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What Are the Stages and Survival Rate of Cervical Cancer?

Reviewed on 4/11/2022
What Are the Stages and Survival Rate of Cervical Cancer?
Learn the four stages of cervical cancer and their survival rates.

Cervical cancer is cancer that begins when cells lining the cervix, the lower part of the uterus (womb), become abnormal and grow out of control.

There are four stages of cervical cancer, and each is divided into sub-stages. The stage of a cancer is based on how big a tumor is and whether it has spread.

  • Stage 1: the cancer is localized to the cervix and has not spread to nearby tissues or other organs
    • Stage 1A: the tumor is so small it can only be seen with a microscope or colposcopy
    • Stage 1B: the tumor is larger, but still localized to the cervix and it is usually visible without a microscope
  • Stage 2: cancer has spread outside the cervix into surrounding tissues, but it has not grown into the muscles or ligaments that line the pelvis or into the lower part of the vagina
    • Stage 2A1: the cancer is 4 cm or less
    • Stage 2A2: the cancer is more than 4 cm
    • Stage 2B: cancer has spread into the tissues around the cervix
  • Stage 3: cancer has spread from the cervix into the structures around it or the lymph nodes in the pelvis or abdomen
    • Stage 3A: cancer has spread to the lower third of the vagina but not the pelvic wall
    • Stage 3B: the tumor has grown through to the pelvic wall or is blocking one or both of the tubes that drain the kidneys (ureters) 
    • Stage 3C: cancer may be any size in the pelvis but has not spread to distant sites in the body
      • Stage 3C1: the cancer is in nearby pelvic lymph nodes
      • Stage 3C2: the cancer is in the para-aortic lymph nodes in the abdomen
  • Stage 4: cancer has spread (metastasized) to parts of the body outside the cervix and uterus
    • Stage 4A: cancer has spread to nearby organs such as the bladder or rectum
    • Stage 4B: cancer has spread to distant organs, such as the lungs (often called secondary or metastatic cancer)

What Are Survival Rates of Cervical Cancer?

Life expectancy for cervical cancer is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis.

  • Stage 1: About 95% of patients diagnosed at this stage will survive their cancer for 5 years or more after diagnosis
  • Stage 2: About 70% of patients diagnosed at this stage will survive their cancer for 5 years or more after diagnosis
  • Stage 3: More than 40% of patients diagnosed at this stage will survive their cancer for 5 years or more after diagnosis
  • Stage 4: About 15% of patients diagnosed at this stage will survive their cancer for 5 years or more after diagnosis

What Are Symptoms of Cervical Cancer?

Cervical cancer may not have any symptoms in the early stages. Symptoms of cervical cancer often do not start until cancer grows and spread into nearby tissue. When symptoms of cervical cancer occur, they may include:

Symptoms of advanced cervical cancer may include:

What Causes Cervical Cancer?

The cause of cervical cancer is not always known though it may be due to genetic changes (mutations).

Certain types of human papillomavirus (HPV) infection are the biggest risk factor for cervical cancer.

In addition to HPV infection, risk factors for developing cervical cancer include: 

  • Sexual history
    • Becoming sexually active before 18 years old
    • Many sexual partners
    • Having a partner who is considered high risk (someone with HPV infection or who has many sexual partners)
  • Smoking
  • A weakened immune system
  • Chlamydia infection 
  • Age younger than 20 years at first full-term pregnancy 
  • Having multiple (3 or more) full-term pregnancies 
  • Long-term use of oral contraceptives (birth control pills)
  • Economic status
    • Low-income women may not have easy access to some health care services, including cervical cancer screening with Pap tests and HPV tests, which means they may not get screened or treated for cervical pre-cancers
  • A diet low in fruits and vegetables 
  • Diethylstilbestrol (DES) 
  • A family history of cervical cancer

How Is Cervical Cancer Diagnosed?

Cervical cancer is diagnosed with regular screenings.

  • A Pap smear (Pap test) is a test that collects cells from the cervix to check for abnormal cervical cells that can lead to cervical cancer
    • Pap tests are also used to find abnormal cervical cells before they become cancer (precancers)
  • The HPV test is usually used in 2 situations:
    • The primary HPV test is preferred for cervical cancer screening in women aged 25-65 years 
    • Some HPV tests are part of a co-test when the HPV test and the Pap test are done at the same time to screen for cervical cancer

What Is the Treatment for Cervical Cancer?

Treatments for cervical cancer may include one or more of the following:

  • Surgery 
    • For pre-cancer: 
      • Ablation 
      • Excisional surgery (conization) 
    • For invasive cervical cancer:
      • Hysterectomy (simple or radical) to remove the cervix and uterus
      • Trachelectomy to remove the cervix and the upper part of the vagina but not the body of the uterus 
    • Lymph node removal
  • Radiation therapy 
    • External beam radiation
    • Brachytherapy (internal radiation therapy)
  • Chemotherapy (“chemo”)
  • Chemoradiation, which is chemotherapy given along with radiation to help it work better
    • Cisplatin is given weekly during radiation (carboplatin may be used instead) 
    • Cisplatin plus 5-fluorouracil (5-FU) given every 3 weeks during radiation
  • Targeted therapy 
    • Vascular endothelial growth factor (VEGF): bevacizumab (Avastin)
  • Immunotherapy 
    • Immune checkpoint inhibitors: pembrolizumab (Keytruda)

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Reviewed on 4/11/2022
References
Image Source: iStock Images

https://www.cancerresearchuk.org/about-cancer/cervical-cancer/stages-types-grades

https://www.cancerresearchuk.org/about-cancer/cervical-cancer/survival