Cervical cancer is a tumour of the cervix, the part of the uterus that adjoins the vagina in the female reproductive tract. Certain types of human papillomavirus (HPV) are implicated in more than 90% of these cancers, although the great majority of HPV infections of the cervix are not associated with cancer. HPV is transmitted by vaginal sex, infecting cervical epithelial cells. In a minority of cases, infection persists for years, and pre-cancerous changes called cervical intraepithelial neoplasia can develop, which sometimes progress to cancer. Squamous cell carcinomas are the most common. HPV infection is considered essential for nearly all forms of cervical cancer to develop, but other risk factors are also involved, including smoking, HIV infection and other forms of immune suppression, and long-term use of oral contraceptives.
Cervical cancer is the fourth most common cancer in women worldwide. It can be detected by screening; screening every 3–5 years, with appropriate follow-up, can reduce cancer incidence by up to 80%. HPV vaccines protect against high-risk virus strains, and can prevent up to 90% of cervical cancers. Where screening and vaccination are not available, cervical cancer has substantial mortality; worldwide, an estimated 569,000 cases and 311,000 deaths occurred in 2018, with around 85% of cases being in developing countries.