Cervical cancer types

Every cervical cancer patient is different. The cancer experts at City of Hope have extensive experience in properly staging and diagnosing the disease, and developing a treatment plan that's tailored to each patient’s specific type of cervical cancer.

Cervical cancer starts when the cells that line the cervix begin to develop abnormal changes. Over time, these abnormal cells may become cancerous or return to normal. Most women don’t develop cancer from abnormal cells.

The American Cancer Society (ACS) estimates that 13,820 women will be diagnosed with cervical cancer in the United States in 2024.

Squamous cell carcinoma and adenocarcinoma

Cervical cancer is divided into two main types: squamous cell carcinoma and adenocarcinoma. Each is distinguished by the appearance of cells under a microscope.

Squamous cell carcinomas begin in the thin, flat cells that line the bottom of the cervix. This type accounts for about 90 percent of cervical cancers, according to the ACS.

Adenocarcinomas of the cervix develop in the glandular cells that line the upper portion of the cervix. Cervical adenocarcinomas make up most of the remaining cervical cancer cases.

Both types of cervical cancer may come with symptoms, such as:

• Changes in vaginal bleeding or discharge, including bleeding after sex
• Lower abdominal/pelvic pain
• Pain with sex

Cervical cancers may be diagnosed with a pelvic exam. During this procedure, a medical tool called a speculum is inserted into the vaginal opening to dilate the walls, allowing the doctor or nurse to look inside the vagina and cervix for any abnormalities or signs of cancer. The procedure often includes a Pap test, which involves gently swabbing the surface of the vagina or cervix to collect cells. These cells are then analyzed in a laboratory. In addition to detecting cancer, this test may also reveal the presence of human papillomavirus (HPV), which is linked with cervical cancer.

Treatment options for cervical cancer include:

• Surgery
• Radiation therapy
• Chemotherapy
• Targeted therapy
• Immunotherapy 

Regardless of the type, the outlook of these cancers depends largely on how far they spread. According to the ACS:

• Localized cervical cancer, which hasn’t spread beyond the cervix or uterus, comes with a 92 percent five-year relative survival rate.
• Regional cervical cancer, which has spread outside of the cervix and uterus into nearby lymph nodes, has a five-year relative survival rate of 58 percent.
• Cervical cancer that has spread to organs or other areas of the body (distant) has a five-year relative survival rate of 17 percent.

Rare types of cervical cancer

Other types of cancer may develop in the cervix, but these are rare. They include:

Adenosquamous carcinomas occur when both types of cells are involved in cervical cancer. There are varying definitions of the types of cancer that fall under this category, making it difficult to estimate their prevalence. Adenosquamous carcinoma of the cervix is estimated to account for somewhere between 2 percent and 50 percent of all invasive cervical carcinomas, according to a study published in Modern Pathology.

Glassy cell carcinomas are considered a subtype of adenosquamous carcinomas. As of 2019, this extremely rare cancer had been reported fewer than 15 times in scientific literature, according to researchers in the American Journal of Case Reports. While treatment options aren’t standardized, radiation therapy may be combined with surgery.

Neuroendocrine carcinomas of the cervix make up less than 2 percent of all cervical cancers, according to the International Journal of Gynecological Cancer. In the United States, about 200 women are estimated to be diagnosed with this cancer every year.

Within this rare type of cervical cancer, there are subtypes, with small cell carcinoma being the most common. Small cell carcinomas of the cervix tend to be highly aggressive and have low survival rates. They’ve often spread to lymph nodes and other parts of the body by the time of diagnosis. Treatment options often mimic those of small cell lung cancer, and include a combination of surgery, chemotherapy and radiotherapy. Symptoms and diagnosis may resemble other types of cervical cancer. Due to the aggressive nature of the cancer, additional imaging tests to see whether the cancer has spread may be recommended.

There also are rare types of cervical cancer that are commonly associated with other parts of the body. For example, melanoma, most commonly known as a skin cancer, may on rare occasion begin in the cervix. Only 78 cases had been reported in scientific literature by 2012, according to Critical Reviews in Oncology/Hematology. Symptoms of cervical melanoma may include unusual vaginal bleeding. Due to the rarity of the condition, treatment options aren’t standardized.

Sarcomas that begin in the cervix are also rare, accounting for fewer than 1 percent of all cervical cancers, according to Diagnostic Pathology. Symptoms may resemble other types of cervical cancer and include abnormal vaginal bleeding and abdominal pain. Treatment regimens for cervical sarcomas aren’t standardized and may vary, but a combination of surgery and chemotherapy may be used.

Lymphoma is another example. Cervical lymphomas make up 0.5 percent to 1 percent of all cervical cancer cases, according to an article in Anticancer Research. Patients with this rare cancer may present with symptoms that resemble other cervical cancers, including abnormal vaginal bleeding and discharge, abdominal pain and back pain. Treatment options may include chemotherapy, radiation therapy and surgery.