A Complete Guide to Cervical Cancer: Prevention, Screening & Treatment

Cervical cancer is one of the most preventable cancers when detected early through screening and vaccination. This guide covers its causes, symptoms, prevention strategies, screening methods, treatment options, and specialized services .

We at Dr. MAM Ramaswamy Cancer Institute - A unit of Chettinad Super Speciality Hospital, is committed to the World Health Organization’s (WHO) 2030 goal of eliminating cervical cancer. As a premier destination for oncology in Chennai, our mission is to provide every woman with the knowledge and medical care necessary to lead a cancer-free life.

Causes and Risk Factors

Cervical cancer primarily develops from persistent infection with high-risk types of human papillomavirus (HPV), a sexually transmitted virus affecting over two-thirds of sexually active individuals at some point. HPV types 16 and 18 cause about 70% of cases, with the virus damaging cervical cells over time if the immune system fails to clear it.

Additional risk factors amplify vulnerability. These include:

● Early onset of sexual activity

● Multiple sexual partners

● Smoking, which introduces chemicals that harm cervical cells

● Long-term oral contraceptive use

● Multiple full-term pregnancies (three or more)

● Weakened immunity from HIV or other conditions

Women without HPV exposure or these factors rarely develop the disease.

Symptoms to Watch For

Early-stage cervical cancer often shows no symptoms, underscoring the need for routine screening.

As it progresses, common signs include:

● Abnormal vaginal bleeding (between periods, after sex, or post-menopause)

● Heavier or longer menstrual periods

● Unusual vaginal discharge that may contain blood

Advanced symptoms may include:

● Pelvic pain

● Pain during intercourse

● Lower back or abdominal discomfort

● Leg swelling

● Fatigue

● Urinary or bowel problems

In stage 4 disease, widespread effects such as shortness of breath, bone pain, or fistulas can occur.

Abnormal Bleeding Patterns

Watch for vaginal bleeding between menstrual periods, after sexual intercourse, or after menopause. These are among the earliest and most common red flags.

Periods that suddenly become heavier, longer, or more painful than usual also warrant attention, as they may signal cellular changes in the cervix.

Unusual Vaginal Discharge

A watery, bloody, or foul-smelling discharge appearing between periods or independent of menstruation can indicate early tumor formation.

This differs from normal discharge by its:

● Consistency

● Color (pinkish or blood-tinged)

● Odor

Pain Indicators

Mild pelvic pain or discomfort during sex (dyspareunia) may appear early and is often mistaken for infections.

Lower back pain or unexplained pelvic pressure may be subtle warning signs before more advanced spread.

Prevention Strategies

Prevention focuses on blocking HPV infection and reducing modifiable risks.

HPV Vaccination

The HPV vaccine, such as Gardasil targeting HPV types 16, 18, 6, and 11, significantly reduces risk. Girls vaccinated before age 16 face 80–90% lower cervical cancer incidence. Vaccination is most effective before sexual exposure and includes boys to support herd immunity.

Lifestyle Measures

● Consistent condom use reduces HPV transmission by about 70%

● Quitting smoking

● Limiting sexual partners

● Regular screening to detect precancerous changes early

Screening Guidelines

Screening saves lives by identifying precancerous lesions early.

Cervical cancer screening follows evidence-based guidelines based on age and risk.

Step 1: Ages 21–24

● Begin screening at age 21

● Pap test (cervical cytology) alone

● Repeat every 3 years if normal

● HPV testing not recommended due to high transient infection rates

Step 2: Ages 25–29

● Continue Pap tests every 3 years

● Some ACS guidelines allow primary HPV testing at 25

● Cytology remains standard to avoid overtreatment

Step 3: Ages 30–65

Choose one method consistently:

● Primary HPV test every 5 years (preferred)

● HPV/Pap co-testing every 5 years

● Pap test alone every 3 years if HPV testing unavailable

Switching methods should be guided by a healthcare provider.

Step 4: After Age 65

Screening may stop if:

● Prior screening over 10 years is adequate

● Three consecutive negative Pap tests or two negative HPV tests

Continue screening if:

● Screening history is inadequate

● Prior precancerous lesions

● Recent high-risk HPV infection

Special Considerations

High-risk individuals (HIV-positive, immunocompromised, or prior cervical abnormalities) require more frequent screening (every 1–3 years).

Screening is not required after hysterectomy unless there is a history of cervical cancer or precancer.

Treatment Options by Stage

Treatment depends on cancer stage, patient health, and fertility preferences.

● Early stages (IA–IB1): Surgery such as cone biopsy, simple hysterectomy, or radical trachelectomy

● Locally advanced stages (IB2–IIA, IIB–IVA): Chemoradiation using cisplatin or carboplatin with external beam radiation (EBRT) followed by brachytherapy

● Stage III/IVA: May include immunotherapy such as pembrolizumab

● Stage IVB: Systemic chemotherapy, targeted therapy, immunotherapy, and palliative radiation

Treatment Overview Table

Stage	Primary Treatments	Additional Options
IA–IB1	Surgery (hysterectomy/trachelectomy)	Radiation if needed
IB2–IIA	Chemoradiation or radical hysterectomy	Post-op brachytherapy
IIB–IVA	Chemoradiation (EBRT + brachytherapy)	Immunotherapy
IVB	Chemotherapy / Immunotherapy	Palliative radiation

Comprehensive cervical cancer care at                       Dr. MAM Ramaswamy Cancer Institute - A unit of Chettinad Super Speciality Hospital

Dr. MAM Ramaswamy Cancer Institute - A unit of Chettinad Super Speciality Hospital in Chennai, provides comprehensive cervical cancer care under one roof from prevention to advanced treatment, improving outcomes for patients in India. Early consultation maximizes success rates.

Diagnostic Services

● HPV and Pap screening

● Colposcopy

● Biopsy

● Advanced imaging for accurate staging

Treatment Services

● Surgical oncology

● Chemotherapy

● Radiation therapy (EBRT and brachytherapy)

● Immunotherapy

Additional Support

● Multidisciplinary treatment planning

● HPV vaccination clinics

● Survivorship and follow-up care

Contact Us

Dr. MAM Ramaswamy Cancer Institute 

Chettinad Super Speciality Hospital
Chettinad Health City, Kelambakkam, Chennai – 603103

Call: +91-90944 81000

WhatsApp: +91 90944 81000

Website: www.chettinadhospital.com
Email: cssh@chettinadhospitals.com