Cervical Cancer: Stages

What does stage of cancer mean?

The stage of a cancer is how much cancer there is and how far it has spread in your body. Your healthcare provider uses exams and imaging scans to find out the size of the cancer and where it is. Scans can also show if the cancer has grown into nearby areas, and if it has spread to other parts of your body. The stage of a cancer is one of the most important things to know when deciding how to treat the cancer.

Staging can help healthcare providers have an idea about how the cancer may grow, and how certain kinds of treatment may work. Staging can also help give your healthcare team an idea of what kind of outcomes you can expect (prognosis).

How does cervical cancer spread?

Cervical cancer can spread to other parts of the body. It mainly spreads in 2 ways: 

• It may grow larger and grow into nearby areas, like the vagina, bladder, rectum, or other tissues near the uterus and vagina.

• It may spread to the lymph nodes in the pelvis.

A third type of spread is through the bloodstream. It can then go to parts of the body that are farther away, like the lung, brain, or bone. This is not as common.

When cervical cancer has spread to another part of the body, it's not a new cancer. For instance, if it spreads to the vagina, it's not called vaginal cancer. It's still cervical cancer. This is because cancer is named for the site of the original tumor. The cancer cells in the vagina look like those in the cervix.

What are the stages of cervical cancer?

The staging system most often used for cervical cancer is from the International Federation of Gynecology and Obstetrics (FIGO). Roman numerals 0, I, II, III, and IV (0 to 4) stand for the different stages of the cancer. The higher the number, the more advanced the cancer is.

Stage 0

This stage is not part of the FIGO system. Stage 0 is also called carcinoma in situ (CIS). The cancer has grown only in the surface layer of cells lining your cervix. It's not cancer, but a serious precancer. This means that if it's not treated it may turn into true cervical cancer.

Stage I

This cancer has grown deeper into your cervix. It has not spread. Stage I is then divided into these groups:

• Stage IA1. The cancer is very small and can only be seen with a microscope. It's less than 3 millimeters (mm) deep.

• Stage IA2. The cancer can only be seen with a microscope. It's between 3 and 5 mm deep.

• Stage IB1. The tumor can be seen without a microscope. It's more than 5 mm deep, but not more than 2 cm in size. 

• Stage IB2. The tumor can be seen without a microscope. It's between 2 and 4 cm in size.

• Stage IB3. The tumor can be seen without a microscope. It's at least 4 cm in size.

Stage II

The cancer has spread beyond your cervix and uterus. It has not spread to the walls of your pelvis or to the lower part of your vagina. It has not spread to lymph nodes or distant parts of your body. Stage II is then divided into these groups:

• Stage IIA. The cancer has not spread to the tissues next to the cervix, called the parametria.

• Stage IIA1. The cancer is less than 4 cm in size.

• Stage IIA2. The cancer is more than 4 cm in size.

• Stage IIB. This cancer has spread to the tissues around your vagina and cervix (the parametria).

Stage III

The cancer has spread to your lower vagina or to the walls of your pelvis, or it may be causing kidney problems. It might or might not have spread to nearby lymph nodes. It has not spread to distant parts of your body. Stage III is then divided into these groups:

• Stage IIIA. The cancer has spread to the lower part of your vagina. It has not spread to the wall of your pelvis. It has not spread to nearby lymph nodes.

• Stage IIIB. The cancer has spread to the wall of your pelvis. It may block urine flow from your kidneys to your bladder, causing kidney problems (hydronephrosis). It has not spread to nearby lymph nodes.

• Stage IIIC1. The cancer is any size and has spread to nearby pelvic lymph nodes.

• Stage IIIC2. The cancer is any size and has spread to lymph nodes around your aorta.

Stage IV

The cancer has spread to nearby organs, like your bladder, rectum, or to other parts of your body, like your liver or lungs. Stage IV is then divided into these groups:

• Stage IVA. The cancer has spread to nearby organs, like your bladder or rectum, or it's growing outside your pelvis.

• Stage IVB. The cancer has spread to distant organs beyond your pelvis, such as your liver, lungs, bones, or distant lymph nodes.

Talking with your healthcare provider

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Make sure to ask any questions or talk about your concerns.