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Cervical Cancer: Stages

What does staging mean?

The stage of a cancer is how much and how far the cancer has spread in your body. Your healthcare provider uses exams and tests to find out the size of the cancer and where it is. He or she can also see 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 helps doctors compare one woman’s situation to other women with a similar stage of cervical cancer. A doctor can have some insight about how the cancer may grow, and how certain kinds of treatment may work.

How cervical cancer spreads

Cervical cancer can start growing in other parts of the body and spread in 2 main ways: 

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

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

A third type of spread is through the bloodstream. This is not common.

When cervical cancer has spread to another part of the body, it's not a new cancer. For example, 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.

Stage groupings of cervical cancer

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

Stage 0

This stage is not included in the FIGO system. This stage is also called carcinoma in situ (CIS). The cancer has grown only in the surface layer of cells lining your cervix.

Stage I

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

Stage IA1. The doctor can’t see this cancer without a microscope. It is less than 3 millimeters (mm) deep and less than 7 mm wide.

  • Stage IA2. The doctor can’t see this cancer without a microscope. It is between 3 and 5 mm deep but still less than 7 mm wide.

  • Stage IB1. The tumor may be visible without a microscope. It is a tumor less than 4 cm in size and only in the cervix. 

  • Stage IB2. A doctor can see this cancer without a microscope. It is larger than 4 cm in size and only in the cervix.

Stage II

This cancer is in body parts near your cervix but has not spread outside your pelvis or to the lower part of your vagina. Stage II is then divided into these groups:

Stage IIA. This cancer can be seen with the naked eye and may extend to your upper vagina. It has not spread into the lower part of the vagina.

  • Stage IIA1. The cancer can be seen with the naked eye and is less than 4 cm in size.

  • Stage IIA2. The cancer can be seen with the naked eye and is more than 4 cm in size.

  • Stage IIB. This cancer has spread to the tissues around your vagina and uterus but not to the wall of the pelvis.

Stage III

This cancer has spread to your lower vagina and/or to the wall of the pelvis and/or may be causing kidney problems. Stage III is then divided into these groups:

Stage IIIA. The cancer has spread to the lower third of your vagina. It has not spread to the wall of your pelvis.

  • Stage IIIB. The cancer has spread to the soft tissues around your vagina and cervix all the way to the wall of the pelvis. It may block urine flow to your bladder. It may have spread to lymph nodes in the pelvis. It has not spread to distant parts of your body. 

Stage IV

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

  • Stage IVA. The cancer has spread to nearby organs, such as your bladder or rectum, but not to lymph nodes or distant organs.

  • 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.