer risk.
  • Economic status. Females living in low-income households often do not have equal access to healthcare services like cervical cancer screenings. The CDC provides resources on how to find low-cost or no-cost cervical cancer screenings near you.

A note about risk factors

Having one or more risk factors for cervical cancer does not mean that you’ll certainly develop cervical cancer in your lifetime. It means that your risk level is higher than an individual without any risk factors.

It’s possible to have risk factors for cervical cancer and never develop it.

Early cervical cancer often does not have any symptoms until it has spread into neighboring tissues. When symptoms are present, some of the common ones are:

If you have any of the above symptoms, it’s important to see a doctor to discuss what might be causing them. If these symptoms are not due to cervical cancer, they could be caused by another medical condition that needs treatment.

Getting vaccinated for HPV is one of the best ways to help prevent cervical cancer. The CDC estimates that HPV vaccination can help in preventing over 90 percent of cancers caused by HPV. In addition to cervical cancer, other cancers that can be caused by HPV include:

Currently, the CDC recommends HPV vaccination for:

  • all males and females ages 11 to 12 years, although the vaccine series can be started at age 9 years
  • teens and young adults through age 26 years who have not yet been vaccinated or have not finished the entire vaccine series
  • some adults ages 27 through 45 years, after discussing their HPV risk with their doctor

The HPV vaccine is called Gardasil-9 and is designed to protect you against nine different types of HPV, including types 16 and 18. Depending on your age, you’ll receive either 2 or 3 doses of the HPV vaccine.

Additional prevention steps

Additional steps that you can take to help prevent cervical cancer are:

  • Having regular screenings. Cancerous and pre-cancerous changes can be detected by your doctor by using a Pap smear, HPV test, or both.
  • Using a condom or other barrier method during sex. Using a condom or other barrier method each time you have sex can help protect against contracting HPV. However, it is important to note that a condom or other barrier method cannot prevent all skin-to-skin contact during sex.
  • Getting regular STI screenings. Regular STI screenings can help detect infections like HIV and chlamydia. Ask your sexual partners to get tested as well.
  • Considering quitting smoking. Quitting smoking can lower your risk for developing cervical cancer as well as many other health conditions. Talk with your doctor about smoking cessation and other supportive resources.
  • Eating a nutrient-dense diet. Eating a diet that’s rich in fruits, vegetables, and antioxidant foods is good for your overall health and may also help reduce cervical cancer risk.

Like many cancers, the outlook for cervical cancer is best when it’s detected and treated early. In fact, according to the ACS, the 5-year survival rate for localized cervical cancer is 92 percent.

Diagnosing cervical cancer

The diagnostic process for cervical cancer often starts when you receive an abnormal result on a screening test like a Pap smear or HPV test. This alerts your doctor that further testing is necessary to determine if precancerous or cancerous changes are present.

In addition to taking your medical history and performing a physical examination, your doctor can use the following things to help diagnose cervical cancer:

  • Colposcopy. During a colposcopy, your doctor will use a special lighted instrument to check for abnormal areas in the cervix. They may also take a tissue sample during this time to check for cancerous cells.
  • Cervical biopsy. During a cervical biopsy, a small sample of tissue is removed from the cervix. This sample can then be viewed under a microscope to check for cancer cells.

Treating cervical cancer

There are several different treatment options for cervical cancer. These include:

  • Surgery. A variety of surgical procedures can be used to remove cancer from the body. A couple of examples are conization and hysterectomy.
  • Radiation therapy. Radiation therapy uses high-energy radiation to kill cancer cells or prevent them from growing. This type of treatment can be given either externally or internally.
  • Chemotherapy. Chemotherapy uses strong drugs to kill cancer cells or stop them from growing and dividing.
  • Targeted therapy. Targeted therapy uses drugs that target specific molecules that are present on cancer cells. Because of this, it’s less likely to cause harm to healthy cells.
  • Immunotherapy. Immunotherapy is a type of cancer treatment that helps your immune system respond to cancer cells.

Which treatment is used can depend on factors like your age, overall health, and the stage of the cancer.

For example, surgical approaches are often recommended for earlier stages of cervical cancer. Treatments like radiation and chemotherapy are typically used for later stages of cervical cancer, with surgery as an addition but primary surgery can be considered as well.

It’s also possible that your treatment plan will involve a combination of different treatments.

Additionally, many cervical cancer treatments carry a risk of fertility loss. Due to this, some may choose to decline certain treatment options that allow them to defer full treatment for a short period of time until their fertility goals are accomplished.

Cervical cancer is the fourth most common cancer in females. Most cases of cervical cancer are diagnosed in women between ages 35 and 44 years with the average age of diagnosis being about 50 years old.

Having HPV is the main risk factor for cervical cancer. Others can include:

  • smoking
  • family history
  • long-term oral contraceptive use

There are many steps that you can take that can help reduce your risk for cervical cancer. Two very important ones are getting the HPV vaccine and making sure to receive regular cervical cancer screenings.

The outlook for cervical cancer improves the earlier it’s detected and treated. Because of this, be sure to talk with a doctor if you’re experiencing any signs or symptoms of cervical cancer.