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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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A minority of patients are asymptomatic, diagnosis being established after a routine cervical smear.

The majority present with:

  • postcoital, postmenopausal or intermenstrual bleeding - occurs in 80-90% of patients; initially, irregular but later becomes continuous
  • blood stained vaginal discharge

Features of advanced disease include:

  • heavy bleeding
  • offensive vaginal discharge
  • pain - indicating extension beyond the cervix:
    • lower abdominal pain may signify a large pelvic mass
    • sciatic pain may signify involvement of lymphatic nodes which have become adherent to the sacral plexus
    • back pain may signify vertebral metastases
  • urinary and/or faecal incontinence - from fistulae formation
  • leg swelling
  • uraemia - from ureteric obstruction or ascending pyelonephritis

Pelvic examination may reveal a cervix which is friable and bleeds easily. Early tumours may be seen as a small nodule or ulcer on the vaginal surface, or as a diffuse patch resembling an erosion. Advanced lesions may appear as a crater shaped ulcer with high everted edges or as a warty-looking mass. They may replace the entire cervix.

Rectal examination is essential to ascertain the extent of spread.


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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