Cervical cancer signs and what to look for

"Early diagnosis is incredibly important with cervical cancer," explains molecular engineer and cancer researcher, Dr Angela Pine. "As we screen against high-risk HPV, we can identify those at risk before cell changes have even happened. Technically this could lead to cervical cancer being one of the first cancers to be eliminated. We can definitely get those numbers down."

Screening programme

The NHS screening programme invites women and other people with a cervix aged 25-49 years old for screening every three years, where a sample of cells is taken from the cervix. Those aged 50-64 are screened every five years.

Unlike some cancers, cell changes in the cervix can be detected and treated before cancer even develops. Since 2019, as well as checking samples collected for these cell changes, samples are screened for high-risk HPV. A positive HPV diagnosis will lead to more regular screening to ensure the infection clears up, or to identify any cell changes in time for early intervention.

Under 25s

While those under 25 are not routinely offered a smear test, this does not mean that cancer cannot occur in this age group. However, research suggests that the risks of offering cervical screening under the age of 25 outweigh the benefits². Cell changes in the cervix are quite common in this age and usually clear up on their own.

In addition, as the HPV vaccine is now offered routinely in this age-group, rates of cervical cancer should drop further.

Less than 1% of cervical cancer cases occur in those under-25 - around 4 in 100,000 women are diagnosed each year².

Problems with screening

Although screening is a very effective way of identifying or preventing cervical cancer, around one third of of those invited did not attend a screening in 2021-2022³. This could be due to a number of factors.

"There are so many reasons for non-attendance," says Pine. "Often it’s due to the nature of the test. It’s quite invasive and can be uncomfortable, and some may find it embarrassing. But there are also issues for some with getting time off work to take the test - many people have to take the time off as annual leave."

Cancer symptoms

HPV, the virus that causes the majority of cases of cervical cancer, has no symptoms at all. This means you can carry the virus and pass it on unknowingly. However, cervical cancer, and the cell changes that lead to it, can take years to develop. So, if you are diagnosed with HPV, close monitoring and early intervention can prevent cancer from developing.

One reason for the relatively high mortality rate for cervical cancer is that at the early-stage there are often no symptoms at all. Symptoms only tend to show once the cancer is more advanced.

What are the symptoms of cervical cancer and when should I be concerned?

Vaginal bleeding

Unusual vaginal bleeding outside of your normal monthly period and bleeding during or after sex can be a sign. Pine says: "Bleeding of this type doesn’t necessarily indicate cancer, but any bleeding that’s not normal for you should be investigated.” It is especially important to investigate any unusual bleeding if you are post-menopausal.

Lower back pain:

While lower back pain itself can have a number of causes, continual back pain that has no obvious cause may be a sign of cervical cancer.

Unusual discharge

All women tend to have some vaginal discharge, which may alter in appearance and texture over the course of a month. However unusual discharge may be a sign of cervical cancer. "Any discharge that is different from usual may be a sign," says Pine. Look out for changes in colour, consistency or smell.

Pain or discomfort during sex

For some, pain or discomfort during sex is a frequent experience – and there may be a number of causes. When it comes to cervical cancer, new pain or a change in the type of pain experienced could be a cause. "Some people experience pain during sex regularly. We are looking for changes - anything outside the norm," explains Pine.
“Women are good at knowing their bodies, so may spot signs. But we tend to be less good at prioritising ourselves over others,” says Pine.

Take action early

If you have any concerns about screening or cervical cancer- contact your doctor to discuss your worries. Any symptoms you are worried about should be discussed with your doctor as soon as you can.

Further reading

1. Cancer Research UK: Cervical cancer statistics

2. Jo's Trust: Cervical screening for under 25s.

3. NHS: Cervical screening KPI CS1.