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| Cervical Cancer |
Updated: August 2026
Cervical cancer is unusual among cancers because we know its main cause, we can vaccinate against the infections responsible for most cases, we can detect changes in the cervix before they become cancer, and early disease can often be treated successfully.
The World Health Organization estimates that cervical cancer caused around 604,000 new cases and 280,000 deaths worldwide in 2024, with women in low and middle-income countries carrying a disproportionate burden.
This makes cervical cancer not only a medical issue but also a question of access: access to HPV vaccination, screening, diagnosis and timely treatment.
What Is Cervical Cancer?
The cervix is the lower part of the uterus that connects to the vagina.
Cervical cancer develops when cells in the cervix undergo abnormal changes and eventually begin growing uncontrollably.
These changes usually develop gradually.
Before invasive cancer develops, abnormal precancerous cells may be detectable through cervical screening. Treating these changes provides an opportunity to prevent cancer from developing.
This is why cervical cancer screening is fundamentally different from simply waiting until symptoms appear.
What Causes Cervical Cancer?
The most important cause is persistent infection with high-risk types of human papillomavirus, or HPV.
HPV is a very common group of viruses.
Most HPV infections clear naturally without causing cancer. The concern is when infection with certain high-risk HPV types persists.
Over time, persistent infection can cause abnormal cellular changes that may eventually progress to cervical cancer.
This progression usually takes years, which creates an important window for screening and treatment of precancerous disease.
Does Having HPV Mean You Have Cervical Cancer?
No.
This distinction is essential.
Having HPV does not mean someone has cancer.
Most sexually active people are exposed to HPV at some point, and most infections resolve without producing serious disease.
A positive high-risk HPV result means that a type of HPV associated with cervical cancer has been detected.
Depending on the test result, HPV type, age and screening programme, further assessment or follow-up may be recommended.
What About Genital Warts?
The HPV types that usually cause genital warts are generally different from the high-risk HPV types responsible for cervical cancer.
Most anogenital warts are caused by low-risk HPV types, particularly HPV 6 and HPV 11.
Having genital warts therefore does not mean that someone has cervical cancer or will develop it.
However, a person can be infected with more than one HPV type at the same time. Someone with a low-risk HPV type that causes genital warts can also acquire a high-risk HPV type.
Genital warts should therefore not be confused with cervical cancer, but they also do not replace the need for appropriate cervical screening.
Read our detailed guide to Genital Warts and HPV: Symptoms, Treatment, Transmission and Cancer Risk for more information.
How Is HPV Transmitted?
HPV is transmitted mainly through intimate skin-to-skin and sexual contact.
Penetrative intercourse is not required for every HPV transmission event.
Because HPV is extremely common, infection should not automatically be interpreted as evidence of recent infidelity.
An infection can persist or become detectable long after the original exposure.
What Are the Symptoms of Cervical Cancer?
Early cervical cancer may produce no symptoms at all.
That is one reason screening matters.
When symptoms occur, they can include:
- Abnormal vaginal bleeding
- Bleeding after sexual intercourse
- Bleeding between menstrual periods
- Bleeding after menopause
- Unusual or persistent vaginal discharge
- Pelvic pain
- Pain during sexual intercourse
More advanced disease may cause additional symptoms depending on where the cancer has spread.
These symptoms do not automatically mean cervical cancer. Fibroids, infections, hormonal changes and several other conditions can cause similar problems.
However, unexplained abnormal bleeding, particularly bleeding after sex or after menopause, deserves proper medical assessment.
Who Is at Greater Risk?
Persistent high-risk HPV infection is the central cause, but several factors can influence the likelihood that infection progresses to cancer.
These include:
- Immune suppression
- HIV infection
- Tobacco smoking
- Limited access to cervical screening
- Failure to receive appropriate follow-up after an abnormal screening result
Women living with HIV require particular attention because immune suppression can make persistent HPV infection and progression of cervical disease more likely.
Cervical Cancer Is Often Preventable
Prevention works at several levels.
Primary Prevention
Primary prevention aims to prevent HPV infection and reduce the likelihood that cervical disease develops.
The major intervention is HPV vaccination.
Secondary Prevention
Secondary prevention aims to identify precancerous cervical changes before invasive cancer develops.
This is the role of screening and treatment of precancer.
Tertiary Prevention
Tertiary prevention involves diagnosing and appropriately treating invasive cervical cancer while providing supportive and palliative care where necessary.
WHO's global cervical cancer elimination strategy deliberately combines all three levels rather than relying on a single intervention.
