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Gynecologic Oncology  - ´¿§Ó¤¯Âå®vªººô¶

Cervical cancer stages

A quick guide to what's on this page

Cervical cancer stages

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. Remember - if you have had an abnormal smear and your doctor has said you have CIN, this is not the right page for you. Cervical cancer is not the same as an abnormal smear. The stages of cervical cancer are numbered from 0 to 4. Each stage is sometimes divided into A and B.

• Stage 0 ¡V Your doctor may call this carcinoma in situ. It is not an invasive cancer. It means that there are cancerous cells in the cervix. But they have not spread away from where they started or begun to grow into the deeper tissues of the cervix.
• Stage 1 ¡V The cancer has started to grow into the deeper tissues of the cervix, but has not spread any further.
• Stage 2 ¡V The cancer has begun to spread outside the cervix into the surrounding tissues.
• Stage 3 ¡V The cancer has spread away from the area surrounding the cervix. 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).
• Stage 4 - This stage is advanced cervical cancer. The cancer has spread to other body organs outside the cervix and womb.

What staging is

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 simply numbers the different stages from 0 to 4. There is more about staging cancers in the about cancer section.

Remember - if you have had an abnormal smear and your doctor has said you have CIN, this is not the right page for you. Cervical cancer is not the same as an abnormal smear. Look at our cervical screening section for more about what cervical smear results mean.

Carcinoma in situ (stage 0)

Stage 0 is not considered to be part of the cervical cancer staging system because there are abnormal cells only in the surface layer of the cervix. The cells have not spread away from where they started or begun to grow into the deeper tissues of the cervix. So it is not an invasive cancer. But some doctors still call it stage 0.

This stage is the same as CIN 3. The usual treatment is a cone biopsy but in some situations your doctor may recommend a hysterectomy.

Stage 1

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 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. 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.

Stage 2

In stage 2 cervical cancer, the cancer has begun to spread outside the neck of the womb into the surrounding tissues. Stage 2 can be divided into

• Stage 2A
• Stage 2B

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

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

Stage 2A cervical cancer may be treated with surgery or radiotherapy or both.

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

Stage 3

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. We know from research that this combined treatment can improve the survival rates of stage 3 cervical cancer.

Stage 4

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.