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Health condition · Clinically reviewed

Cervical cancer, HPV-driven and preventable — modern staging and treatment.

Almost all cervical cancers are caused by high-risk HPV. NHS screening + HPV vaccination prevent most cases. Modern staging with MRI + PET-CT and stage-based treatment save lives.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced, not summarised

    Every claim is checked against NICE, ESMO or a peer-reviewed source you can see at the end.

  • 03

    Updated for 2026

    Reflects current UK guidance on HPV-based screening, FIGO 2018 staging and modern immunotherapy.

Key facts

Cervical cancer at a glance.

The essentials, in plain English — what it is, how common it is, how it’s prevented and staged, and how treatment is chosen.

  • What it is

    An HPV-driven squamous cell carcinoma or adenocarcinoma of the cervix.

  • How common

    Around 3,300 new cases each year in the UK.

  • How it is prevented

    HPV vaccination and NHS cervical screening prevent most cases.

  • How it is staged

    FIGO 2018 staging with pelvic MRI and PET-CT.

  • Fertility-preserving

    Radical trachelectomy is an option for selected women with early disease.

  • Advanced disease

    Immunotherapy with pembrolizumab is now standard for advanced or recurrent cervical cancer.

Why this guide matters

Almost every cervical cancer is preventable.

Vaccination stops HPV. Screening finds pre-cancer before it becomes cancer. And modern staging and treatment save lives when cancer does occur.

  • HPV vaccination changes everything

    Vaccination against high-risk HPV prevents the infection that causes almost all cervical cancers.

  • Screening catches pre-cancer

    NHS cervical screening detects abnormal cells long before they can become cancer — and treats them.

  • Stage drives treatment

    FIGO 2018 stage — assessed with pelvic MRI and PET-CT — determines whether treatment is surgery, chemoradiotherapy or systemic therapy.

How the diagnosis is made

From first symptom to a clear plan.

The gynae-oncology pathway UK teams now follow, in order — so you know what to expect and why.

  1. 01

    Assessing

    Symptom + screening history

    Your symptoms, cervical screening history and HPV vaccination status are reviewed together — not in isolation.

  2. 02

    Assessing

    Speculum examination

    A speculum exam allows direct inspection of the cervix for any visible lesion or bleeding source.

  3. 03

    Assessing

    Colposcopy + biopsy

    Colposcopy magnifies the cervix and targeted biopsies confirm the diagnosis and cancer subtype.

  4. 04

    Confirming

    MRI pelvis (T-stage)

    A dedicated pelvic MRI defines tumour size, parametrial spread and local nodal involvement.

  5. 05

    Confirming

    PET-CT (nodal / distant)

    PET-CT identifies distant lymph nodes and metastatic spread for accurate FIGO 2018 staging.

  6. 06

    Planning

    HPV subtype + PD-L1 testing

    Tumour HPV subtyping and PD-L1 status guide prognosis and immunotherapy eligibility.

  7. 07

    Planning

    Gynae-oncology MDT

    A specialist multi-disciplinary team recommends treatment tailored to stage, fertility wishes and fitness.

Typical timeline: 4–8 weeks from first symptom to a treatment plan.

Symptoms

What cervical cancer actually shows up as.

Many early cervical cancers are silent and picked up by screening. When symptoms appear, they matter — here is what to watch for and when to act.

  • Post-coital bleeding

    Bleeding after sex is one of the classic warning signs and should always be investigated.

  • Intermenstrual bleeding

    Bleeding between periods — especially if new or persistent — warrants a speculum examination.

  • Postmenopausal bleeding

    Any vaginal bleeding after the menopause needs urgent gynaecology assessment.

  • Persistent vaginal discharge

    Blood-stained, offensive or persistent discharge should be reviewed, not ignored.

  • Pregnancy considerations

    Cervical cancer diagnosed in pregnancy needs an experienced multi-disciplinary plan for mother and baby.

  • Pelvic pain

    Persistent pelvic pain, deep pain with intercourse or unexplained back pain deserves review.

  • Lymphoedema (advanced)

    Leg swelling from pelvic lymph-node involvement can appear in more advanced disease.

  • Red flag

    Heavy vaginal bleeding with faintness, low blood pressure or collapse — call 999.

Treatment

How cervical cancer is treated in the UK.

Treatment is chosen by FIGO 2018 stage, fertility wishes and fitness — from local excision, to fertility-preserving surgery, chemoradiotherapy and immunotherapy.

  • LLETZ (very early stage IA1)

    Large loop excision of the transformation zone can be curative for microscopic, very-early-stage disease.

  • Radical hysterectomy

    Removal of the uterus, cervix, parametrium and pelvic nodes — the standard for early-stage disease when fertility is complete.

