Cervical cancer is most often caused by a long-lasting infection with high-risk HPV. HPV is very common, and most people clear it naturally without ever knowing they had it. However, some high-risk types of HPV can cause changes in the cells of the cervix, and if those changes are not found and treated, they can develop into cervical cancer over time.

That is why screening, early diagnosis and timely treatment matter so much: they can detect cell changes before cancer develops or catch cervical cancer sooner, when treatment is more effective, while delays can make the outcome far worse. This is also why cervical cancer screening and the HPV vaccine are so important, as they help prevent cervical cancer by identifying risk earlier and reducing the chance of high-risk HPV infection taking hold.

In this guide, we explain what causes cervical cancer, the warning signs to look out for, who may have a higher risk of developing it, how it is diagnosed and treated, and how screening and HPV vaccination can prevent it. It is written for anyone with a cervix who is sexually active, anyone worried about their cervical cancer risk or diagnosis, and anyone who believes medical negligence delayed their diagnosis or treatment or made their condition worse.

What Are the Main Causes of Cervical Cancer?

The main cause of cervical cancer is persistent infection with high-risk human papillomavirus (HPV). Cancer Research UK states that HPV is linked to 99.7 per cent of cervical cancer cases, making it the primary cause of cervical cancer.

HPV can be passed on through sexual contact. It is one of the most common viruses, and many sexually active people will have it at some point.

In most cases, the immune system clears HPV infections within one to two years without it causing harm. Where a high-risk infection remains in the body, it can cause cervical cells to change from healthy cells into abnormal cells. 

There are two main types of cervical cancer:

• Squamous cell carcinoma: this is the most common type. It starts in the squamous cells, which are the thin, flat cells on the outer part of the cervix.
• Adenocarcinoma: this starts in the glandular cells inside the cervical canal.

Other risk factors can also affect the chances of developing cervical cancer. These include smoking, having a weakened immune system, having other sexually transmitted infections, long-term use of the contraceptive pill, becoming sexually active at an early age, and diethylstilbestrol (DES) exposure before birth, as DES was once given during pregnancy to prevent miscarriage and is linked to a rare cancer type called clear cell adenocarcinoma.

These risk factors help explain why some people have a higher chance of developing cervical cancer - and why screening, vaccination and timely follow-up care matter.

Learn more about cervical cancer from the NHS.

Who Is Most at Risk of Cervical Cancer?

Anyone with a cervix who has been sexually active can develop cervical cancer. This is because HPV is passed on through sexual contact, including skin-to-skin contact in the genital area.

However, some people have a higher risk of developing cervical cancer. This can include people who:

• Are aged between 30 to 35, as the condition is more prevalent among younger women
• Have a long-lasting high-risk HPV infection
• Have a weakened immune system
• Have HIV - women with HIV are six times more likely to develop cervical cancer, according to the World Health Organization
• Smoke
• Have had other sexually transmitted infections
• Became sexually active at an early age
• Have had multiple full-term pregnancies
• Have taken the contraceptive pill for several years
• Were exposed before birth to diethylstilbestrol, also known as DES

These are risk factors, not causes in themselves, and should be taken into account during health check-ups. Routine cervical cancer screening is commonly started at age 25, which supports age-specific awareness.

It is important that doctors, nurses and screening teams take these risk factors seriously. If someone has symptoms, abnormal results or a history that places them at higher risk, they should receive clear advice and timely onward care.

To learn more about who is affected and when, take a look at our guides to the risks of cervical cancer by age and how common cervical cancer is.

What Are the Warning Signs of Cervical Cancer?

Cervical cancer does not always cause symptoms at an early stage. This is why cervical cancer screening is so important. It can detect high-risk HPV and abnormal cell changes before cancer develops, and identify pre-cancerous cells before they progress to invasive cervical cancer.

When symptoms do appear, they may become more noticeable in advanced cervical cancer and they should be listened to and properly considered. Warning signs can include:

• Vaginal bleeding between periods
• Bleeding after sex
• Bleeding after the menopause
• Periods that are heavier or different from what is normal for you
• Changes to vaginal discharge
• Pain during sex
• Pain in the lower back, pelvis or lower abdomen

These symptoms can have many causes, and they do not always mean that someone has cervical cancer. However, they should not be ignored, especially if they continue, get worse or feel unusual for you.

If a person reports symptoms to a GP, nurse or gynaecologist, they should expect their concerns to be taken seriously. This may mean being examined, referred for further checks, or given clear advice about what to do if symptoms continue.

When symptoms are dismissed or not followed up, diagnosis may be delayed. In cervical cancer cases, that delay can affect the treatment a person needs and the impact the condition has on their life.

How Can Cervical Cancer Screening Prevent Cervical Cancer?

Cervical cancer cannot always be prevented, but vaccination, regular screening tests and timely treatment are the most effective ways to limit the effects.