HPV Vaccination
HPV vaccines protect against important high-risk HPV types responsible for cervical cancer.
Some HPV vaccines also protect against low-risk types responsible for most genital warts.
Vaccination is most effective when given before exposure to HPV, which is why programmes generally target girls before or around early adolescence.
Vaccinating someone against HPV does not mean they are being treated for a sexually transmitted infection.
The objective is prevention.
Is HPV Vaccination Available in Nigeria?
Yes.
Nigeria introduced HPV vaccination into its routine immunisation programme beginning in 2023, targeting eligible girls and progressively expanding implementation across the country.
This represents an important opportunity because preventing persistent high-risk HPV infection today can prevent cervical cancer many years later.
Parents and caregivers should use official immunisation services and current national guidance because programme eligibility and delivery arrangements can change.
Does HPV Vaccination Cause Infertility?
There is no credible evidence that approved HPV vaccination causes infertility.
Claims linking HPV vaccination with infertility have contributed to vaccine hesitancy in several countries, but they are not supported by established vaccine-safety evidence.
The benefit being sought is substantial: preventing infections responsible for the overwhelming majority of cervical cancers.
Does HPV Vaccination Mean Screening Is No Longer Necessary?
No.
Vaccination and screening complement each other.
Vaccines provide strong protection against important cancer-causing HPV types, but screening remains necessary according to national recommendations.
This is especially important for generations of adults who were not vaccinated before HPV exposure.
What Is Cervical Cancer Screening?
Screening means testing people who do not necessarily have symptoms to identify increased risk or precancerous changes.
Several approaches have been used.
HPV Testing
HPV testing looks for high-risk HPV infection associated with cervical cancer.
High-performance HPV testing has become increasingly important in modern cervical cancer prevention.
WHO's 2026 guidance on HPV DNA genotyping explains how HPV genotyping can be incorporated into screening programmes to help stratify risk and determine appropriate follow-up.
Pap Smear or Cervical Cytology
A Pap test examines cervical cells for abnormal changes.
Pap screening has prevented many cervical cancers where organised screening programmes have achieved high coverage.
However, cervical cancer prevention is increasingly moving toward HPV-based testing because HPV testing can identify women at increased risk before cellular abnormalities become advanced.
Visual Inspection With Acetic Acid
In some lower-resource settings, visual inspection with acetic acid, often abbreviated VIA, has been used to identify abnormal areas of the cervix.
This approach can be useful where laboratory infrastructure is limited, particularly within screen-and-treat programmes.
The screening strategy used in a particular setting should follow current national and WHO guidance.
Is Cervical Screening the Same as a Diagnostic Test?
No.
Screening is designed for people without known cervical cancer.
An abnormal screening result does not automatically mean cancer.
It means additional evaluation or treatment may be required depending on the result.
Someone who already has concerning symptoms may need diagnostic assessment rather than simply joining a routine screening programme.
What Happens After an Abnormal Screening Result?
The next step depends on:
- The screening method
- HPV result
- HPV genotype where available
- Cervical findings
- Age
- Immune status
- Previous results
- National screening protocol
Possible next steps include repeat testing, additional triage tests, colposcopy, biopsy or treatment of a precancerous lesion.
The important point is:
Screening only saves lives when abnormal results are followed up.
A programme that tests women but loses them before diagnosis or treatment has not completed the prevention pathway.
What Is Colposcopy?
Colposcopy allows a healthcare professional to examine the cervix closely using magnification.
Abnormal areas can be identified, and tissue samples may be taken for biopsy when necessary.
A biopsy allows a pathologist to examine tissue under a microscope to determine whether precancer or cancer is present.
How Is Cervical Cancer Diagnosed?
Cervical cancer cannot be reliably diagnosed from symptoms alone.
Assessment may involve:
- Pelvic examination
- Colposcopy
- Biopsy
- Pathology examination
- Imaging where appropriate
Once cancer is confirmed, additional investigations help determine its extent or stage.
Staging is important because treatment depends heavily on whether cancer remains confined to the cervix or has spread to nearby tissues or more distant parts of the body.
How Is Cervical Cancer Treated?
Treatment depends on factors including:
- Stage of cancer
- Tumour size
- Patient's overall health
- Fertility considerations
- Previous treatments
- Available expertise and resources
Treatment may involve surgery, radiotherapy, chemotherapy or combinations of these approaches.
Surgery
Very early cervical cancer may sometimes be treated surgically.
