Cervical Cancer Overview^[condition] and NIH Women's Health Research

Cervical cancer is a slow-developing cancer that starts in the cells of the cervix. Most cervical cancers arise in the squamocolumnar junction between the endocervix and ectocervix.¹ Some early symptoms of cervical cancer may include pelvic pain and vaginal bleeding after sex or between menstrual cycles. Once the cancer has spread from the cervix to other parts of the body, symptoms such as abdominal pain, painful urination, or painful bowel movements may occur.²

The majority of cervical cancers are caused by persistent infections with high-risk types of human papillomavirus (HPV), primarily HPV 16 and HPV 18.³ Women with high-risk HPV infections are more likely to develop cervical cancer if they are immunocompromised or are taking immunosuppressants. Other risk factors for cervical cancer include smoking, obesity, the use of oral contraceptives, and giving birth to many children.⁴ A small but clinically important proportion of cervical cancers, generally estimated to include about 5% to 11% of cases, are not associated with HPV infection and instead arise as biologically distinct tumor subtypes with unique molecular features and clinical behavior.⁵

Cervical cancer disproportionately affects women who face persistent barriers to HPV prevention, screening, and timely care, including Black and Hispanic/Latina women, women living with HIV or other immunocompromising conditions, those who are uninsured or underinsured, and women in rural or medically underserved communities.⁶ The higher risk in these groups is driven less by biological differences and more by structural and social factors (e.g., reduced access to screening, delayed follow up, and limited availability of timely, evidence‑based cancer treatment) that allow HPV infections to persist and progress to cancer.⁷ Because cervical cancer is largely preventable, addressing these inequities is central to reducing disparities in incidence and mortality.

Cervical cancer is diagnosed through cervical screening (i.e., HPV testing and/or Pap testing) followed by diagnostic evaluation when abnormal results are identified. HPV testing detects the presence of high‑risk viral DNA, whereas Pap testing assesses cervical cells for precancerous abnormalities. Detecting and treating these lesions can prevent progression to cancer. Magnetic resonance imaging (MRI) is used to determine the extent and stage of the disease.⁸

Treatment for cervical cancer depends on disease stage and may include surgery, radiation therapy, and chemotherapy.⁹ Cervical cancer prevention includes HPV vaccination—which is most effective when given before the onset of sexual activity³—and regular cervical cancer screening with HPV testing and/or Pap testing, even among vaccinated individuals.⁸

In 2006, the National Cancer Institute (NCI) and the National Human Genome Research Institute (NHGRI) teamed up to launch The Cancer Genome Atlas (TCGA) Program. TCGA characterized the genetic material of more than 30 types of cancer,¹⁰ including the two main types of cervical cancer (squamous cell carcinoma and adenocarcinoma). Building on foundational genomic work from TCGA, recent NCI-supported studies integrate tumor genetics, immune markers, and advanced imaging to guide precision treatment, including immunotherapy combined with chemoradiation for locally advanced disease. Through the NIH Intramural Research Program, researchers are also developing biomarker- and artificial intelligence-based tools to better predict which HPV infections are most likely to progress to cancer, improving early detection and personalized care.¹¹

Early detection is crucial for treating cervical cancer, but the screening rates for this condition are notably lower in certain populations. The PRESTIS trial, a randomized clinical trial that was funded by NCI and the National Institute on Minority Health and Health Disparities (NIMHD), explored whether self-collection kits could boost participation in cervical cancer screening among people who were not being screened regularly. The researchers reported that while only 17.4% of study participants who received a phone call about the importance of screening completed the screening process at a clinic, participation went up significantly among those who received an at-home self-collection kit in the mail (41.1%) and those who received both the kit and a follow-up call (46.6%).¹²