Cervical cancer stages

Your doctor will use tests to help stage your cancer. The stage of a cancer tells the doctor how far it has spread. It is important because treatment is often decided according to the stage of a cancer. Doctors use different systems to stage cancers. The system usually used for cervical cancer numbers the different stages from 1 to 4. There is more about staging cancers in the Cancers in general section.

Carcinoma in situ means that some of the cells of the cervix have cancerous changes. But the abnormal cells are all contained within the surface layer of the cervix. Carcinoma in situ is not a cancer but in some women the changes will develop into a cancer after some years. It is important to have treatment as soon as possible for carcinoma in situ. As long as the affected area is removed, cancer can be prevented. Carcinoma in situ can be found during cervical screening tests. We have information about abnormal screening results on our cervical screening page.

Stage 1 means that the cancer is just in the neck of the womb. It is often divided into

• Stage 1A
• Stage 1B

These days, stage 1A and 1B are both divided into two smaller groups

• Stage 1A1 and stage 1A2
• Stage 1B1 and stage 1B2

In stage 1A the growth is so small it can only be seen with a microscope (or colposcope). Stage 1A1 means the cancer has grown less than 3 millimetres (mm) into the tissues of the cervix, and it is less than 7mm wide. Stage 1A2 means the cancer has grown between 3 and 5 mm into the cervical tissues, but it is still less than 7mm wide.

In stage 1B the cancerous areas are larger, but the cancer is still only in the tissues of the cervix and has not usually spread. It can usually be seen without a microscope, but not always. In stage 1B1 the cancer is no larger than 4 centimetres (cm). In stage 1B2 the cancer is larger than 4cm across.

Stage 1 cervical cancer is generally treated with surgery or radiotherapy. But if you have stage 1B2 cervical cancer, your doctor may suggest combined chemotherapy and radiotherapy (chemoradiation).

In stage 2 cervical cancer, the cancer has begun to spread outside the neck of the womb into the surrounding tissues. But it has not grown into the muscles or ligaments that line the pelvis (pelvic wall), or to the lower part of the vagina. Stage 2 can be divided into

• Stage 2A
• Stage 2B

In stage 2A the cancer has spread down into the top of the vagina. 

Stage 2A is divided into

• Stage 2A1
• Stage 2A2

In stage 2A1 the cancer is 4 cm or less. In stage 2A2 the cancer is more than 4 cm.

In stage 2B there is spread up into the tissues around the cervix.

Stage 2A cervical cancer may be treated with surgery or combined chemotherapy and radiotherapy (chemoradiation).

Stage 2B cervical cancer is usually treated with chemoradiation. Research studies have shown that this combined treatment can improve the survival rates of stage 2 cervical cancer.

In stage 3 cervical cancer, it has spread away from the cervix and into surrounding structures in the pelvic area. It may have grown down into the lower part of the vagina and the muscles and ligaments that line the pelvis (pelvic wall). And it may have grown up to block the tubes that drain the kidneys (the ureters). It can be divided into

• Stage 3A
• Stage 3B

Stage 3A is when the cancer has spread to the lower third of the vagina but not the pelvic wall.

Stage 3B means the tumour has grown through to the pelvic wall or is blocking one or both of the tubes that drain the kidneys.

This stage is usually treated with radiotherapy and chemotherapy (chemoradiation). We know from research that this combined treatment can improve the survival rates of stage 3 cervical cancer.

Stage 4 cervical cancer is advanced cancer. The cancer has spread to other body organs outside the cervix and womb. It can be divided into

• Stage 4A
• Stage 4B

Stage 4A is when the cancer has spread to nearby organs such as the bladder or rectum (back passage). 

If the cancer has spread to organs further away, such as the lungs, your doctor may call it stage 4B.

This stage of cancer may be treated with surgery, radiotherapy, chemotherapy or a combination of these treatments. Some women may choose just to have treatment to control symptoms at this stage.