The exact procedure depends on the extent of disease and individual circumstances.
Some patients with early disease may be candidates for fertility-preserving approaches, while others require more extensive surgery.
Radiotherapy
Radiotherapy uses radiation to destroy cancer cells.
It can play a major role in treating cervical cancer, particularly for locally advanced disease.
Because pelvic radiotherapy can affect nearby tissues, side effects may involve the bowel, bladder, reproductive organs, skin and general energy levels.
Chemotherapy
Chemotherapy may be used alongside radiotherapy or in other treatment situations.
The medicines used and their side effects depend on the clinical circumstances.
For more information, read the AnjKreb guide Chemotherapy and Radiotherapy Side Effects: What to Expect and When to Seek Help.
Can Cervical Cancer Be Cured?
Yes, particularly when detected early and treated appropriately.
WHO states that cervical cancer can be cured when diagnosed early and managed appropriately.
Outcomes generally become more difficult as disease becomes more advanced.
This is another reason prevention and screening matter so much.
Cervical Cancer and HIV
Women living with HIV require particular attention in cervical cancer prevention.
WHO reports that women living with HIV are approximately six times more likely to develop cervical cancer than women without HIV.
HIV-related immune suppression can make it more difficult for the body to clear HPV infection, increasing the likelihood of persistent high-risk HPV infection and progression of cervical disease.
Women living with HIV should therefore follow cervical screening recommendations appropriate to their clinical circumstances.
This is also why HIV and cervical cancer services can benefit from stronger integration.
AnjKreb readers can learn more about modern HIV care in WHO HIV Clinical Staging in Adults: Stages 1 to 4 Explained.
Can Condoms Prevent HPV?
Condoms can reduce the risk of HPV transmission but do not provide complete protection because HPV can infect areas not covered by a condom.
They remain important for reducing the risk of HIV and several other sexually transmitted infections.
HPV vaccination and cervical screening therefore remain important even when safer-sex practices are followed.
Can Someone Who Has Never Had Sex Develop Cervical Cancer?
The risk is considerably lower because persistent sexually acquired high-risk HPV causes almost all cervical cancers.
However, individual medical decisions should not be based solely on assumptions about sexual history.
Anyone experiencing concerning cervical or vaginal symptoms should seek appropriate medical assessment.
Why Cervical Cancer Is an African Health Equity Issue
Cervical cancer illustrates a major global health inequality.
We already have tools capable of preventing many cases and detecting precancer before invasive disease develops.
Yet women living in countries with weaker vaccination programmes, limited screening coverage, delayed pathology services and restricted access to cancer treatment face much greater risks.
The WHO African Region includes countries with some of the world's highest cervical cancer incidence and mortality rates.
The problem is therefore not simply whether the technology exists.
It is whether women can actually access it.
What Does Cervical Cancer Elimination Mean?
WHO has set a global goal of eliminating cervical cancer as a public health problem.
Elimination does not mean there will literally never be another case.
WHO defines elimination as reaching and maintaining an incidence below 4 cases per 100,000 women per year.
To put countries on that path, WHO established the 90-70-90 targets for 2030.
90%: Girls fully vaccinated against HPV by age 15.
70%: Women screened with a high-performance test by age 35 and again by age 45.
90%: Women identified with cervical disease receive appropriate treatment.
The treatment target includes treating 90% of women with precancer and appropriately managing 90% of women with invasive cancer.
Why All Three Targets Matter
Vaccination alone cannot immediately protect women who were already exposed to high-risk HPV.
Screening alone cannot protect future generations as efficiently as widespread vaccination.
And identifying precancer or cancer achieves little if women cannot access treatment.
That is why WHO's strategy combines:
Vaccination + screening + treatment.
Common Cervical Cancer Myths
Myth: Cervical cancer is hereditary, so there is nothing you can do.
Persistent high-risk HPV infection causes almost all cervical cancers. Prevention through vaccination and screening can substantially reduce risk.
Myth: An HPV-positive result means cancer.
No. HPV infection is common, and most infections do not progress to cancer.
Myth: Genital warts mean cervical cancer.
No. Most genital warts are caused by low-risk HPV types that are different from the high-risk HPV types responsible for most cervical cancers.
Myth: If I have no symptoms, I do not need screening.
Early cervical abnormalities frequently produce no symptoms. That is precisely why screening exists.
Myth: HPV vaccination encourages sexual activity.
Vaccination is disease prevention. Its purpose is to establish immunity before exposure to cancer-causing HPV types.
