The signs of cervical cancer are among the trickiest to spot of all cancer diagnoses. For one, cervical cancer is rare. For every one woman diagnosed with cervical cancer, 25 are diagnosed with breast cancer, per the American Cancer Society. What’s more, the signs typically don’t appear until the illness reaches its later stages. “Cervical cancer is a slow-onset cancer, so by the time someone is showing symptoms it’s usually more advanced,” explained Lauren Streicher, M.D., a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, and medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause.
What’s more, when symptoms do appear early, they are often signs that can be attributed to other, more common causes. “Non-specific symptoms can mean many other things, so just because you may exhibit these symptoms, it doesn’t automatically mean cervical cancer. Get them checked out, but chances are it’s nothing serious,” Dr. Streicher said.
About the experts: Lauren Streicher, M.D., a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, and medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause; Kecia Gaither, M.D., an ob/gyn and director of perinatal services and maternal fetal medicine at NYC Health+ Hospitals/Lincoln in New York City; Christine Horner, M.D., a women’s health advocate and author of Radiant Health, Ageless Beauty.
The best way to catch cervical cancer early and get the treatment you need? Regular Pap tests. “Since the cancer is slow to develop, yearly Pap tests and visits to your gynecologist can help ensure you don’t have any abnormalities in the cervix,” Dr. Streicher said. Follow your physician’s recommendations on how frequently you should be tested. And in the meantime, if you notice any of the following signs in between your appointments, call your doctor. It never hurts to get things checked out.
Subtle signs of cervical cancer
Abnormal bleeding or spotting
According to Kecia Gaither, M.D., an ob/gyn and director of perinatal services and maternal fetal medicine at NYC Health+ Hospitals/Lincoln in New York City, unexplained bleeding can be a sign of cervical cancer. “Symptoms of cervical cancer are vague, and can mean many things, but bleeding in between periods, bleeding after intercourse, or after menopause can all be signs of cervical cancer,” she explained. Heavier-than-usual menstrual bleeding, bleeding after a pelvic exam, bleeding after douching, or longer-than-usual menstrual periods would also qualify.
Unusual vaginal discharge
There are many reasons for vaginal discharge (and many forms that are completely normal), but Dr. Gaither explained that if it is watery and foul-smelling, that may be a sign of cervical cancer. According to the Cleveland Clinic, watery or bloody vaginal discharge that is heavy and foul-smelling can be a sign of Stage I cervical cancer, so a change in your discharge may be one of the first things you see.
Pain during intercourse
Tumor growth throughout the tissue of the cervix can cause pain during intercourse for women with cervical cancer, per the Mayo Clinic. However, there are a handful of other reasons you may be experiencing pain during sex. “Pain or bleeding from sex can mean many non-serious things as well,” Dr. Streicher said. “It can mean inflammation of the cervix, a vaginal infection or cervical polyp—all of these are non-serious causes—which is why the general mantra is that if anything doesn’t seem right and is consistent, get it checked out.”
Abnormal Pap test results
If your Pap test results don’t come back normal, don’t freak out that it’s cervical cancer right away. Your doctor will review the results to see what types of abnormalities were found. Not all cell abnormalities found in the cervix are cancer. According to the National Cancer Institute, abnormal pap test results could also be triggered by cells that don’t look normal because of irritation, infection, or changes in hormones, lesions caused by a human papillomavirus (HPV) infection, or cells that could become cancer in the future if not treated. Depending on the results, your doctor may order further testing, such as a colposcopy or biopsy.
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Constant back or pelvic pain
Lower back and pelvic pain can be linked to problems with the reproductive organs, which include the cervix. Dr. Gaither warned that “persistent back pain” is what to look out for. Per the Cleveland Clinic, back, pelvic, and abdominal pain don’t typically arise until later stages, when the cancer may have spread. So if it’s constant and you also have one or more other symptoms, speak to your doctor immediately.
Loss of appetite or unexplained weight loss
As with many cancers, loss of appetite or unexplained weight loss can be a cause for concern. In fact, a 2024 study published in JAMA found that unintentional weight loss was associated with a much higher risk of a cancer diagnosis in the coming year. So while this symptom on its own does not mean cervical cancer specifically, if you experience a wide array of these warning signs, in addition to a loss of appetite or weight loss, talk to your doctor.
Unrelenting fatigue
Extreme fatigue is a broad symptom that accompanies a wide range of chronic illnesses and shouldn’t be used as a marker for cervical cancer on its own. However, like unexplained weight loss, it commonly appears before and during cancer, per the American Cancer Society. Unlike standard feelings of tiredness, you may feel tired in a way that doesn’t improve with rest or sleep, sad or cranky, very weak, or like you can’t focus your thoughts. If you’re experiencing many of the other symptoms on this list along with unrelenting fatigue, it’s worth mentioning to your doctor.
Leg pain or swelling
Leg pain or swelling is a sign of cervical cancer, though it might not show up until later stages of the disease, said Christine Horner, M.D., a women’s health advocate and author of Radiant Health, Ageless Beauty. “Cervical cancer can spread to lymph nodes in the area between the hip bones. Cancer cells can also stop lymph fluid from draining away. This might lead to swelling in your legs due to fluid build-up. The swelling is called lymphedema.” According to the National Library of Medicine, lymphedema can also be caused by an inherited condition or an obstruction in the lymphatic system.
An HPV diagnosis
This is less of a symptom, and more of a risk factor for cervical cancer. According to the American Cancer Society, HPV infections cause almost all cervical cancers. HPV is a group of more than 200 related viruses that are transmitted through intimate skin-to-skin contact, per the National Cancer Institute. Of the 200 viruses, two are responsible for most HPV-related cancers—but all can be prevented with vaccination.
The Centers for Disease Control and Prevention (CDC) recommends the HPV vaccine for all children around ages 11 or 12 and all young adults through age 26 if they didn’t receive it earlier.
Having HIV
Another risk factor for cervical cancer is having human immunodeficiency virus (HIV). According to research in The Lancet, women living with HIV have a sixfold higher risk of developing cervical cancer because of their compromised immune system. “The immunodeficiency status makes you more prone to catching things,” explained Dr. Gaither. While there is currently no cure for HIV, per the CDC, treatment can control the virus and reduce your risk of developing associated illnesses.
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