Cervical cancer

Risk factors

The main cause of cervical cancer is persistent HPV infection. Other factors that may increase risk include:

• Early exposure to HPV
• Smoking
• Weakened immune system
• Low screening participation

Screening and early detection

Cervical cancer is one of the few cancers where effective prevention and early detection is possible.

In Sweden:

• HPV vaccination is offered as part of the national vaccination program
• The vaccine protects against the most common types of HPV that cause cervical cancer
• Vaccination works best when given before exposure to HPV, but can still provide protection if given later in life
• All women are invited to regular cervical screening (HPV test/cell sampling)

Together, HPV vaccination and participation in screening provide strong protection against cervical cancer and have already led to a significant reduction in cases in Sweden.

Early-stage cervical cancer often causes no symptoms, which makes screening especially important.

Possible symptoms include:

• Abnormal vaginal bleeding (e.g. after intercourse or between periods)
• Unusual vaginal discharge
• Pelvic pain or discomfort during intercourse

Diagnosis and treatment

If cervical cancer is suspected, an investigation is carried out to confirm the diagnosis and determine the stage of the disease.

This may include:

• Gynecological examination
• Cell sampling (HPV test/Pap test)
• Biopsy
• Imaging tests to assess spread

In Sweden, patients are managed through standardized care pathways (SVF) to ensure timely diagnosis and coordinated care.

Treatment options may include:

• Surgery, often used in early-stage cancer
• Radiotherapy, sometimes combined with chemotherapy
• Chemotherapy, particularly advanced cases

Living with and beyond cervical cancer

Many people recover from cervical cancer, especially when diagnosed early. With increasing survival, more people are living with and beyond the disease.

Recovery is a continuous process, and people may experience:

• Physical effects, such as fatigue, pain, or treatment-related side effects
• Emotional challenges, including anxiety or fear of recurrence
• Changes in daily life and sexual health

In Sweden, support is available throughout the cancer journey:

• Follow-up care through specialist healthcare teams
• Access to a contact nurse (kontaktsjuksköterska) for guidance and coordination
• Cancer rehabilitation services, supporting physical, emotional, and social
• recovery
• Psychological support and patient organizations, offering peer support and
• practical advice

With the right support, many people are able to return to everyday life and maintain a good quality of life.

Fertility and family planning

Cervical cancer often affects people of reproductive age, making fertility an important consideration. Treatment may affect fertility in different ways:

• Surgery may involve removing the cervix or uterus
• Radiotherapy can affect the ovaries and uterus, impacting the ability to become pregnant
• Some treatments may lead to early menopause

Fertility-preserving treatment options may be possible in early stages. In Sweden, fertility counselling is part of cancer care, and decisions are made together with a multidisciplinary care team to balance effective treatment with future reproductive goals.

Reducing inequalities in cervical cancer care

Cervical cancer is largely preventable, but differences in access to HPV vaccination, screening, and follow-up care can lead to unequal outcomes.

Key factors include:

• Participation in screening programs, which is essential for early detection
• Access to HPV vaccination, which protects against most cervical cancers
• Health literacy and awareness, influencing when people seek care
• Socioeconomic and cultural factors, including barriers related to income, education, or language

In Sweden, efforts to reduce inequalities include:

• Organized screening programs with regular invitations
• National HPV vaccination programs
• Increasing use of self-sampling for HPV testing to improve access