How Long Does It Take for Cervical Cancer to Develop?

Cervical pre-cancer diagnoses are much more common than invasive cervical cancer diagnoses. Surprisingly, cervical cancer doesn't develop as quickly as you think. Here's what you should know.

What causes cervical cancer?

The cervix is part of the female reproductive system and is the lowest part of the uterus (womb), or the neck of the womb. It's a strong muscle opening from the uterus to the vagina. In the United States, about 13,960 new cases of invasive cervical cancers will be diagnosed in 2023, according to American Cancer Society estimates.

"Cervical cancer occurs when there is a change in the cells near the opening of the womb," said Hana Patel, M.B.B.S, a general practitioner and mental health coach in London.

This cancer usually originates in cells on the outer layer of the cervix (the ectocervix) or in glandular cells inside the cervix that produce mucus (the endocervix).

"The most common cause and the main risk factor for cervical cancer is infection with the human papillomavirus, HPV," said Melissa Lumish, M.D., a board-certified medical oncologist specializing in the treatment of gynecologic cancers at Memorial Sloan Kettering in New York City.

In the U.S., HPV causes more than 90 percent of cervical cancers, she added.

"This is incredibly important to know because nearly three-fourths of women who are sexually active will be affected by HPV," Lumish said.

High-risk HPV can sometimes cause the cells of the cervix to mutate and develop into cervical cancer.

"There are many types of HPV virus, and two in particular, HPV 16 and 18, are more likely to cause cancer and are found present in over 60 percent of cervical cancer cases," Patel said.

Nine of every 10 cervical cancers are linked to HPV, according to the Centers for Disease Control and Prevention (CDC). Cervical cancers not caused by HPV are sometimes referred to as HPV-negative cervical cancers.

What are potential risk factors for cervical cancer?

HPV isn't the only possible risk factor for cervical cancer. Lumish discussed other risk factors that have been identified but are not nearly as strong as HPV.

These potential cervical cancer risk factors include:

• Smoking. This is believed to decrease your immune response to HPV and is also a cause independent of having HPV.
• Taking oral contraceptives for a long time. Women who take oral contraceptives for five or more years may have a greater risk of cervical cancer than women who have never used oral contraceptives, according to the National Cancer Institute (NIH).
• Early age of sexual onset.
• Having multiple sexual partners.
• Having a personal history of other sexually transmitted infections (STIs).
• Age. Cervical cancer is more common in women under 45.
• Family history. If your mother, sister or daughter has had cervical cancer, you may have an increased risk.
• Previous cancer. There is a greater risk of cervical cancer if you have had vagina, vulva, kidney or bladder cancer.
• Having children and the age at which you have children. Women who have children are more at risk of cervical cancer. Having the first baby before age 17 also increases the risk. More research is needed to determine why this occurs.

"In addition, having HIV or another immune-related condition, such as having had an organ transplant, are also risk factors," Patel said.

What are the early symptoms of cervical cancer?

Unlike with some other cancers, there aren't necessarily clear signs of this cancer. Lumish stressed that most often, cervical cancer is asymptomatic.

"That's why we strongly recommend screening and ensuring you have your Pap smears regularly," Lumish said.

However, some people do experience symptoms.

Patel said that early symptoms of cervical cancer may include:

• Irregular bleeding or unexpected bleeding between periods
• Bleeding after sex
• Pain near the vaginal area
• Pain during sex
• Pain during a pelvic examination
• Abnormal vaginal discharge
• Having an abnormal Pap smear test

How quickly does cervical cancer develop?

Regular Pap smear tests based on your doctor's recommendations are important. Cervical cancer takes a long time to develop and is unlikely to appear between regularly scheduled smear tests.

"It usually takes around 10 to 15 years at least for cervical cells to develop from completely normal tissue to dysplasia, which is just abnormal changes in the tissue in a precancerous way," Lumish said, adding that actually developing cancer can take many, many years.

"There are obviously exceptions to that, but those probably apply to the less-common types of cervical cancer and also don't necessarily apply to people who have been undergoing regular screening," she said.

Some risk factors can speed up the progression of cervical cancer. These are similar to some of the risk factors listed above, including smoking, having HIV or another immunosuppressive condition, and having another sexually transmitted infection (such as chlamydia), Lumish added.

The bottom line

"There's been about a 75 percent decrease in the incidence of cervical cancer and the death from it in the last 50 years in countries where regular Pap screening and HPV vaccination are widely prevalent," Lumish said.

But regular screening and HPV vaccination, ideally around ages 12 to 13 and before age 45, can help reduce the incidence of cervical cancer.