Myth: Cervical screening makes women infertile.
Routine cervical screening itself does not cause infertility.
Myth: Cervical cancer cannot be treated.
It can be treated, and early-stage disease can often be cured.
When Should You Seek Medical Attention?
Do not wait for routine screening if you develop concerning symptoms.
Seek medical assessment for unexplained:
- Bleeding after sex
- Bleeding between periods
- Postmenopausal bleeding
- Persistent unusual vaginal discharge
- Pelvic pain
- Pain during intercourse
These symptoms can have causes other than cancer.
The objective is not to panic.
It is to find out what is causing them.
What Women Can Do
Cervical cancer prevention can be reduced to several practical actions.
Know whether you are due for cervical screening.
Attend follow-up if a screening result is abnormal.
Seek medical attention for unexplained vaginal bleeding.
Ensure eligible girls receive HPV vaccination through recommended programmes.
Do not assume vaccination eliminates the need for future screening.
Avoid tobacco.
And share accurate information about HPV rather than reinforcing myths that discourage vaccination or screening.
What Health Systems Need to Do
Individual behaviour is only part of the solution.
Countries also need:
- Reliable HPV vaccine supply
- Strong routine immunisation programmes
- Accessible cervical screening
- Reliable laboratories
- Functional referral systems
- Pathology services
- Trained healthcare workers
- Affordable treatment
- Cancer registries
- Community education
- Systems that prevent women with abnormal results from being lost to follow-up
WHO's 2026 cervical screening guidance also emphasises that HPV-based screening programmes must account for health-system capacity, feasibility, equity and follow-up pathways rather than treating a laboratory test as an isolated intervention.
Frequently Asked Questions
What is the main cause of cervical cancer?
Persistent infection with high-risk HPV types is responsible for almost all cervical cancers.
Is HPV the same as cervical cancer?
No. HPV is an infection. Most infections clear without causing cancer.
Do genital warts cause cervical cancer?
Usually, no. Most genital warts are caused by low-risk HPV types, particularly HPV 6 and 11, while cervical cancer is associated with persistent infection with high-risk HPV types.
Can cervical cancer be prevented?
Many cases can be prevented through HPV vaccination, appropriate cervical screening and treatment of precancerous lesions.
Can cervical cancer occur without symptoms?
Yes. Early disease and precancerous changes may produce no noticeable symptoms.
Does bleeding after sex mean cervical cancer?
Not necessarily. Several conditions can cause bleeding after intercourse, but unexplained bleeding should be medically assessed.
Is HPV vaccination useful?
Yes. HPV vaccination is a central component of WHO's global cervical cancer elimination strategy.
Do vaccinated women still need screening?
Yes. Vaccination does not eliminate the need for screening according to appropriate national recommendations.
What is an HPV test?
It detects high-risk HPV infection associated with cervical cancer development.
What is a Pap smear?
A Pap test examines cells collected from the cervix for abnormal cellular changes.
Can cervical cancer be cured?
Early cervical cancer can often be treated successfully, and WHO states that cervical cancer is curable when diagnosed early and treated appropriately.
Key Takeaways
Cervical cancer is largely preventable.
Persistent high-risk HPV infection causes almost all cases.
HPV infection itself does not mean someone has cancer.
Most genital warts are caused by different, low-risk HPV types and should not be confused with cervical cancer.
Early cervical disease may cause no symptoms.
HPV vaccination protects against important cancer-causing HPV types.
Screening can identify women at increased risk and detect precancer before invasive disease develops.
Women living with HIV require particular attention because their risk of cervical cancer is substantially higher.
Abnormal vaginal bleeding should not be ignored.
And cervical cancer prevention only works fully when women with abnormal screening results can access appropriate diagnosis and treatment.
The global goal is ambitious but remarkable:
Cervical cancer could become one of the first cancers eliminated as a public health problem.
References and Further Reading
World Health Organization. Cervical cancer. Updated July 2026.
https://www.who.int/news-room/fact-sheets/detail/cervical-cancer
World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem.
https://www.who.int/publications/i/item/9789240014107
World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention: use of HPV DNA genotyping. 2026.
https://www.who.int/publications/i/item/9789240121744
World Health Organization. Cervical Cancer Elimination Initiative.
https://www.who.int/initiatives/cervical-cancer-elimination-initiative
Centers for Disease Control and Prevention. Human Papillomavirus Infection: Anogenital Warts.
https://www.cdc.gov/std/treatment-guidelines/anogenital-warts.htm
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