A minority of patients are asymptomatic, diagnosis being established after a routine cervical smear.
The majority present with:
Features of advanced disease include:
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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