Canadian Cancer Society logo

Cervical cancer

You are here: 

Staging cervical cancer

Staging is a way of describing or classifying a cancer based on the extent of cancer in the body. Extent includes the size of the tumour and where the cancer is in the body. Your healthcare team uses the stage to plan treatment and estimate your prognosis.

The most common staging system for cervical cancer is the International Federation of Gynecology and Obstetrics (FIGO) staging system. It is based on the TNM system, which is used to describe the extent of many solid tumour cancers. Each stage is given a number from 1 to 4. Stages 1 to 4 are usually given as the Roman numerals I, II, III and IV. Generally, the higher the number, the more the cancer has spread.

When describing the stage, doctors may use the terms local, regional and distant. Local means that the cancer is only in the cervix and has not spread to other parts of the body. Regional means close to or around the cervix but within the pelvis. Distant means in a part of the body farther from the cervix and outside of the pelvis.

Some doctors may also use the following terms when discussing cervical cancer:

  • Early stage cervical cancer usually includes stages IA, IB and IIA.
  • Locally advanced cervical cancer usually includes stages IIB, III and IVA.
  • Advanced stage cervical cancer usually means stage IVB.

TNM descriptions

T describes the size of the primary tumour and if it has grown into tissues around the cervix. T is usually given as a number from 1 to 4. A higher number means that the tumour is larger or has grown deeper into nearby tissues or both.

 

N describes the lymph nodes in the pelvis, called pelvic lymph nodes. N0 means the cancer hasn’t spread to the lymph nodes. N1 means cancer has spread to lymph nodes.

 

M describes whether or not the cancer has spread, or metastasized, to other parts of the body. M0 means that cancer has not spread to other parts of the body. M1 means that it has spread to other parts of the body.

Stage IA

StageTNMDescription

IA

T1a

N0

M0

The tumour is in the cervix (extension of the tumour to the body of the uterus is not taken into account). The cancer is considered invasive because cancer cells have entered the stromal tissue (the supporting connective tissue layer of the cervix). The tumour is not more than 5 mm deep and is 7 mm or less at its widest part.

Cancer cells can only be diagnosed with a microscope.

IA1

T1a1

N0

M0

The tumour has grown into, or invaded, the stroma. It is not more than 3 mm deep and is 7 mm or less at its widest part.

IA2

T1a2

N0

M0

The tumour has grown into the stroma. It is more than 3 mm, but not more than 5 mm, deep and is 7 mm or less at its widest part.

Stage IB

StageTNMDescription

IB

T1b

N0

M0

The tumour is in the cervix (extension of the tumour to the body of the uterus is not taken into account).

The tumour can be seen on the cervix without a microscope (clinically visible) or can only be seen with a microscope but is larger than stage IA2 tumours.

IB1

T1b1

N0

M0

The tumour can be seen without a microscope and is less than 4 cm in size at its widest part.

IB2

T1b2

N0

M0

The tumour can be seen without a microscope and is more than 4 cm in size at its widest part.

Stage IIA

StageTNMDescription

IIA

T2a

N0

M0

The tumour has grown beyond the uterus but not to the pelvic wall or to the lower third of the vagina. The cancer has not spread to the loose connective tissue around the cervix and uterus (no parametrial invasion).

IIA1

T2a1

N0

M0

The tumour can be seen without a microscope and is less than 4 cm in size at its widest part.

IIA2

T2a2

N0

M0

The tumour can be seen without a microscope and is more than 4 cm in size at its widest part.

Stage IIB

StageTNMDescription

IIB

T2b

N0

M0

The tumour has grown beyond the uterus but not to the pelvic wall or to the lower third of the vagina. The cancer has spread to surrounding tissue of the cervix (parametrial invasion).

Stage IIIA

StageTNMDescription

IIIA

T3a

N0

M0

The tumour has grown to the lower third of the vagina but not to the pelvic wall.

Stage IIIB

StageTNMDescription

IIIB

T3b

any N

M0

The tumour has grown to the pelvic wall, blocks a ureter (the tube that carries urine from the kidney to the bladder) causing an enlarged kidney (hydronephrosis) or stops the kidney from working (non-functioning kidney).

The cancer may or may not have spread to the lymph nodes in the pelvis.

IIIB

T1, T2 or T3

N1

M0

The tumour:

  • is within the cervix
  • has spread beyond the uterus but not to the pelvic wall or the lower third of the vagina
  • has spread to the pelvic wall or lower third of the vagina, blocks a ureter causing an enlarged kidney (hydronephrosis) or stops the kidney from working (non-functioning kidney)

The cancer has spread to the lymph nodes in the pelvis.

Stage IV

StageTNMDescription

IVA

T4

any N

M0

The tumour has grown to the lining (mucosa) of the bladder or rectum, or the cancer has spread beyond the pelvis.

The cancer may or may not have spread to the lymph nodes in the pelvis.

IVB

any T

any N

M1

The tumour can be any size and may or may not have grown into any surrounding tissues.

The cancer may or may not have spread to lymph nodes.

There is a distant metastasis (cancer has spread to other parts of the body, such as the lungs, liver or bone).

Recurrent cervical cancer

Recurrent cervical cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to the primary tumour, it’s called regional recurrence. It can also recur in another part of the body, which is called a distant metastasis.

Classifying squamous cell carcinoma of the cervix

In addition to staging, doctors may also classify squamous cell carcinoma (SCC) of the cervix using the following terms:

  • Pre-invasive SCC of the cervix, or carcinoma in situ, means the cancer hasn’t spread below the squamous cell layer of the cervix.
  • Micro-invasive SCC of the cervix means the cancer has just begun to spread below the squamous cell layer of the cervix which can only be seen through a microscope. Micro-invasive SCC is classified as stage IA cervical cancer.
  • Invasive SCC of the cervix means the cancer has spread further into the cervix or to the surrounding tissues. This can often be seen during an exam without a microscope.

Stories

photo of Mathieu At the end of the day, Mathieu gave me a big hug and left with a smile on his face.

Read Mathieu's story

A home away from home

Illustration of house

For cancer patients who must travel a great distance to get to treatment, Canadian Cancer Society lodges offer a welcoming place to stay.

Learn more