Virginia Commonwealth University

VCU Massey Cancer Center

Cervical cancer

Cervical cancer occurs most often in women over the age of 40. Most cervical cancers are squamous cell carcinomas (80 percent) or adenocarcinomas (20 percent). Rarely, melanoma or lymphoma may originate in the cervix.

The mortality rates in the U.S. for cervical cancer have declined sharply as Pap screenings have become more prevalent.

What are precancerous conditions of the cervix?

Precancerous conditions of the cervix are identified as the presence of abnormal cells that are not yet cancerous; however, if left untreated they may develop into cancer years later.

Precancerous changes of the cervix usually do not cause pain and, in general, do not cause any symptoms. They are detected with a a Pap test. If left untreated, they may develop into cancer over time.

Squamous intraepithelial lesions (SIL) is a term that refers to abnormal changes in the cells on the surface of the cervix.

  • Squamous cells are the flat cells found on the surface (of the cervix).
  • Intraepithelial means that the abnormal cells are present only in the surface layer of cells. 
  • Lesion refers to an area of abnormal tissue.

According to the National Cancer Institute, changes in these cells can be divided into two categories:

  • Low-grade SIL – refers to mild to moderate changes. They may go away on their own with time, or may progress to a high-grade lesion or invasive cancer.

These precancerous low-grade lesions also may be called mild dysplasia or cervical intraepithelial neoplasia 1 (CIN 1), or moderate dysplasia or CIN 2. These changes can appear at any age.

  • High-grade SIL – refers to moderate to severe precancerous changes. They are less likely to spontaneously resolve and are more likely to progress to invasive cancer.  High-grade lesions also may be called moderate or severe dysplasia, CIN 2 or 3, or carcinoma in situ. Precancerous conditions can be treated through freezing (cryotherapy), vaporization (laser) or removal (leep, conization or hysterectomy). Ask your health care provider which is most appropriate for you.

What is the cervix?

The cervix is the lower, narrow part of the uterus (womb) located between the bladder and the rectum. It forms a canal that opens into the vagina, which leads to the outside of the body.

Anatomy of the female pelvic area

Endometrium – the lining of the uterus.

Uterus – also called the womb, the uterus is a hollow, pear-shaped organ located in a woman’s lower abdomen, between the bladder and the rectum.

Ovaries – two female reproductive organs located in the pelvis.

Cervix – the lower, narrow part of the uterus (womb) located between the bladder and the rectum. It forms a canal that opens into the vagina, which leads to the outside of the body.

Vagina – the passageway through which fluid passes out of the body during menstrual periods. It also is called the “birth canal.” The vagina connects the cervix (the opening of the womb, or uterus) and the vulva (the external genitalia).

Vulva – the external portion of the female genital organs.