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Cervical cancer develops in the neck of the womb. Nearly all cases are caused by long-lasting infection with high-risk types of human papillomavirus (HPV), and the cancer is preceded for years by precancerous changes that screening can find and treat.

Early cancers are treated mainly with surgery, and larger or locally advanced cancers with radiotherapy combined with chemotherapy. In carefully selected young women with very early disease, fertility can sometimes be preserved. HPV vaccination and regular screening prevent most cases.

Symptoms

• Bleeding after sex
• Bleeding between periods or after the menopause
• Heavier or longer periods than usual
• Persistent, unpleasant-smelling or bloodstained vaginal discharge
• Pain during sex or persistent pelvic pain
• Leg swelling, back pain or urinary problems in advanced disease
• No symptoms in early stages, which is why screening matters

Causes and risk factors

High-risk HPV, particularly types 16 and 18, is passed on through sexual contact and is extremely common; most infections clear on their own within 2 years. Cancer can follow when the infection persists. Smoking, a weakened immune system including HIV infection, long-term use of the contraceptive pill, several full-term pregnancies and not attending screening increase the risk. HPV vaccination before exposure greatly reduces risk but does not remove the need for screening.

How it is diagnosed

• HPV test and cervical cytology: Screening tests that detect the virus and abnormal cells. They are not used on their own to diagnose cancer when symptoms are present.
• Colposcopy and biopsy: A magnified examination of the cervix with small samples taken from abnormal areas.
• Cone biopsy or loop excision: Removes a larger piece of the cervix, both to diagnose and, for precancer and the very earliest cancers, to treat.
• Pelvic MRI: Shows the tumour size and whether it extends beyond the cervix, which determines whether surgery is suitable.
• PET-CT or CT: Looks for spread to lymph nodes and beyond, and examination under anaesthesia may be added.

Treatment options

• Treatment of precancer (CIN): Loop excision under local anaesthetic removes the abnormal area and prevents cancer developing.
• Cone biopsy or trachelectomy: Fertility-sparing options for very early cancers in women who wish to have children, with careful selection.
• Radical hysterectomy with lymph node assessment: Standard surgery for early-stage cancer. Current evidence favours the open approach over keyhole surgery for this operation.
• Chemoradiotherapy: External radiotherapy daily for about 5 weeks with weekly cisplatin, followed by internal radiotherapy (brachytherapy). The standard for locally advanced disease.
• Systemic therapy: Chemotherapy, bevacizumab and immunotherapy for cancer that has spread or returned.

When it is urgent

Seek emergency care near you for heavy vaginal bleeding that soaks pads hourly or causes faintness, for severe pelvic pain with fever, for inability to pass urine, or for a swollen, painful leg that may indicate a clot. During chemoradiotherapy, a fever or persistent vomiting and diarrhoea need same-day review by the treating team.

Travelling to Türkiye for treatment

Abnormal bleeding should be examined locally without delay. A trip can suit colposcopy and loop treatment of precancer, a second opinion on staging, or a planned radical hysterectomy with about 2 weeks' stay. Chemoradiotherapy with brachytherapy takes 7 to 8 weeks without gaps; it is possible abroad only if you can stay for the entire course, and interruptions reduce its effectiveness. Follow-up examinations over the next 5 years should be set up at home.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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