Cancer Types

Cervical Cancer

Information about cervical cancer.

What is the cervix?

The cervix is part of the female reproductive organs. It is found in the lower part of the uterus at the top of the vagina.

What is cervical cancer?

Cervical cancer starts in the cells on the surface of the cervix. Most cancers in the cervix are caused by cell changes from the human papillomavirus (HPV). HPV is a very common virus that is passed on by sexual contact.

There are many different types of HPV. Some types can cause cancer and are called high-risk types. If the high-risk HPV type is not treated, overtime it may develop into cancer.

Cervical cancer often takes ten years or more to develop.

Most cervical cancers are either:

  • Squamous cell carcinoma which starts in the squamous cells in the cervix
  • Adenocarcinoma which starts in glandular cells in the cervix

Who can be affected by cervical cancer?

Anyone with a cervix can get cervical cancer: women, trans-men, non binary people assigned female at birth and some intersex people.

The most critical risk factor for cervical cancer is persistent HPV infection.

Cervical cancer mainly occurs in women over 35 years old and is less common in women under 25. Most cervical cancers are diagnosed in women under 60 years old.

Risk factors

Anything that can increase your risk is called a risk factor. Having one or more of these risk factors does not mean that you will develop cervical cancer.

The risk factors for cervical cancer are:

  • Not having regular cervical screening test
  • Smoking
  • Age (most common for people aged 45 and under)
  • Previous abnormal cervical screening result
  • Taking contraceptive pills (the pill) over a long period of time if you also have an HPV infection
  • Taking immune suppressive medications
  • Infection with HPV

Signs and symptoms

Early abnormal changes to cervical cells (pre-cancer) often do not have any symptoms. Some symptoms may only appear once they become cancer. That's why having regular cervical screening test is so important – they help find these changes before they become cancer.

Some signs and symptoms of cervical cancer include:

  • Bleeding or spotting between periods
  • Bleeding or spotting after sex
  • Bleeding or spotting after periods have stopped (after menopause)
  • Unusual and persistent discharge from your vagina
  • Persistent pain in your pelvis
  • Pain during sex

These signs and symptoms are common and not normally due to cancer but it's still important to get them checked out. Visit your doctor or nurse if you do notice any signs and symptoms.

Preventing or finding cervical cancer early

HPV vaccination:

HPV vaccination protects against high-risk types of HPV that can cause cervical cancer and a range of other head and neck and anogenital cancers. It is safe and very effective and free for people aged 9 to 26 years. HPV vaccinations are provided to primary school-age children at participating schools. If you are aged 26 and below and have not received your HPV vaccination, you can get it free from your GP, health centre and some Family Planning centres.

For more information: Ministry of Health HPV Immunisation Programme

Cervical Screening

Regular cervical screening tests every three years can detect changes on the cervix that can be treated before they become cancers (these are called pre-cancers or abnormal cells). It's still important to have a cervical screening test even if you have been immunised against HPV as the vaccine does not cover all types of HPV that can cause cancer or you could have contracted the virus before you were vaccinated.

In September 2023, HPV screening became the new method for cervical screening in Aotearoa New Zealand. HPV testing is a better first screening test. It looks for the human papillomavirus (HPV), which causes cell changes that may lead to cervical cancer.

This gives you options for how you have your screening sample taken:

  • a vaginal swab — you can either self-test, or a health professional can help
  • a cervical sample (previously known as a smear test) — taken by a health professional.

The HPV test is available to:

  • women and people with a cervix 30 years and over who are unscreened (have never had a screening test) or under-screened (haven’t had a cytology test in the past five years)
  • anyone requiring follow up smears
  • Māori and Pacific people
  • anyone who holds a community service card.

Find out more about the screening processes available and how to access them: Time to Screen, Cervical Screening Programme

Testing and diagnosis

A cervical screening test checks the health of your cervix. If you've had an abnormal result from a cervical screening test, you may need an additional test called a colposcopy, a procedure using a lighted magnifying instrument to examine the vulva, vagina and cervix to identify the abnormal cells. You might also have a biopsy. A biopsy involves removing a small amount of cervical tissue and sending to the lab for analysis under the microscope. If the biopsy finds cervical cancer, you will be referred to a team of doctors who specialise in the treatment of cervical cancer. You may also have one or more of the following tests done:

  • Blood test
  • Chest X-ray
  • CT scan
  • MRI scan
  • PET scan

(An X-ray, CT scan, MRI scan and PET scan are all different ways you can take an image inside the body)


Treatment of abnormal pre-cancerous cells

Treatment involves removing the abnormal cells using a loop excision, cone biopsy or laser. Most of the treatments are done under local anaesthetic and are very low risk. Treatment is successful 95% of the time. After treatment, you are likely to need a cervical screening test or other tests more often than usual to check that the abnormal cells have all gone.

Treatment of cervical cancer

If the biopsy found cervical cancer, you may have one or more of the following treatment options, depending on the extent of cancer in the cervix.

  • Cone biopsy
  • Removal of the cervix
  • Removal of the uterus (hysterectomy) or removal of the uterus, fallopian tubes and ovaries
  • Lymph node removal
  • Pelvic exenteration (removal of all or part of surrounding organs, e.g. ovaries and lower colon)
  • Radiation (high energy x-rays to destroy the cancer cells)
  • Chemotherapy (drugs to stop the growth of cancer cells)
  • Chemoradiation (a combination of chemotherapy and radiation).

A team of health professionals will look after your care.

After your treatment

Follow-up after your treatment varies and depends on your needs and whether you had abnormal changes or cervical cancer.

You may have one or more of the following tests:

  • Pelvic exam
  • Cervical screening test
  • Feeling your lymph nodes
  • Blood tests
  • Imaging tests such as an X-ray, CT scan, MRI scan

If you experience any signs and symptoms after your treatment, visit your doctor as soon as you can. Don't wait for a scheduled appointment.

Helpful website

Cancer Society, Cervical Cancer page Time to Screen cervical screening page