Invasive cervical cancer is when cancer spreads beyond the cervix. Most cervical cancers are caused by HPV. When caught early, cervical cancer is often curable, and early detection has increased with current screening methods.

Invasive cervical cancer is cancer that has spread beyond the surface of the cervix. The cervix is the narrow end of the uterus that forms a canal between the uterus and the vagina.

In the United States, there are about 13,000 new cases of cervical cancer every year. When cervical cancer is diagnosed and treated in the early stages, the outlook for people with cervical cancer is good.

This article discusses symptoms, risk factors, treatment, outlook, and how you might be able to prevent invasive cervical cancer.

About 90% of cervical cancers start in thin, flat cells called squamous cells on the outer part of the cervix. Most other cervical cancers are adenocarcinomas, which start in glandular cells in the inner part of the cervix. Cervical cancer can also develop in other types of cells, but it’s rare.

Invasive cervical cancer means the cancer has moved beyond the layer of tissue where it started, even if only by a few millimeters.

Risk factors

Almost all cervical cancers are the result of persistent infection with human papillomavirus (HPV), especially HPV16 and HPV18. Other risk factors for invasive cervical cancer include:

  • becoming sexually active before age 18
  • having many sexual partners
  • smoking
  • a weakened immune system
  • chlamydia infection
  • long-term use of oral contraceptives
  • three or more full-term pregnancies or first full-term pregnancy before age 20
  • a family history of cervical cancer

Staging describes how far cancer may have spread, which can help guide treatment. Tests that help determine what stage invasive cervical cancer might be in include:

Stage 0 refers to noninvasive cervical cancer. It’s also called precancer or carcinoma in situ (CIS). The stages of invasive cervical cancer are:

  • Stage 1: The cancer hasn’t spread outside the cervix.
  • Stage 2: Cancer has spread to the upper two-thirds of vagina. It may also have spread to tissue around the uterus.
  • Stage 3: Cancer has spread to the lower third of vagina and/or pelvic wall. Or it may be interfering with kidney function and/or spread to nearby lymph nodes.
  • Stage 4: Cancer has spread beyond the pelvis to lining of the bladder or rectum or other parts of the body. Stage 4 is also called metastatic cervical cancer.

Each stage has substages based on the tumor size and spread.

Early stage cervical cancer usually doesn’t have symptoms. With progression, symptoms may include:

  • bleeding between periods, after intercourse, or after menopause
  • heavier menstrual flow
  • pelvic pain during sex
  • unusual discharge
  • urinary urgency and increased frequency

Later stage invasive cervical cancer may cause:

  • painful bowel movements, bleeding from the rectum
  • painful urination, blood in the urine
  • backache
  • abdominal pain
  • swelling in the legs

If you have an abnormal screening test result, a doctor may recommend a colposcopy and cervical biopsy to check for cancer.

A colposcopy is a procedure in which an instrument with a light and magnifying lens provides a closer look at the cervix. The doctor can take a tissue sample for biopsy at this time. There are several types of cervical biopsy, including:

  • Punch biopsy: This procedure uses a circular instrument to remove a small, round piece of tissue.
  • Endocervical curettage: This procedure uses a narrow instrument to scrape off a small amount of tissue.
  • Cone biopsy: The doctor removes a larger, cone-shaped piece of tissue from the cervix. This may involve using a heated wire loop, which is called a loop electrosurgical excision procedure (LEEP), or a surgical scalpel or laser (cold knife method).

Invasive cervical cancer is treatable and highly curable when caught early.

Surgery is usually the first treatment for cervical cancer. In some cases, a cone biopsy may remove all the cancer. Depending on the extent of the cancer, other surgical options include:

  • Radical trachelectomy: This will remove the cervix, nearby tissue, and upper part of the vagina. It may also include the removal of nearby lymph nodes.
  • Total hysterectomy: Hysterectomy removes the uterus and cervix.
  • Radical hysterectomy: A radical hysterectomy removes the uterus, cervix, part of the vagina, and a wide area of surrounding tissues and ligaments. This operation may also include the removal of ovaries, fallopian tubes, or nearby lymph nodes.
  • Modified radical hysterectomy: This procedure is the same as a radical hysterectomy, but it involves the removal of a smaller part of the vagina and less surrounding tissues.
  • Bilateral salpingo-oophorectomy: This procedure involves the removal of the ovaries and fallopian tubes.
  • Total pelvic exenteration: This procedure involves the removal of the cervix, vagina, ovaries, bladder, lower colon, rectum, and nearby lymph nodes. This is a rare, complex surgery.

Other treatments for invasive cervical cancer may include:


The biggest predictor of survival for invasive cervical cancer is the cancer’s stage at diagnosis. According to the National Cancer Institute, the 5-year relative survival rate for cervical cancer is:

  • early stage: 91.8%
  • regional spread: 59.4%
  • distant spread: 17.1%

These statistics are based on cases diagnosed between 2012 and 2018. They may not reflect the latest treatments. Relative survival rates compare people with cervical cancer to those in the general population.

Cervical cancer can often be prevented through routine screening and HPV vaccination.

Routine screening for cervical cancer typically includes a Pap smear (also called a Pap test) and and an HPV test. An HPV test looks for the virus that can cause cervical cells to change. A Pap smear can reveal precancerous changes to cells in the cervix.

It can take several years for cervical cancer to develop. You can have precancerous lesions removed before they become invasive.

The ACS recommends cervical cancer screening from age 25 to 65, with:

  • a primary HPV test every 5 years
  • or combination HPV and Pap testing every 5 years
  • or Pap test alone every 3 years

If you’re at high risk of cervical cancer, you may need more frequent screening.

A 2020 study that included more than 1 million people found that HPV vaccination was associated with a substantially lower risk of invasive cervical cancer.

The Centers for Disease Control and Prevention (CDC) recommends routine vaccination of preteens at ages 11 or 12, starting as young as 9 years. Additionally, people ages 13 through 26 years who weren’t previously vaccinated adequately can get the HPV vaccine.

Cervical cancer that has spread beyond the surface of the cervix is called invasive. There are four stages that describe cervical cancer progression. Often, there are no symptoms in the early stages.

The majority of cervical cancer cases are preventable. The HPV vaccine can substantially lower your risk of cervical cancer. And with routine screening, you can detect and remove precancerous lesions before they become invasive. Cervical cancer is treatable and the outlook for people with early stage disease is quite favorable.