Cervical screening checks for high-risk HPV and abnormal cell changes in the cervix. Its purpose is to find these changes early, before they have the chance to develop into cervical cancer. Previously known as a smear test, cervical screening is a cytology screening method that looks for abnormal cervical cells and pre-cancerous changes alongside HPV testing.

In England, women should have cervical screening every 5- years starting at age 25 until they are 65. People 65 or older are only screened if a recent test was abnormal.

The HPV vaccine protects against the types of HPV that cause most cases of cervical cancer and can prevent future HPV infections, but it does not treat an existing HPV infection. It is most effective when given before someone becomes sexually active, but it remains important to follow NHS advice if you are eligible for the vaccine and have not had it yet.

Using condoms can reduce the chance of HPV being passed on and lower exposure to other sexually transmitted diseases, although it does not remove the risk completely. This is because HPV can affect areas that are not covered by a condom. Stopping smoking may also reduce the risk of cervical cancer, as smoking is a recognised risk factor.

Prevention also depends on healthcare systems working as they should. Screening samples must be handled correctly, results must be reported accurately, and abnormal results must be followed up. Where this does not happen, a person may miss the chance to receive treatment before cancer develops.

How Is Cervical Cancer Diagnosed and Treated?

Cervical cancer may be diagnosed after an abnormal cervical screening result, or after someone speaks to a GP about symptoms, with further assessment guided by a health care professional. The symptoms may include unusual bleeding, pain during sex, changes to vaginal discharge, or pain in the pelvis, lower back or lower abdomen.

If cervical screening shows high-risk HPV or abnormal cell changes, the person may be invited for a colposcopy. This is a closer examination of the cervix, usually carried out by a specialist doctor or nurse. If they see an area of concern, they may take a small tissue sample, such as a punch biopsy or cone biopsy.

If cervical cancer is diagnosed, the treatment plan will depend on the type of cervical cancer, whether it is at an early stage or more advanced, whether it has spread, and the person’s wider health and circumstances.

Treatment may include surgery, radiotherapy, chemotherapy, targeted therapy or a combination of these. The NHS provides more detailed information on how cervical cancer is diagnosed and treated.

A diagnosis of cervical cancer can affect a person’s health, fertility, work, family life, relationships and psychological wellbeing. When diagnosis or treatment is delayed, those effects may be greater. This is why it is so important that symptoms, screening results and referrals are handled properly from the start.

Take a look at our cervical cancer symptoms, signs and treatment infographic for a simple visual summary of the key information.

How Can Medical Negligence Exacerbate the Impact of Cervical Cancer?

Cervical cancer often develops over many years. This means there may be opportunities to identify high-risk HPV, abnormal cell changes or early stage cancer before the condition becomes more serious.

When those opportunities are missed because of medical negligence, the impact can be significant. A person may need more extensive treatment, experience avoidable changes to their health, or face a greater impact on their fertility, work, relationships and psychological wellbeing.

Medical negligence may arise where care falls below a reasonable standard and causes avoidable harm. In cervical cancer cases, this may involve:

• A cervical screening sample being reported incorrectly
• Abnormal cell changes not being followed up
• A failure to refer a person for colposcopy
• Symptoms such as unusual bleeding being dismissed or not investigated
• A delay in referring a person to a gynaecologist
• A failure to explain the need for further tests or follow-up appointments
• A delay in starting cervical cancer treatment

These issues can change what happens next. A cancer that could have been treated earlier may be diagnosed at a more advanced stage. Treatment may then become more intensive, and the long-term effects may be more serious.

Not every delay means that medical negligence has occurred. However, if you feel that your symptoms were not listened to, your screening results were not handled properly, or your follow-up care did not happen when it should have, it is understandable to want clear answers.

What Should You Do if Your Cervical Cancer Was Missed or Misdiagnosed?

If you believe your cervical cancer was missed, misdiagnosed or diagnosed later than it should have been, it can help to write down what happened while the details are still clear.

Try to make a note of:

• When your symptoms started
• What symptoms you reported, such as vaginal bleeding, pelvic pain or pain during sex
• Who you spoke to, and whether they were a GP, nurse, consultant or screening team
• What advice you were given
• The dates of any cervical screening tests, colposcopy appointments, biopsies or hospital appointments
• Any letters, text messages or results you received
• How the delay affected your treatment, health, work, family life or psychological wellbeing

You do not need to have all of this information before speaking to a solicitor. A specialist medical negligence solicitor can request your medical records and review what happened on your behalf.

At JMW, we start by gathering evidence to build a clear picture of the care you received. This may include your own records of symptoms and appointments, copies of your medical records, and evidence from anyone who attended appointments with you. We then work with independent medical experts, who consider whether a reasonable standard of care was met and whether earlier action would have changed your outcome.

Medical negligence claims usually have a three-year time limit. This often runs from the date the negligence happened, or from the date on which you knew or ought to have known that you suffered significant injury. Different rules may apply in some circumstances, including where a person does not have the mental capacity to manage a claim.

Taking advice does not commit you to making a claim. It helps you understand your options and decide what feels right for you.