  • Trachelectomy (fertility-preserving)

    Radical removal of the cervix while preserving the uterus — an option for selected women wishing to conceive.

  • Concurrent chemoradiotherapy

    Combined radiotherapy and platinum-based chemotherapy is the standard for locally advanced disease.

  • Brachytherapy

    Internal radiotherapy delivered directly to the cervix — an essential part of curative treatment for advanced local disease.

  • Pembrolizumab (advanced/recurrent)

    Immunotherapy with pembrolizumab is now standard for PD-L1-positive advanced or recurrent cervical cancer.

  • Bevacizumab + chemo

    Adding bevacizumab to chemotherapy improves outcomes in metastatic and recurrent disease.

  • Palliative + supportive care

    Symptom control, psychological support and specialist palliative care matter at every stage.

What this guide is based on

The sources behind every number on this page.

UK and European guidance, specialist society standards and patient-organisation resources, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or gynae-oncology team knows your history and can tell you which parts apply to you.

  • National Institute for Health and Care Excellence (NICE). Cervical cancer (NG159).

  • European Society for Medical Oncology (ESMO). Clinical Practice Guidelines — cervical cancer.

  • Jo’s Cervical Cancer Trust. Patient information and support.

  • NHS Cervical Screening Programme — guidance and information.

Red flags

When cervical cancer becomes an emergency.

Most of the time, cervical cancer is worked up over weeks. These are the situations that need action today — not next week.

  • Heavy vaginal bleed

    Heavy bleeding with faintness, low blood pressure or collapse — call 999 or attend A&E immediately.

  • Pelvic pain crisis

    Severe uncontrolled pelvic pain in known cervical cancer needs urgent oncology and pain-team review.

  • Ureteric obstruction

    Reduced urine output, flank pain or rising creatinine may reflect ureteric compression — urgent scan and drainage.

  • Vesicovaginal fistula

    Continuous leakage of urine per vagina in advanced or post-radiotherapy disease needs specialist review.

  • Post-op complications

    Fever, heavy bleeding, wound problems or severe pain after surgery — seek urgent help.

  • Neutropenic sepsis

    Fever or feeling very unwell within weeks of chemotherapy — call the chemo hotline or attend A&E immediately.

  • Bone metastases

    New persistent bone pain, especially spine or pelvis, needs prompt imaging in known cervical cancer.

  • Pregnancy with cervical cancer

    Cervical cancer in pregnancy is a specialist emergency needing a combined obstetric and gynae-oncology plan.

  • Palliative-stage crisis

    Uncontrolled bleeding, breathlessness or pain in palliative disease — contact your specialist team today.

Living with it

Recovery and survivorship, with structured support.

Four things that make the biggest difference day to day — follow-up, menopause care, fertility conversations and emotional support.

A quiet reminder

Ask about rehabilitation early.

Menopause care, pelvic-health physiotherapy and psychological support all work best when they’re set up from the start.

  1. 01 Monitoring

    Structured follow-up

    Regular gynae-oncology review with examination and imaging when needed keeps recovery on track.

  2. 02 Side effects

    Menopause and vaginal health

    Treatment-induced menopause and vaginal changes are common — HRT and pelvic-health support help enormously.

  3. 03 Fertility

    Fertility and family planning

    Discuss fertility preservation early — options exist before radical surgery or chemoradiotherapy in selected women.

  4. 04 Support

    Emotional and sexual wellbeing

    Psychological, sexual and relationship support are a normal part of survivorship — ask for it early.

Frequently asked

Everything we get asked about cervical cancer.

Quick answers on HPV, screening, staging, fertility and when to worry.

  • What is cervical cancer?

    A cancer of the cervix, almost always caused by persistent infection with high-risk human papillomavirus (HPV). The two main types are squamous cell carcinoma and adenocarcinoma.

  • Can cervical cancer be prevented?

    Yes — HPV vaccination and NHS cervical screening prevent most cases. Screening detects pre-cancerous changes long before they can become cancer.

  • How is cervical cancer staged?

    Cervical cancer is staged using the FIGO 2018 system, which combines clinical examination, pelvic MRI and PET-CT to assess tumour size, local spread and distant disease.

  • Can I still have children after treatment?

    For very early disease, fertility-preserving surgery such as radical trachelectomy may be possible. It is essential to discuss fertility options with your gynae-oncology team before treatment starts.

  • What is pembrolizumab and when is it used?

    Pembrolizumab is an immunotherapy that helps your immune system attack cancer cells. In cervical cancer, it is used for PD-L1-positive advanced or recurrent disease, often combined with chemotherapy.

  • When should I worry about symptoms?

    Post-coital bleeding, bleeding between periods, postmenopausal bleeding or persistent blood-stained discharge always deserve a speculum examination. Heavy bleeding with faintness or collapse — call 999.

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